Department of Child and Adolescent Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
Eur Child Adolesc Psychiatry. 2024 Jan;33(1):127-137. doi: 10.1007/s00787-023-02144-5. Epub 2023 Jan 23.
In addition to the core symptoms defining ADHD, affected children often experience motor problems; in particular, graphomotor movements including handwriting are affected. However, in clinical settings, there is little emphasis on standardized and objective diagnosing and treatment of those difficulties. The present study investigated for the first time the effects of methylphenidate as well as physiotherapeutic treatment on objectively assessed graphomotor movements compared to a control condition, i.e. parental psychoeducation, in 58 children (mean age: 9.52 ± 1.91 years) newly diagnosed with ADHD in an outpatient clinic for child and adolescent psychiatry. Families were invited to join one of the treatment groups. Before and after 8 weeks of treatment, children performed six different tasks on a digitizing tablet which allowed the objective analysis of three important kinematic parameters of graphomotor movements (fluency, velocity, and pen pressure) in different levels of visual control and automation. Graphomotor movement fluency and velocity improves over time across the groups, especially in tasks with eyes closed. We did not find clear evidence for beneficial effects of methylphenidate or physiotherapeutic treatment on children's overall graphomotor movements suggesting that treatments need to be better tailored towards specific and individual deficits in graphomotor movements.
除了定义 ADHD 的核心症状外，受影响的儿童通常还会出现运动问题；特别是包括书写在内的手眼协调运动受到影响。然而，在临床环境中，很少强调对这些困难进行标准化和客观的诊断和治疗。本研究首次调查了哌醋甲酯以及物理治疗对新诊断为 ADHD 的 58 名儿童（平均年龄：9.52 ± 1.91 岁）的客观评估的手眼协调运动的影响，与对照组相比，即父母心理教育，在儿童和青少年精神病学的门诊诊所。邀请家庭参加治疗组之一。在治疗前和 8 周后，孩子们在数字化仪上执行了六个不同的任务，这些任务允许对手眼协调运动的三个重要运动学参数（流畅度、速度和笔压）进行不同程度的视觉控制和自动化分析。随着时间的推移，各组的手眼协调运动流畅度和速度都有所提高，尤其是在闭眼的情况下。我们没有发现哌醋甲酯或物理治疗对儿童整体手眼协调运动有明显有益影响的证据，这表明治疗需要更好地针对手眼协调运动的特定和个体缺陷进行调整。
