精神分裂症患者前庭及本體感覺統合之研究

The Study of Vestibular-Proprioceptive Integration in Schizophrenics

高麗芷(Lee-Jyy Rau)

《職能治療學會雜誌》 2卷 (1984/01) Pp. 19-26

https://doi.org/10.6594/JTOTA.1984.02.04

摘要

本研究旨在探討精神分裂症患者是否有前庭及本體感覺統合失常問題。研究證實，此類患者確有失常現象。其症狀計有曳步而行、身體成S型彎曲、手握力微弱及遺有原始性反射動作。又在「姿勢模仿」、「雙側動作協調」、「張眼單腳站立」及「閉眼單腳站立」等測驗上，亦較正常人爲差。本研究亦發現「南加州感覺統合測驗」中之「超越身體中線」與「左右分辨」等兩項測驗，不能有效分辨出正常成年人與精神分裂症成年患者。故此兩項測驗無適用於成年患者之價值。
前庭及本體感覺統合機能是感覺統合之基礎。當其失常時，患者集中注意力的能力將深受影響。故欲治療精神分裂症患者的注意力渙散問題，從治療其前庭及本體感覺統合機能上著手，將是一種有效的方法。

並列摘要

This study was undertaken to investigate the possibility that schizophrenics have dysfunction in vestibular-proprioceptive integration. Using pattern of gait, body alignment while standing, Imitation of Postures, Crossing Midline of Body, Bilateral Motor Coordination, Right-Left Discrimination, Standing Balance with Eyes Open, Standing Balance with, Eyes Closed, primitive reflex integration and grasp strength as indicators of vestibular-proprioceptive integration. Eighty-six schizophrenics and forty-four non-schizophrenic psychotics between 16 and 44 years of age hospitalized at Taipei City Psychiatric Center, as well as thirty-three normal subjects within the same age range were given those tests from March 1, 1982 to June 19, 1982.
Results of this study indicated that schizophrenics have vestibular-proprioceptive integration dysfunction as evidenced by shuffling gait, pronounced body spinal S-curve profile (sagitally and longitudinally), weak grasp strength, poor performance in Imitation of Postures, Bilateral Motor Coordination, Standing Balance with Eyes Open, Standing Balance with Eyes Closed and primitive reflex integration. These phenomena were found not only in chronic schizophrenia as King has noted, but also in other types of schizophrenia and non-schizophrenic psychoses. No significant difference was found between non-schizophrenic psychotics and paranoid schizophrenics, between non-schizophrenic psychotics and reactive schizophrenics, nor between non-schizophrenic psychotic and acute schizophrenics. However, there were significant differences on the posture of head between non-schizophrenic psychotics and non-paranoid schizophrenics, between non-schizophrenic psychotics and non-paranoid schizophrenics, between non-schizophrenic psychotics and p recess schizophrenics, as well as between non-schizophrenic psychotics and chronic schizophrenics.
Vestibular-proprioceptive mechanisms play a fundamental role in sensory integration. The vestibular-proprioceptive system normally regulates the mutual interaction of sensory input and motor output. Dequiros stated that when a person had vestibular-proprioceptive dissociation, attention span for the purposes of learning was very badly disturbed.
Results of this study hold implications for the researcher working with schizophrenics; they showed that Crossing Midline of Body and Bight-Left Discrimination were not good items to discriminate adult schizophrenics from normal subjects.