Rett综合征/Rett相关疾病儿童的感觉统合和功能延伸

IF 1.7 Q2 PEDIATRICS Clinical Medicine Insights-Pediatrics Pub Date : 2019-08-01 DOI:10.1177/1179556519871952
Wendy Drobnyk, K. Rocco, S. Davidson, S. Bruce, Fang Zhang, S. Soumerai
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引用次数: 6

摘要

背景:功能性手技能的丧失是Rett综合征的主要特征。刻板印象、运动障碍和其他感觉处理问题严重限制了个体接触和维持抓握物体的能力。这种功能性伸展和抓握能力的丧失严重限制了他们参与自助、游戏和学校相关活动的能力。我们提出,Ayres感觉统合(ASI)治疗可以改善感觉加工和运动规划,这将为提高对物体的把握奠定感觉-运动基础,这是发展手部功能使用的重要第一步。目的:探讨ASI治疗对Rett综合征/Rett相关疾病患儿伸手及抓握率的影响。方法:我们使用中断时间序列设计来测量干预开始和停止后发生的结果变量的变化。我们分析了基线期、干预期和干预后7个月的每日视频观察。结果:在基线期间,抓取率中度下降。从基线结束到干预后结束,抓握率增加了15%。到达率没有显著变化。结论:本研究提供的初步数据显示,在ASI治疗后,Rett综合征儿童的手部掌握能力有很小的改善;需要在不同环境下进行更大规模的研究,以确定这种方法的有效性。本研究表明,中断时间序列研究设计为评估罕见疾病儿童的干预措施提供了有效的模板。
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Sensory Integration and Functional Reaching in Children With Rett Syndrome/Rett-Related Disorders
Background: The loss of functional hand skills is a primary characteristic of Rett syndrome. Stereotypies, dyspraxia, and other sensory processing issues severely limit the individual’s ability to reach toward and sustain grasp on objects. This loss of functional reach and grasp severely limits their ability to participate in self-help, play, and school-related activities. We proposed that Ayres Sensory Integration (ASI) treatment would improve sensory processing and motor planning, which would lay the sensory-motor groundwork for improving grasp of objects, an important first step in developing functional hand use. Objective: We examined effects of ASI treatment on rate of reaching and grasping for children with Rett syndrome/Rett-related disorders. Methods: We used an interrupted time series design to measure changes in outcome variables occurring after intervention initiation and cessation. We analyzed daily video observations during baseline, intervention, and post-intervention periods, over a span of 7 months. Results: During baseline, rate of grasping declined moderately. There was a 15% increase in grasping from the end of baseline to end of the post-intervention period. There was no significant change in rate of reaching. Conclusions: This study provides preliminary data showing very small improvements in hand grasp of children with Rett syndrome following ASI treatment; larger studies in diverse settings are needed to establish the effectiveness of this approach. This study shows that an interrupted time series research design provides a valid template for evaluating interventions for children with rare disorders.
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