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自闭症及严重本体感觉功能障碍患者的加压服装:一项回顾性探索性病例系列研究

Compressive Garments in Individuals with Autism and Severe Proprioceptive Dysfunction: A Retrospective Exploratory Case Series.

作者信息

Guinchat Vincent, Vlamynck Elodie, Diaz Lautaro, Chambon Coralie, Pouzenc Justine, Cravero Cora, Baeza-Velasco Carolina, Hamonet Claude, Xavier Jean, Cohen David

机构信息

Department of Child and Adolescent Psychiatry, Reference Centre for Rare Psychiatric Diseases, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Sorbonne Université, 75006 Paris, France.

Psychiatric Section of Mental Development, Psychiatric University Clinic, Lausanne University Hospital (CHUV), Prilly, 1011 Lausanne, Switzerland.

出版信息

Children (Basel). 2020 Jul 13;7(7):77. doi: 10.3390/children7070077.

Abstract

(1) Background: Compression garments (CGs) are an adjuvant treatment for generalized joint hypermobility (GJH), including the Ehlers-Danlos syndrome/hypermobility types. The effects of CGs are likely to be related to better proprioceptive control. We aimed to explore the use of CGs in individuals with autism and severe proprioceptive dysfunction (SPD), including individuals with GJH, to control posture and challenging behaviors. (2) Methods: We retrospectively described 14 patients with autism and SPD, including seven with comorbid GJH, who were hospitalized for major challenging behaviors with remaining behavioral symptomatology after the implementation of multidisciplinary approaches, including medication, treatment of organic comorbidities, and behavioral restructuring. Each patient received a CG to wear for at least 1 h (but most often longer) per day for six weeks. We assessed challenging behaviors in these participants with the Aberrant Behavior Checklist (ABC), sensory integration with the Dunn questionnaire, and postural sway and motor performance using a self-designed motricity path at baseline, two weeks, and six weeks. (3) Results: We observed a significant effect on most ABC rating scores at two weeks, which persisted at six weeks (total score, = 0.004; irritability, = 0.007; hyperactivity, = 0.001; lethargy, = 0.001). Postural control in dorsal and profile positions was significantly improved between before and after wearing the CGs ( = 0.006 and 0.007, respectively). Motor performance was also significantly improved. However, we did not observe a significant change in Dunn sensory scores. During the six-week duration, the treatment was generally well-tolerated. A comorbid GJH diagnosis was not associated with a better outcome. (4) Conclusions: CGs appear to be a promising adjuvant treatment for both behavioral and postural impairments in individuals with autism and SPD.

摘要

(1) 背景:加压服装(CGs)是一种针对广泛性关节过度活动症(GJH)的辅助治疗方法,包括埃勒斯-当洛综合征/过度活动型。CGs的效果可能与更好的本体感觉控制有关。我们旨在探讨CGs在自闭症和严重本体感觉功能障碍(SPD)个体中的应用,包括患有GJH的个体,以控制姿势和具有挑战性的行为。(2) 方法:我们回顾性描述了14例患有自闭症和SPD的患者,其中7例合并GJH,这些患者因实施多学科方法(包括药物治疗、器质性合并症治疗和行为重构)后仍存在主要的具有挑战性的行为症状而住院。每位患者每天佩戴CG至少1小时(但大多数情况下更长时间),持续六周。我们在基线、两周和六周时,使用异常行为检查表(ABC)评估这些参与者的具有挑战性的行为,使用邓恩问卷评估感觉统合,并使用自行设计的运动路径评估姿势摆动和运动表现。(3) 结果:我们观察到在两周时大多数ABC评分得分有显著效果,在六周时仍然存在(总分,P = 0.004;易怒,P = 0.007;多动,P = 0.001;嗜睡,P = 0.001)。佩戴CG前后,背部和侧面姿势控制有显著改善(分别为P = 0.006和0.007)。运动表现也有显著改善。然而,我们未观察到邓恩感觉评分有显著变化。在六周的疗程中,该治疗总体耐受性良好。合并GJH诊断与更好的结果无关。(4) 结论:CGs似乎是一种有前景的辅助治疗方法,可用于治疗自闭症和SPD个体的行为和姿势障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61ed/7401870/bdc3748a1333/children-07-00077-g001.jpg

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