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M. Lelong, Annina E. Zysset, Mirjam Nievergelt, Reto Luder, Ulrich Götz, C. Schulze, F. Wieber
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Abstract

Background: Motor deficiencies are observed in a large number of children with ADHD. Especially fine motor impairments can lead to academic underachievement, low self-esteem and frustration in affected children. Despite these far-reaching consequences, fine motor deficiencies have remained widely undertreated in the ADHD population. The aim of this review was to systematically map the evidence on existing training programs for remediating fine motor impairments in children with ADHD and to assess their effectiveness. Methods: The scoping review followed the PRISMA-ScR guidelines. In March 2020, PsycINFO, MEDLINE (PubMed), Web of Science, Google Scholar and The Cochrane Database of Systematic Reviews were searched for evidence. The eligibility criteria and the data charting process followed the PICO framework, complemented by study design. The investigated population included children with a formal ADHD diagnosis (either subtype) or elevated ADHD symptoms aged between 4 and 12 years, both on and off medication. All training interventions aiming at improving fine motor skills, having a fine motor component or fine motor improvements as a secondary outcome were assessed for eligibility; no comparators were specified. Results: Twelve articles were included in the final report, comprising observational and experimental studies as well as a review. Both offline and online or virtual training interventions were reported, often accompanied by physical activity and supplemented by training sessions at home. The training programs varied in length and intensity, but generally comprised several weeks and single or multiple training sessions per week. All interventions including more than one session were effective in the treatment of fine motor deficiencies in children with ADHD and had a wide range of additional positive outcomes. The effects could be maintained at follow-up. Conclusions: Fine motor training in children with ADHD can be very effective and multiple approaches including specific fine motor and cognitive training components, some kind of physical activity, feedback mechanisms, or multimodal treatments can be successful. Training programs need to be tailored to the specific characteristics of the ADHD population. A mHealth approach using serious games could be promising in this context due to its strong motivational components.
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背景:在大量ADHD儿童中观察到运动缺陷。尤其是精细运动障碍会导致学业成绩不佳、自尊心低下和受影响儿童的挫败感。尽管有这些影响深远的后果,精细运动缺陷在ADHD人群中仍然广泛得不到治疗。本综述的目的是系统地绘制现有训练计划的证据,以纠正ADHD儿童的精细运动障碍,并评估其有效性。方法:范围审查遵循PRISMA-ScR指南。2020年3月,我们检索了PsycINFO、MEDLINE (PubMed)、Web of Science、Google Scholar和Cochrane系统评价数据库来寻找证据。入选标准和数据绘制过程遵循PICO框架,并辅以研究设计。被调查的人群包括4 - 12岁的正式ADHD诊断(无论是亚型)或ADHD症状加重的儿童,无论是服药还是停药。所有旨在改善精细运动技能、将精细运动成分或精细运动改善作为次要结果的训练干预措施都被评估为合格性;没有指定比较国。结果:最终报告纳入了12篇文章,包括观察性和实验性研究以及综述。据报道,线下和在线或虚拟培训干预措施都有,通常伴随着身体活动,并辅以在家的培训课程。训练计划的长度和强度各不相同,但通常包括几周,每周一次或多次训练。包括一个以上疗程的所有干预措施在治疗多动症儿童的精细运动缺陷方面都是有效的,并且有广泛的其他积极结果。这些效果在随访中可以保持。结论:多动症儿童的精细运动训练非常有效,包括特定的精细运动和认知训练成分、某种身体活动、反馈机制或多模式治疗在内的多种方法都可以成功。培训项目需要根据多动症人群的具体特点量身定制。在这种情况下,使用严肃游戏的移动医疗方法可能很有前途,因为它具有很强的激励成分。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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