運用國際健康功能與身心障礙分類系統探討水中運動介入對於腦性麻痺兒童的療效：系統性文獻回顧

The Efficiency of Aquatic Interventions in Children with Cerebral Palsy by Using the International Classification of Functioning, Disability and Health (ICF) Framework: A Systematic Review

李郁瑩(Yu-Ying Li) ； 劉金枝(Chin-Chih Liu) ； 鄭湘君(Hsiang-Chun Cheng)

《弘光學報》 79期 (2017/03) Pp. 73-89

https://doi.org/10.6615/HAR.201703.79.07

摘要

研究問題與目的：本研究是運用國際健康功能與身心障礙分類系統探討水中運動計畫對於腦性麻痺兒童的療效。研究方法：經由PubMed、Medline、Scopus、ProQuest及CEPS中文電子期刊服務等資料庫搜尋自1984年至2012年11月的文獻，檢索方法為以醫學標題詞彙及關鍵字，檢索水中活動對於腦性麻痺族群之實證文獻。使用國際健康功能與身心障礙分類系統(International Classification ofFunctioning, Disability and Health, 簡稱 ICF)分析水中活動治療成效。研究結果：總共納入13篇的文獻包含10篇群體研究、2篇單一受試者和1篇觀察研究。採用美國腦性麻痺及發展醫學學會(American Academy for Cerebral Palsy and Developmental Medicine，簡稱AACPDM )治療成效委員會所提出的研究品質和實證層級評估方法來進行分析。研究結果顯示腦性麻痺兒童在參加水中活動計畫或游泳技巧訓練後，身體適能、社會行為、身體結構、活動和參與層級的表現上呈現明顯進步。水中活動訓練後有些效果會轉移至陸地活動的表現上，但游泳訓練後的成效反映在游泳技巧或水中獨立活動的表現上。研究結論:文獻回顧結果顯示水中活動之介入對於腦性麻痺兒童在身體結構、活動和參與層級上有改善之成效。本篇文獻回顧結果提供臨床治療師應用水中運動於腦性麻痺兒童之參考。

關鍵字

水中活動 ； 游泳訓練 ； 腦性麻痺 ； 國際健康功能與身心障礙分類

並列摘要

Purpose: The purpose of this systematic review was to examine the efficiency of aquatic interventions for children and adolescents with cerebral palsy with the international classification of functioning, disability and health (ICF) framework. Method: A systematic search of literature published between 1984 and 2016 in PubMed, Medline, Scopus, ProQuest and CEPS databases was conducted. Studies included both the group and single subject research design articles of the children and adolescent with cerebral palsy receiving aquatic intervention. The outcomes measures were classified on the basis of dimensions of the ICF framework. The methodological quality and coding level of evidence in all included articles were assessed following the guidelines proposed by the Treatment Outcomes Committee (TOC) of the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) guidelines. Result: A total of 13 studies, 10 group design and 3 single-subject research design were included in the study. The children with cerebral palsy showed significant improvement at the level of body structure/function, activity and participation after receiving aquatic interventions. The aquatic training effects transferred to land activity abilities and the swimming training effects showed in swimming skills or independent aquatic activities performance. Conclusion: The review indicated that aquatic intervention could improve body structure and functions, daily function and activity participation for children and adolescents with cerebral palsy. The result provides the clinicians with reference when applying the aquatic interventions for children and adolescents with cerebral palsy.

並列關鍵字

aquatic therapy ； swimming ； cerebral palsy ； international classification of functioning ； disability and health framework

參考文獻

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Ballaz, L., Plamondon, S., & Lemay, M. (2011). Group aquatic training improves gait efficiency in adolescents with cerebral palsy. Disability and Rehabilitation, 33(17-18), 1616-1624.

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Becker, B.E., & Cole, A.J. (2004). Comprehensive aquatic therapy (2nd ed.). Philadelphia: Butterworth-Heinemann.

Chrysagis, N., Douka, A., Nikopoulos, M., Apostolopoulou, F., & Koutsouki, D. (2009). Effects of an aquatic program on gross motor function of children with spastic cerebral palsy. Biology of Exercise, 5(2), 13-25.