動作發展遲緩兒童合併扁平足相關因子之研究

Related Factors in Children with the Motor Development Delay and Flat Feet

鄭惠文(Hui-Wen Cheng) ； 林巾凱(Chin-Kai Lin) ； 遲景上(Ching-Shiang Chi) ； 唐美華(Mei-Hua Tang)

《台灣復健醫學雜誌》 40卷4期 (2012/12) Pp. 205-213

https://doi.org/10.6315/2012.40(4)03

摘要

扁平足為學齡前兒童常見的足部問題，臨床上發展遲緩兒童有類似的問題，且更為嚴重複雜。扁平足在遲緩兒童的相關研究探討目前不多，因此本研究主要是探討發展遲緩學齡前兒童扁平足相關因子及扁平足對下肢功能性活動的影響。本研究收集共88位四至六歲的動作遲緩兒童，而適合納入參與研究分析者共有50位個案（重度與輕中度兩組各有25位）；男生有28位（56%），女生有22位（44%）。本研究以足印採集分析，透過足弓指數（Arch index）來判別扁平足嚴重度，並以拜登指數（Beighton score）測試關節鬆弛度、動作ABC-2（movement assessment battery for children-2）測試單腳站立、跳格子、墊腳尖行走直線等三項下肢動作功能。以皮爾森相關考驗、獨立樣本t檢定作統計分析。結果呈現：一、動作發展遲緩兒童的「關節鬆弛」、「下肢肌力」與其「扁平足嚴重度」呈中度相關性。二、動作發展遲緩兒童扁平足「重度組」在下肢功能性活動執行比「輕中度組」顯著較差。三、預測扁平足嚴重度的最佳預測因子為單腳站立、蹠曲肌力。因此，建議臨床上有扁平足的動作發展遲緩兒童應可以藉由加強單腳站立、踝關節蹠曲肌力，以改善足弓塌陷的問題及其造成的功能影響。

關鍵字

發展遲緩兒童 ； 扁平足

並列摘要

Condition of flat feet is a common among preschool children. Clinical studies show that children with developmental delays have problems similar to flat feet, perhaps of a more and complicated nature compared to the normal children. As literature on flat feet in children with developmental delays was hardly available, the main topic of this study was to explore factors associated with flat feet in preschool children with developmental delays, and the effect of flat feet on lower-extremity functions.The 50 participants in this study were selected from 88 children aged 4-6 years with motor delay. They were divided into two groups according to severity of delays: the group (n=25) and mid-to-moderate group (n=25). Males and females were for 28 (56%) and 22 (44%) of the participants, respectively. Evaluation measures included the Arch Index in a footprint analysis that determines the severity of flat feet, the Beighton score that quantifies joint laxity, and three lower-extremity functions (standing on one foot, hopscotch, and walking tip-toe along a straight line) by means of the Movement Assessment Battery for Children. The methods of statistical analysis included Pearson correlation and independent samples t-test.The results showed: 1. there was a moderate correlation between joint laxity and lower-extremity muscle strength with flat feet in children with developmental delays; 2. children with motor development delays in the ”severe flat feet group” had significantly worse lower-limb functions than those in the mild-to-moderate group; 3. the best predictors for the severity of flat feet were the ability to one-leg stand and plantar flexor strength.Therefore, these results suggest that children with motor development delays might enhance their ability to one-leg stand and strengthen their dorsiflexor muscles, in order to improve collapsed arches and the functional consequences in the clinical setting.

並列關鍵字

children with developmental delay ； flat feet