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发展性协调障碍个体的平衡控制:系统评价和荟萃分析。

Balance control in individuals with developmental coordination disorder: A systematic review and meta-analysis.

机构信息

Rehabilitation Research Centre (REVAL), Rehabilitation Sciences and Physiotherapy, Hasselt University, Agoralaan Building A, 3590, Diepenbeek, Belgium; Department of Rehabilitation Sciences and Physiotherapy/Movant, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium.

Department of Rehabilitation Sciences and Physiotherapy/Movant, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium.

出版信息

Gait Posture. 2021 Jan;83:268-279. doi: 10.1016/j.gaitpost.2020.10.009. Epub 2020 Oct 17.

Abstract

BACKGROUND

Although it is recognized that the majority of children with developmental coordination disorder (DCD) have balance deficits, comprehensive insights into which balance domains are affected, are still lacking in literature.

RESEARCH QUESTION

To what extent is balance control deficient in individuals with DCD compared to controls?

METHODS

Pubmed, Scopus and Web of Science were systematically searched. Risk of bias was assessed with the Scottish Intercollegiate Guidelines Network checklist for case-control studies. Mean and standard deviations characterizing balance control were extracted to calculate standardized mean differences (SMD) and pooled, if possible, using Review Manager.

RESULTS

The results of 31 studies (1152 individuals with DCD, 1103 typically developing (TD) peers, mean age 10.4 years old) were extracted of which 17 were used for meta-analysis. The mean SMD for the balance subscale of the Movement Assessment Battery for Children was 1.63 (pooled 95 %CI =[1.30;1.97]), indicating children with DCD to perform significantly poorer than their TD peers. Force plate studies also revealed that children with DCD present with a larger sway path during bipedal stance with eyes closed (pooled mean SMD = 0.55; 95 %CI=[0.32;0.78]). Children with DCD tend to have direction-specific limited stability limits and task-independent delayed onset of anticipatory postural adjustments.

INTERPRETATION

Children with DCD perform poorer on different domains of balance compared to TD peers. Future research should focus on comprehensive balance assessment in these children, preferably using a longitudinal design.

摘要

背景

尽管大多数发育性协调障碍(DCD)儿童都存在平衡缺陷,但文献中仍缺乏对受影响平衡领域的全面了解。

研究问题

与对照组相比,DCD 个体的平衡控制能力在何种程度上存在缺陷?

方法

系统检索了 Pubmed、Scopus 和 Web of Science。使用苏格兰校际指南网络病例对照研究清单评估偏倚风险。提取了描述平衡控制的均值和标准差,以计算标准化均数差(SMD),并在可能的情况下使用 Review Manager 进行汇总。

结果

共提取了 31 项研究(1152 名 DCD 患者,1103 名典型发育(TD)同龄人,平均年龄 10.4 岁)的结果,其中 17 项用于荟萃分析。运动评估电池儿童平衡分量表的平均 SMD 为 1.63(汇总 95 %CI =[1.30;1.97]),表明 DCD 儿童的表现明显差于 TD 同龄人。测力板研究还表明,闭眼双足站立时,DCD 儿童的摆动路径更大(汇总平均 SMD=0.55;95 %CI=[0.32;0.78])。DCD 儿童的方向特异性稳定极限有限,任务独立性的预期姿势调整延迟。

解释

与 TD 同龄人相比,DCD 儿童在不同的平衡领域表现较差。未来的研究应侧重于对这些儿童进行全面的平衡评估,最好使用纵向设计。

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