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认知导向作业疗法对改善发育性协调障碍儿童运动技能的有效性:一项随机等待期对照试验。

Effectiveness of Cognitive Orientation to Occupational Performance intervention in improving motor skills of children with developmental coordination disorder: A randomized waitlist-control trial.

机构信息

Graduate Programs in Rehabilitation Sciences, 8166University of British Columbia, Vancouver, Canada.

512469BC Children's Hospital Research Institute, Vancouver, Canada.

出版信息

Clin Rehabil. 2022 Jun;36(6):776-788. doi: 10.1177/02692155221086188. Epub 2022 Apr 24.

Abstract

OBJECTIVES

To determine if Cognitive Orientation to Occupational Performance was effective in improving performance and transfer of motor learning in children with developmental coordination disorder (with/without attention deficit hyperactivity disorder); and whether outcomes were maintained three months post-intervention.

DESIGN

Randomized waitlist-control trial (ClinicalTrials.gov ID: NCT02597751).

SETTING

BC Children's Hospital, Vancouver, Canada.

SUBJECTS

Thirty-seven children with developmental coordination disorder and 41 children with co-occurring attention deficit hyperactivity disorder (all 8-12 years), randomized to treatment or waitlist groups.

INTERVENTIONS

One-hour of intervention once weekly for 10 weeks.

MAIN MEASURES

(1) Canadian Occupational Performance Measure to measure self-perceived performance of motor goals (10-point scale); (2) Performance Quality Rating Scale to measure therapist-observed movement quality (10-point scale); and (3) Bruininks-Oseretsky Test of Motor Proficiency - 2nd ed. to measure overall motor skill ability/transfer of motor learning (percentile).

RESULTS

Both groups showed significant improvement ( < 0.001) in motor performance (developmental coordination disorder: pre: 2.7 ± 2.2, post: 7.0 ± 1.0; developmental coordination disorder with attention deficit hyperactivity disorder: pre: 2.3 ± 1.7, post: 7.0 ± 1.5) and movement quality (developmental coordination disorder: pre: 3.0 ± 1.5, post: 6.3 ± 1.7; developmental coordination disorder with attention deficit hyperactivity disorder: pre: 3.0 ± 1.9, post: 5.7 ± 2.3). Three months after treatment, children maintained their gains, but only children with developmental coordination disorder showed transfer of learning to overall motor skills (pre:12 ± 15, post:12 ± 12, follow-up:14 ± 20,  < 0.001).

CONCLUSION

Intervention was similarly effective for children with developmental coordination disorder with/without attention deficit hyperactivity disorder in achieving and maintaining functional motor goals, but only children with developmental coordination disorder showed transfer of learning to other motor skills.

摘要

目的

确定认知导向作业疗法是否能有效提高患有发育性协调障碍(伴或不伴注意缺陷多动障碍)儿童的运动学习表现和迁移;以及干预结束后三个月时,结果是否能保持。

设计

随机等待期对照试验(ClinicalTrials.gov 标识符:NCT02597751)。

设置

加拿大不列颠哥伦比亚省儿童医院,温哥华。

受试者

37 名患有发育性协调障碍的儿童和 41 名同时患有注意缺陷多动障碍的儿童(均为 8-12 岁),随机分为治疗组或等待组。

干预措施

每周 1 次,每次 1 小时,共 10 周。

主要测量指标

(1)加拿大职业表现测量表评估儿童对运动目标的自我感知表现(10 分制);(2)动作质量评定量表评估治疗师观察到的运动质量(10 分制);(3)布鲁因克斯-奥塞尔斯基运动能力测试-第 2 版评估整体运动技能能力/运动学习迁移(百分位数)。

结果

两组儿童的运动表现(发育性协调障碍:治疗前:2.7±2.2,治疗后:7.0±1.0;发育性协调障碍伴注意缺陷多动障碍:治疗前:2.3±1.7,治疗后:7.0±1.5)和运动质量(发育性协调障碍:治疗前:3.0±1.5,治疗后:6.3±1.7;发育性协调障碍伴注意缺陷多动障碍:治疗前:3.0±1.9,治疗后:5.7±2.3)均有显著改善(均 < 0.001)。治疗结束三个月后,儿童保持了他们的收益,但只有患有发育性协调障碍的儿童表现出学习向整体运动技能的迁移(治疗前:12±15,治疗后:12±12,随访:14±20, < 0.001)。

结论

对于患有发育性协调障碍伴/不伴注意缺陷多动障碍的儿童,认知导向作业疗法在实现和维持功能性运动目标方面同样有效,但只有患有发育性协调障碍的儿童表现出学习向其他运动技能的迁移。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fb9/9082975/71e25130d1b5/10.1177_02692155221086188-fig1.jpg

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