腦性麻痺孩童及正常發展孩童之動作協調表現之差異：電腦化動作協調測驗之發展與應用

The Differences of Motor Coordination Between Children With Cerebral Palsy and Typically Developing Children: Development and Application of a Computerized Motor Coordination Assessment

劉伃書(Yu-Shu Liu) ； 梁凱傑(Kai-Jie Liang) ； 王湉妮(Tien-Ni Wang) ； 蔡沛潔(Pei-Jei Tsai) ； 陳顥齡(Hao-Ling Chen)

《職能治療學會雜誌》 37卷1期 (2019/06) Pp. 41-54

https://doi.org/10.6594/JTOTA.201906_37(1).0002

摘要

背景及目的：學齡腦性麻痺孩童多可用健側手寫字，但多數因動作協調能力不佳而有書寫困難。目前書寫相關的動作協調評估工具多為紙本描圖測驗，易有人為計分誤差且只用超線次數作為能力標準並不夠全面。電腦化評估測驗能解決紙本評估的缺點，且客觀的評估動作協調能力。本研究目的為發展一個適用學齡孩童的電腦化動作協調評估工具，及探討腦性麻痺與正常發展孩童的動作協調能力之差異。方法：本研究自行發展電腦化動作協調評估測驗，共含兩個測驗圖形：圓形和五邊形。共招募各15位年齡為5－12歲之腦性麻痺及正常發展孩童。軟體會紀錄孩童描繪的點與標準線上的點之方均根差值（Root Mean Square Error，RMSE）、花費時間及超線次數作為動作協調的表現指標。結果使用二因子混合設計變異數分析（two-way mixed ANOVA）來分析組別與圖形之效應。結果：結果顯示三種指標在組別與圖形間皆無交互作用（RMSE：F＜0.001；超線次數：F＝0.064；花費時間：F＝2.148）。進一步分析主效果，腦性麻痺孩童之RMSE顯著高於正常發展孩童（p＝0.005）。兩組孩童在超線次數及花費時間皆無顯著差異（超線次數：p＝0.13；花費時間：p＝0.154），且圖形間亦無顯著差異。結論：本研究自行發展之電腦化動作協調測驗可客觀評估動作協調能力品質。其中方均根差值可區分兩組孩童能力差異，補足以往只用超線次數為標準之限制。

關鍵字

動作協調 ； 電腦化測驗 ； 腦性麻痺

並列摘要

Background: Many children with cerebral palsy (CP) are able to write, but have difficulty due to poor motor coordination (MC). Current handwriting assessments related to MC are paper-and-pencil tasks with disadvantages such as scoring discrepancy caused by personal errors and incomprehensive results provided by numbers of crossline (NC) only. Computerized assessments may resolve these problems and provide an objective way to assess MC. The aim of this study was to develop a computerized MC assessment and to examine the difference of MC between children with CP and typically developing children (TDC). Method: Two shapes, circle and pentagon, were constructed in the self-developed MC assessment. 15 CP and 15 TDC, aged from 5 to 12 years old, were recruited. Root mean square error (RMSE), NC, and duration recorded by iPad were used to represent the MC performance. Two-way mixed ANOVA was used to analyze MC differences between CP and TDC. Result: There was no significant group-by-shape interaction on the three indexes (RMSE: F＜0.001, NC: F=0.064, duration: F=2.148). Further analysis of main effect revealed that RMSE was significantly higher in CP compared to TDC (p=0.005). No significant group difference was found in NC or duration (NC: p=0.13, duration: p=0.154). No significant difference was found between the two shapes. Conclusion: A computerized MC assessment has been developed to quantify the MC performance. The RMSE can be applied as an index to differentiate MC between children with CP and TDC.

並列關鍵字

Cerebral Palsy ； Computer-based Assessment ； Motor Coordination