大量練習平衡訓練對於腦性麻痺兒童前置姿勢調整的影響－個案報告

目的：腦性麻痺(cerebral palsy)兒童的前置性姿勢調整(anticipatory postural adjustments, APA)較正常兒童不安全及沒效率，本個案報告的目的是探討大量練習(massed Practice)訓練對於一位腦性麻痺兒童APA的改變。方法：一位痙攣型雙邊麻痺(spastic diplegic)腦性麻痺兒童參與本個案報告，接受為期3天、每天60次在站立下密集練習伸手往前拿取正在移動的球的訓練。實驗設計採用訓練前後重複量測(pretest-posttest repeated measure study design)的方法，評估是在站立下各以最舒服的速度伸手取球、最快速度伸手取球及伸手取正在移動的球等三種情境做連續各15次伸手取物，以壓力中心(center of Pressure, COP)前後方向的移動變化來量化APA。結果：經過練習之後，個案表現出更一致的基本的COP向後移動(posterior shift of COP)空間參數(spatial parameter)型態，並改善手部動作啟動和APA間連結。結論：本個案報告顯示大量練習功能訓練是一個安全、且也許能夠誘發或是加速APA發展的訓練。未來值得更進一步的研究探討。

關鍵字

前置性姿態調整；大量練習；腦性麻痺

並列摘要

Background and Purpose: Children with cerebral palsy (CP) tend to develop less efficiency, unsafely and laborious anticipatory postural adjustments (APA). The purpose of this case report was to describe the effect of massed practices on APA for a child with CP. Methods: One child with spastic CP participated in this study. Repeated measure pretest-posttest control design was used. The child practiced the functional forward reach task with moving target for 60 trials on each of 3 consecutive days. Assessments took place on four occasions: 3 days prior to practice, one day prior to practice, one day after practice, and 3 days after practice. The changes of APA were quantified by center of pressure (COP) measurements in anterior-posterior direction during functional reach tasks. Result: After massed practice, the child demonstrated more consistent basic spatial posterior APA COP shift, and exhibited improvements in the link between reach movement and APA. Conslusion: The results of this case report demonstrated that the development of APA may be facilitated by massed practice in a child with spastic CP. No adverse effects during the training had been noted. Further investigation is warranted to further examine the effects of massed practice in this population.

並列關鍵字

Anticipatory postural adjustments APA ； Massed practice ； Cerebral palsy CP

國際替代計量

大量練習平衡訓練對於腦性麻痺兒童前置姿勢調整的影響－個案報告

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