School of Nursing, the Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Kowloon, HKSAR, China.
Yantai Aviation Medical Room, Shandong airlines, China.
Phytomedicine. 2022 Jul 20;102:154191. doi: 10.1016/j.phymed.2022.154191. Epub 2022 May 22.
Beneficial effects of parent-administered pediatric tuina on ADHD in children have been reported in previous studies, but no rigorously designed randomized controlled trials (RCTs) have been conducted on it.
To assess the feasibility and preliminary effects of parent-administered pediatric tuina for ADHD symptoms in preschoolers.
This project was a two-arm, parallel, open-label, pilot RCT. Sixty-four participants were randomized into two groups at a 1:1 ratio. Parents in the parent-administered tuina group (n = 32) attended an online training program on pediatric tuina for ADHD and conduct this intervention on their children at home. Parents in the parent-child interaction group (n = 32) attended an online training about progressive muscle relaxation exercise and carried out parent-child interactive physical activities with their children at home. Both interventions were carried out every other day during a two-month intervention period, with each manipulation for at least 20 min. Feasibility outcomes included recruitment rate, consent rate, participants' adherence, retention rate, and adverse event. Outcomes were assessed at baseline, week 4, and week 8. The primary outcome measure was the Swanson, Nolan, and Pelham parent scale (SNAP); the secondary outcomes included preschool anxiety scale, children's sleep habits questionnaire, and parental stress scale. A mixed-method process evaluation embedded within the outcome evaluation was performed.
The recruitment rate was 12.8 per month. The consent rate was 98.5%. Good adherence was shown from the parent logbook. Four participants withdraw from the study. No severe adverse event was reported. For the SNAP total score, both groups showed improvement with moderate within-group effect size (Cohen's d > 0.5, all p < 0.001) and the between-group effect size was minimal (d< 0.2, p > 0.05). Perceived improvements on children's appetite and sleep quality, and parent-child relationship was observed from the qualitative data.
The study design and the parent-administered pediatric tuina intervention were feasible. Parent-administered pediatric tuina provided beneficial effects on improving core hyperactivity/impulsivity symptoms in preschool children. Parents perceived improvements on children's appetite and sleep quality. Further large-scale are warranted.
以往的研究报告表明，家长实施的小儿推拿对儿童注意缺陷多动障碍（ADHD）有有益影响，但尚未对此进行严格设计的随机对照试验（RCT）。
评估家长实施小儿推拿治疗学龄前儿童 ADHD 症状的可行性和初步效果。
本研究为一项两臂、平行、开放标签、初步 RCT。64 名参与者按 1:1 的比例随机分为两组。家长实施小儿推拿组（n=32）的家长参加了小儿推拿治疗 ADHD 的在线培训计划，并在家中对其孩子进行该干预。家长-儿童互动组（n=32）的家长参加了关于渐进性肌肉松弛运动的在线培训，并在家中与孩子进行了亲子互动体育活动。在为期两个月的干预期间，两种干预方式每隔一天进行一次，每次操作至少 20 分钟。可行性结果包括招募率、同意率、参与者的依从性、保留率和不良事件。结果在基线、第 4 周和第 8 周进行评估。主要结局测量指标为斯旺森、诺兰和佩勒姆父母量表（SNAP）；次要结局指标包括学龄前焦虑量表、儿童睡眠习惯问卷和父母压力量表。在结果评估中嵌入了混合方法的过程评估。
招募率为 12.8 人/月。同意率为 98.5%。从家长日志中可以看出，依从性良好。有 4 名参与者退出研究。未报告严重不良事件。对于 SNAP 总分，两组均显示出改善，具有中等的组内效应量（Cohen's d>0.5，均 p<0.001），组间效应量最小（d<0.2，p>0.05）。从定性数据中观察到儿童食欲和睡眠质量以及亲子关系的改善。
研究设计和家长实施的小儿推拿干预是可行的。家长实施的小儿推拿对改善学龄前儿童核心多动/冲动症状有有益影响。家长感知到儿童食欲和睡眠质量的改善。需要进一步开展大规模研究。
