- 期刊
物理治療對在家教育學童之成效
The Effects of Physical Therapy for the Disabled Students Educated at Home
摘要
為落實「特殊教育法」精神，了解台北縣在家教育學童之身心障礙情形，並探討到校物理治療之效果，乃進行此研究。於1995年8月在於台北縣分區對148位在家教育學童舉行醫療鑑定與物理治療評估之彼，77位學童依據治療師、老師之判斷與家長之參與意顯，接受7個月之到校定點直接治療或諮詢治療。本研究中，物理治療之評估與治療以向美國國立復健醫療研究中心所提之「功能障礙模式」(disability model)為主，即使用哈利博士等人所設計之「兒童身心障礙評量表」，了解其功能障礙情形，並據此訂定訓練目標並評量治療前後之差別。結果顯示：96%學童為重度智障，60%再加上腦性麻痺，40%有癲癇，幾乎全為多重障礙；其日常生活自理依賴者佔82%至96%，移位能力需協助者佔75%至93%，溝通與人際關係需協助者佔82%至92%；49%有關節攣縮，26%有脊柱側彎；提供到校物理治療確實可增加這些學童之移動能力與日常生活自理能力，尤以接受直接治療者之效果更明顯。然而本研究之醫療人員皆以研究方式短期參與，為長期有效執行，法令制度仍有待改進，且宜彈性採取專業科際整合模式、直接或諮詢治療方式提供在家或在校治療。
並列摘要
The purposes of this study were to investigate the physical conditions and functional abilities of 201 students who were educated at home in Taipei County, and to evaluate the effect of a school physical therapy program on these children. One hundred and 48 home-educated students received physical examinations by a group of physicians and physical therapists in August 1995. Among them, 77 students (52%) also received direct or indirect physical therapy services at their nearby school for 7 months according to their treatment potential and the motivation of parents after that evaluation. The ”disability model” developed by the National Center for Medical Rehabilitation Research of USA, was used in physical therapy evaluation and treatment. ”Pediatric Evaluation of Disability Inventory” developed by Haley and colleagues, was used as evaluation tool and treatment guideline for the children. Severe mental retardation with cerebral palsy or convulsion was diagnosed in 60% or 41% of the students. Eighty-two to 96 percent of the students were dependent on out side assistance to perform various activities of daily living, 75% to 93% were dependent in various mobility functions, and 82% to 92% in various communication activities and personal-social activities. Forty-nine percent of the students had conditions involving joint contracture, and 26% had scoliosis. The school physical therapy program improved the mobility and activities of daily living of these students, especially in the direct treatment group. The results suggest that physical therapy is definitely needed for handicapped children. Students with multiple disabilities also need a trans-disciplinary or inter-disciplinary approach to education at school. The authors suggest that policies should be changed to allow for the long-term involvement of medical personnel in the educational system in Taiwan.