可獨立行走的雙邊痙攣型腦性麻痺兒童與一般兒童下肢肌力與身體組成之相關分析

The Relations between Body Composition and Muscle Strength of Lower Extremities in Independent Walkers with Spastic Diplegic Cerebral Palsy and Non-Disabled Children

廖華芳(Hua-Fang Liao) ； 劉盈綺(Ying-Chi Liu) ； 劉金枝(Chin-Chih Liu)

《物理治療》 27卷6期 (2002/12) Pp. 273-282

摘要

背景與目的：腦性麻痺兒童常有體適能障礙，然相關研究仍不足，故本研究目的在比較雙邊痙攣型腦性麻痺與一般兒童身體組成與下肢肌力的差異，並探討荷重坐站阻力與身體非脂肪質量的相關性。方法：選取6-12歲可獨立行走的雙邊痙攣型腦性麻痺兒童26位（平均年齡98±22月）和一般兒童60位（平均年齡104±19月）。每位兒童皆在同一天內接受身高、體重、體脂肪與荷重坐站測試。以體脂肪夾量測之皮下脂肪厚度，並根據公式算出體脂肪百分比與身體非脂肪質量。荷重坐站最大阻力代表下肢伸直肌的肌力，本研究測試兒童由坐至站1次的最大荷重阻力。使用獨立樣本t檢定比較兩組兒童身體組成參數與荷重坐站1次最大阻力；以線性迴歸分析求出荷重坐站1次最大阻力與身體非脂肪質量、身體質量指數與體脂肪百分比的相關係數，並Fisher's Z轉換以分析不同組別相關係數之差異檢定。結果：可獨立行走的雙邊痙攣型腦性麻痺兒童的身體非脂肪質量與荷重坐站阻力顯著低於一般兒童；但在體脂肪百分數及身體質量指數上，兩組兒童無顯著差異。腦性麻痺兒童與一般兒童其坐站荷重肌力與身體非脂肪質量皆呈顯著相關，且兩組兒童兩參數間之相關係數無顯著差別。兩組不同動作功能之腦性麻痺兒童中，身體非脂肪質量與荷重坐站阻力之相關係數有顯著差別。結論：能獨立行走的雙邊痙攣型腦性麻痺兒童，在身體組成中體脂肪百分數及身體質量指數與一般兒童相似，下肢肌力與身體非脂肪質量則低於一般兒童。兩組兒童的身體非脂肪質量與肌力具有高度相關。動作功能較差之腦性麻痺兒童上述二參數間之相關較不明顯。因此，進行體適能訓練時，應將動作功能程度因素納入考量。

關鍵字

腦性麻痺 ； 兒童 ； 體組成 ； 肌力 ； 坐站活動

並列摘要

Background and Purposes: Children with cerebral palsy (CP) often have health-related problems. Muscle strength and body composition are two components of fitness. The related studies are few. The purposes of this study were: to compare the body composition and muscle strength between children with cerebral palsy and non-disabled children and to investigate the relations between lean body mass and loaded sit-to-stand capacity. Methods: This was a prospective relations analysis study. Six to 12 year-old children were recruited, including 26 children with spastic diplegia (mean age 98±22 mo.) who were able to walk independently and 60 non-disabled children (mean age 105±19 mo.). The data from skinfold measurements were used to calculate the body fat percentage and lean body mass (LBM). The loaded sit-to-stand capacity, which represented the strength of extensors of the low extremities, was tested by loaded sit-to-stand test to obtain 1 maximum repetition (STS-1RM). The independent t test was used to compare the values between two groups, and the linear regression model was used to test the correlation between two variables, such as lean body mass with strength, body mass index with body fat percentage. Fisher's Z transformation was used to test the differences between two correlations. Results: The LBM and STS-1RM was less in children with CP than in the non-disabled children, however, the body fat percentage and body mass index were not significantly different between the two groups. There were high correlations between the LBM and STS-1RM, and the correlation coefficients were not significantly different between children with CP and non-disabled children. The correlation coefficients between the LBM and STS-1RM for children with different functional groups of CP were different significantly. Conclusions: The children with CP of independent walker have similar body fat percentage and body mass index, less LBM and STS-1RM compared to non-disabled children. The LBM and STS-1RM were highly correlated in both groups. However, the correlations between LBM and STS-1RM were different in different functional groups of children with CP. Further study for the problem of fitness should consider the functional level for children with CP.

並列關鍵字

Cerebral palsy ； Children ； Body composition ； Muscle strength ； Sit-to-stand activity