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非腦性麻痺之智能不足患者脊柱側彎之盛行率:台北市一教養院院生分析研究

The Prevalence of Scoliosis in the Institutionalized Non-cerebral Palsy Mentally Retarded Patients

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摘要


目前國內並無對智能不足相關疾病的脊柱側彎研究,本研究目的為探討非腦性麻痺之智能不足與脊柱側彎間之相關性,研究對象是台北市某一教養院院生。目的是調查非腦性麻痺之智能不足院生當中的脊柱側彎盛行率、嚴重度,及智能不足與脊柱側彎兩者嚴重程度是否相關。本研究中共收集237位診斷為智能不足的院生,先利用亞當氏向前彎腰試驗進行篩檢,再為篩檢陽性院生安排站立脊椎X光攝影檢查,測量Cobb角度判定脊柱側彎的程度。篩檢結果顯示呈陽性之院生有41位,陽性率為17.3%;其中女性16.19%,男性18.18%。此41位院生之站立脊椎X光攝影檢查結果顯示:其中有40位Cobb角度大於5度,篩檢正確率97.6%。該教養院非腦性麻痺之智能不足院生之脊柱側彎盛行率為16.9%。所量得Cobb角度平均18.2度,其中女性平均23.3度,男性平均14.9度。以一方分類變異數分析發現智能不足嚴重程度與Cobb角度大小並無明顯相關。結論:脊柱側彎在智能不足族群與一般族群相比有較高盛行率,而且以嚴重度未註明這組盛行率最高。但智能不足嚴重度和脊柱側彎程度並沒有相關。對智能不足院生做定期追蹤可減少因進一步脊柱側彎惡化所產生功能缺損。

並列摘要


This study aimed to assess the prevalence, severity, and correlation between non-cerebral palsy mental retardation and scoliosis in a special education institute in Taipei. Adam's forward bending test was used to clinically screen 237 mental retardation non-cerebral palsy patients for scoliosis. Those patients with positive forward bending tests were referred for standing spinal radiographs, so that the Cobb angle could be quantified to allow evaluation of the severity of the scoliosis. Of the 237 students, 41 (17.3%) had positive signs in the screening test (female:16.19%, male:18.18%). All 41 patients then underwent standing spinal radiographs and the results revealed a scoliosis prevalence of 16.9%. The accuracy of the screening test was 97.6%. The Cobb angle averaged 18.2 (female:23.3, male:14.9). There was no significant correlation between severity of mental retardation and the Cobb angle found with one-way ANOYA analysis. In conclusion, there is a higher prevalence of scoliosis in mentally retarded subjects with the highest prevalence in subjects with severity unspecified mental retardation. There is no significant relationship between mental retardation and scoliosis. Regular follow up for mentally retarded patients may reduce functional impairment resulting from exacerbations of scoliosis.

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