腦性麻痺兒之任務為導向步行訓練成效-個案報告

Task-Oriented Ambulation Training for Children with Cerebral Palsy - Case Report

黃靄雯(Ai-Wen Hwang) ； 廖華芳(Hua-Fang Liao)

《物理治療》 29卷4期 (2004/08) Pp. 254-262

摘要

目的：探究以任務為導向之社區步行訓練是否提高腦性麻痺兒童之行走功能。方法：以 A － B 單一個案研究設計，比較兩名腦性麻痺兒童社區三個月步行訓練前後之行走功能。社區步行訓練為整合原發展中心之動作訓練與社區適應課程，以在社區環境中行走至商店完成購買行為為目標任務，每週三次，每次 40 分鐘，訓練計畫由物理治療師與老師討論設計後交由老師執行。行走功能療效指標包括生理耗能指數、自選之行走速度及最長連續行走的時間。介入前共測量兩次，間隔二週，並以平均值作為基準線。介入三個月之後由同一名物理治療師測量相同的參數。結果：兩個案經介入後，相較於基準線，行走速度增加分別為10 . 84 公尺／分鐘（ 63 % ）、 5 . 36 公尺／分鐘（ 143 % ) ；其生理耗能指數分別減少 0 . 20 心跳數／公尺（ 10 % ）、6 . 17 心跳數／公尺（ 63 % ) ; 最長連續行走的時間分別增加 23 分鐘（ 175 % ）、14 分鐘（ 117 % ) ；根據老師之記錄，社區行走功能亦有明顯改善。結論：使用助行器之腦性麻痺兒童，能藉由以任務為導向之社區行走訓練來增加行走功能。（物理治療 2004 ; 29 ( 4 ) : 254－262 )

關鍵字

腦性麻痺 ； 生理耗能指數 ； 社區 ； 任務為導向 ； 行走功能

並列摘要

Purpose: To investigate the effectiveness of the task-oriented community ambulation training for children with cerebral palsy. Methods: With A-B single case study design, the ambulation functions before and after 3-month community walking training were compared for two children with cerebral palsy in a day- care center. The training program was modified from two original lessons, the movement ambulation lesson and community adjustment lesson. Children received community walking training 3 times a week, 40 minutes every session, and totally 32 sessions for 3 months. The training program was designed by a physical therapist after discussion with the teacher, and implemented by the classroom teacher. The target behavior of the task-oriented program was that children walked from the day-care center to the nearby store to buy things. The outcome measures included physiological cost index, self-selected walking speed, and the maximal walking period. Children received three measurements, two at the baseline phase and one after intervention. Results: For case 1 and case 2, the self-selected walking speed increased obviously by 10.84 (m/min) (63%)and 5.36(m/min) (143%); the walking efficiency was improved with decrease in physiological cost index 0.20 (beats/m) (10%) and 6.17 (beats/ m) (63%); the longest duration of walking indoor increased 23 minutes (175%) and l4minutes(117%)respectively. The teacher also reported improvement in walking functions of these two children while walking outdoors. Conclusion: The task-oriented community walking program could improve the walking function for children with cerebral palsy who walked with assistive device. (FJPT 2004;29(4):254-262)

並列關鍵字

Cerebral palsy ； Physiological cost index ； Community ； Task-oriented approach ； Walking function