Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan.
Department of Rehabilitation Medicine, Shizuoka Children's Hospital, Shizuoka, Japan.
Pediatr Int. 2020 Sep;62(9):1039-1043. doi: 10.1111/ped.14265.
Individual weaknesses in motor skills are a characteristic of children with congenital upper limb deficiencies. These weaknesses increase with age. In Japan, however, prosthetic prescription and subsequent rehabilitation approaches for children with upper limb deficiencies are insufficient and often delayed. This study aimed to elucidate whether rehabilitation approaches, including prostheses prescription and occupational therapy, improve these children's adaptive behaviors, especially their motor skills.
The study included nine children, aged 0-6 years, with unilateral transradial or transcarpal upper limb deficiencies. We measured their adaptive behaviors and motor skills at the beginning of prosthetic therapy and after 1.5 years, using the Vineland Adaptive Behavior Scales - Second Edition.
The score for the motor skills domain was significantly lower than the median score of the domains at the beginning of prosthetic therapy. The motor skill weaknesses significantly improved after 1.5 years of prosthetic therapy.
Although children with congenital upper limb deficiencies have individual weaknesses in their motor skill behavior, it was shown that these weaknesses can be improved through rehabilitation approaches, including occupational and prosthetic therapies. Issuing the appropriate prostheses and implementing the appropriate training to use the prostheses for congenital upper limb deficiencies are reasonable and meaningful interventions to improve quality of life.
运动技能的个体缺陷是先天性上肢缺陷儿童的特征。这些缺陷会随着年龄的增长而增加。然而,在日本,上肢缺陷儿童的假肢处方和随后的康复方法不足,而且往往延迟。本研究旨在阐明包括假肢处方和职业治疗在内的康复方法是否能改善这些儿童的适应行为,特别是他们的运动技能。
本研究纳入了 9 名 0-6 岁单侧桡骨或腕骨上肢缺陷儿童。我们使用第二版 Vineland 适应行为量表,在假肢治疗开始时和 1.5 年后测量他们的适应行为和运动技能。
假肢治疗开始时,运动技能领域的评分明显低于各领域的中位数评分。假肢治疗 1.5 年后,运动技能缺陷明显改善。
尽管先天性上肢缺陷儿童的运动技能行为存在个体缺陷,但通过康复方法,包括职业治疗和假肢治疗,可以改善这些缺陷。为先天性上肢缺陷儿童提供合适的假肢并实施使用假肢的适当训练是改善生活质量的合理和有意义的干预措施。