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针对发育性协调障碍儿童的神经肌肉训练:一项随机对照试验。

Neuromuscular training for children with developmental coordination disorder: A randomized controlled trial.

作者信息

Cheng Yoyo T Y, Wong Thomas K S, Tsang William W N, Schooling Catherine Mary, Fong Shirley S M, Fong Daniel Y T, Gao Yang, Chung Joanne W Y

机构信息

School of Public Health, University of Hong Kong, Hong Kong.

School of Nursing and Healthcare, Hong Kong Nang Yan College of Higher Education, Hong Kong.

出版信息

Medicine (Baltimore). 2019 Nov;98(45):e17946. doi: 10.1097/MD.0000000000017946.

Abstract

BACKGROUND

Adaptive balance control is often compromised in children with developmental coordination disorder (DCD). Neuromuscular training (NMT) is commonly used in clinical settings to improve neuromuscular control and hence balance performance in these children. However, its effectiveness has not been proven scientifically. This randomized controlled study aimed to explore the effectiveness of NMT for improving adaptive balance performance and the associated leg muscle activation times in children with DCD.

METHODS

Eighty-eight children with DCD were randomly assigned to the NMT or control group (44 per group). The NMT group received two 40-minute NMT sessions/week for 3 months, whereas the control group received no intervention. The outcomes were measured at baseline and 3 and 6 months. The primary outcome was the sway energy score (SES) in both the toes-up and toes-down conditions as derived using the Adaptation Test (ADT). Secondary outcomes included the medial gastrocnemius, medial hamstring, tibialis anterior and rectus femoris muscle activation onset latencies during ADT, measured using surface electromyography and accelerometry. Data were analyzed using a repeated measures analysis of covariance based on the intention-to-treat principle.

RESULTS

At 3 months, no significant within-group or between-group differences were noted in the SESs for either group. At 6 months, the toes-down SES decreased by 6.8% compared to the baseline value in exclusively the NMT group (P = .004). No significant time, group or group-by-time interaction effects were observed in any leg muscle activation outcomes.

CONCLUSIONS

Short-term NMT failed to improve adaptive balance performance and leg muscle activation times in children with DCD. Further studies should explore the clinical applications of longer-term task-specific interventions intended to improve the adaptive balance performance of these children.

摘要

背景

发育性协调障碍(DCD)儿童的适应性平衡控制常常受损。神经肌肉训练(NMT)在临床环境中常用于改善这些儿童的神经肌肉控制,从而提高平衡能力。然而,其有效性尚未得到科学验证。这项随机对照研究旨在探讨NMT对改善DCD儿童适应性平衡能力及相关腿部肌肉激活时间的有效性。

方法

88名DCD儿童被随机分为NMT组或对照组(每组44名)。NMT组每周接受两次40分钟的NMT训练,为期3个月,而对照组不接受任何干预。在基线、3个月和6个月时测量结果。主要结果是使用适应性测试(ADT)得出的在足尖上抬和足尖下压两种情况下的摇摆能量得分(SES)。次要结果包括在ADT期间使用表面肌电图和加速度计测量的腓肠肌内侧头、半腱肌内侧头、胫骨前肌和股直肌的肌肉激活起始潜伏期。数据采用基于意向性分析原则的重复测量协方差分析进行分析。

结果

在3个月时,两组的SES在组内或组间均未观察到显著差异。在6个月时,仅NMT组的足尖下压SES与基线值相比下降了6.8%(P = 0.004)。在任何腿部肌肉激活结果中均未观察到显著的时间、组或组×时间交互效应。

结论

短期NMT未能改善DCD儿童的适应性平衡能力和腿部肌肉激活时间。进一步的研究应探索旨在改善这些儿童适应性平衡能力的长期特定任务干预措施的临床应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6de7/6855479/64912f8b53b5/medi-98-e17946-g002.jpg

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