本體覺輸入對於唐氏症兒童動作表現影響之研究

Abstract

唐氏症兒童中有很高比例有動作發展遲緩的問題，過去的研究顯示本體覺輸入(proprioceptive input)對於動作的控制與學習非常重要，但是操作本體覺輸入對於唐氏症兒童動作控制的影響仍有待探究。本研究希望探討本體覺輸入對於唐氏症兒童動作表現的影響，並比較與一般兒童之間的差異。本研究參與者包括唐氏症組四至七歲兒童18名(15名男生，3名女生)，年齡相當對照組兒童21人(14名男生，7名女生)。本研究係以分組因果比較研究設計，以重複量測的方式，讓所有參與者在三種本體覺情境下接受「布氏歐氏動作效能測試(簡版)」的評估，所有參與者也都接受「感覺史量表」的評估，以了解參與者感覺功能的狀況。研究結果顯示唐氏症兒童的動作表現顯著低於對照組兒童，依「布氏歐氏動作效能測試(簡版)」標準分數的評估結果，72.2%的唐氏症兒童屬於動作發展障礙。「感覺史量表」的評估結果顯示，唐氏症兒童在「感覺敏感」、「感覺登錄不良」、「分心」、「精細動作/視知覺」障礙與失調的比例顯著高於對照組，其中有「精細動作/視知覺」障礙的唐氏症兒童高達13人(72.2%)。相關分析也顯示這些感覺功能障礙與「跑步與敏捷性」、「平衡能力」、「兩側協調性」、「上肢協調性」、「視動控制能力」、「上肢速度與靈巧性」等向度的表現有顯著相關。對唐氏症組兒童來說，肢體附加重量會使動作表現下降，單側附加重量的情境下降的比例高於雙側附加重量的情境；對照組兒童在單側附加重量的情境下，動作表現則是有所增進。Children with Down syndrome face difficulties in motor development. How to help these children develop their motor skills becomes research focus in early intervention. The previous research results showed proprioceptive input was very important to motor control, but how proprioceptive input influences motor performance of children with Down syndrome remain unclear. The purpose of this study was to investigate the influence of proprioceptive input on motor performance of children with Down syndrome. Repeated measure casual-comparative research design was employed in first stage of this research. One group of Down syndrome children age 4 to 7 (15 boys and 3 girls) and one group of typically developed children with chronological age matched (14 boys and 7 girls) participated in this study. Each participant received short form evaluation of Short form of Bruininks-Oseretsky Test of Motor Proficiency under three different proprioceptive input conditions to compare motor performance among three groups. Participants also received evaluation of Sensory Profile to reveal the relationship with motor performance. The results indicated motor performance of Down syndrome group was significantly lower than that of contorl group. Thirteen Down syndrome children (72.2%) were classified as disabled according to BOTMP-short evaluation result. The results of sensory profile revealed that Down syndrome children had sensory dysfunction in the domain of sensory sensitivity, poor registration, inattention and fine motor/visual percention domain. The sensory dysfunction was significant related to the performance in running speed and agility, balance, bilateral coordination, upper limb coordination, visual motor control, upper limb speed and dexterity of Down syndrome children. Unilateral increase weight over extremities input significantly decreased the motor performance of Down syndrome children but increased the motor performance of children in control group.