CAJ | 학술논문

目的探讨小脑运动训练(DDAT)对不同亚型注意缺陷多动障碍(ADHD)伴直立平衡功能异常患儿的治疗作用.方法对符合美国《精神障碍诊断与统计手册(第4版)》ADHD诊断标准,伴直立平衡功能失调的91例ADHD患儿,其中,注意缺陷型ADHD(ADHD-I) 43例、多动-冲动型ADHD(ADHD-HI) 15例、混合型ADHD(ADHD-C) 33例均予DDAT治疗6个月,分别于DDAT治疗前、开始治疗后3个月和6个月、治疗结束后3个月对各亚型进行SNAP-Ⅳ量表评估,治疗前后进行直立平衡功能、Conners父母症状问卷分析.结果 ADHD-I、ADHD-HI、ADHD-C的注意缺陷评分治疗前(1.99±0.34、0.96 ±0.31、2.17 ±0.31)均高于治疗结束后3个月(1.19 ±0.45、0.81 ±0.28、1.32 ±0.37),ADHD-I和ADHD-C差异有统计学意义(P＜0.05).ADHD-I、ADHD-HI、ADHD-C治疗前和治疗结束后3个月的多动/冲动评分分别为0.81 ±0.35、2.01±0.35、1.96±0.33vs.0.45±0.33、0.79 ±0.41、1.10 ±0.35,各亚型差异均有统计学意义(P＜0.05).Conners父母症状问卷调查中,品行问题(1.11 ±0.48vs.0.76 ±0.44)、学习问题(1.97 ±0.58vs.1.60±0.67)、身心问题(0.61±0.49 vs.0.29±0.35)、多动-冲动(1.46±0.69vs.1.09 ±0.55)、焦虑(1.05±0.63vs.0.62±0.47)评分较治疗前均有显著降低,差异均有统计学意义(P＜0.05).平衡功能测试仪检测,治疗后平衡功能失调改善的有效率87.9％,亚型之间有效率差异无统计学意义(P＞0.05).结论 DDAT对有直立平衡功能异常的ADHD患儿安全有效,针对改善小脑功能的运动训练能明显改善ADHD患儿的症状和平衡功能.
목적 탐토소뇌운동훈련(DDAT)대불동아형주의결함다동장애(ADHD)반직립평형공능이상환인적치료작용.방법 대부합미국《정신장애진단여통계수책(제4판)》ADHD진단표준,반직립평형공능실조적91례ADHD환인,기중,주의결함형ADHD(ADHD-I) 43례、다동-충동형ADHD(ADHD-HI) 15례、혼합형ADHD(ADHD-C) 33례균여DDAT치료6개월,분별우DDAT치료전、개시치료후3개월화6개월、치료결속후3개월대각아형진행SNAP-Ⅳ량표평고,치료전후진행직립평형공능、Conners부모증상문권분석.결과 ADHD-I、ADHD-HI、ADHD-C적주의결함평분치료전(1.99±0.34、0.96 ±0.31、2.17 ±0.31)균고우치료결속후3개월(1.19 ±0.45、0.81 ±0.28、1.32 ±0.37),ADHD-I화ADHD-C차이유통계학의의(P＜0.05).ADHD-I、ADHD-HI、ADHD-C치료전화치료결속후3개월적다동/충동평분분별위0.81 ±0.35、2.01±0.35、1.96±0.33vs.0.45±0.33、0.79 ±0.41、1.10 ±0.35,각아형차이균유통계학의의(P＜0.05).Conners부모증상문권조사중,품행문제(1.11 ±0.48vs.0.76 ±0.44)、학습문제(1.97 ±0.58vs.1.60±0.67)、신심문제(0.61±0.49 vs.0.29±0.35)、다동-충동(1.46±0.69vs.1.09 ±0.55)、초필(1.05±0.63vs.0.62±0.47)평분교치료전균유현저강저,차이균유통계학의의(P＜0.05).평형공능측시의검측,치료후평형공능실조개선적유효솔87.9％,아형지간유효솔차이무통계학의의(P＞0.05).결론 DDAT대유직립평형공능이상적ADHD환인안전유효,침대개선소뇌공능적운동훈련능명현개선ADHD환인적증상화평형공능.
Objective To evaluate the effects of an exercise-based treatment programme (dyslexia,dyspraxia and attention-deficit treatment,DDAT) on various subtypes of attention-deficit/hyperactivity disorder (ADHD).Method Ninety-one ADHD children with standing balance dysfunction (ADHD-I 43,ADHD-HI 15 and ADHD-C 33) were given DDAT for 6 months,the efficacy of DDAT was evaluated before DDAT,three,six months after the treatment and three month after end of the treatment according to SNAP-Ⅳ,before and after the treatment by balancing function test and Conners Parents Rating Scale.Result Inattention subscale scores of ADHD-I,ADHD-HI and ADHD-C before and after the interventions were 1.99 ±0.34,0.96 ±0.31,2.17 ±0.31and 1.19 ±0.45,0.81 ±0.28,1.32 ±0.37,differences of ADHD-I and ADHD-C were significant (P ＜ 0.05),hyperactivity subscale scores of three subtypes of ADHD were 0.81 ±0.35,2.01 ±0.35,1.96 ±0.33 vs.0.45 ±0.33,0.79 ±0.41,1.10 ±0.35,there were significant differences as well (P ＜ 0.05).The score of hyperactivity symptom was reduced more compared to that of inattention symptom by the SNAP-Ⅳ scale parent forms.There were significant difference before and after the treatment based on Conners parent scale for conduct problem(1.11 ± 0.48 vs.0.76 ±0.44),learning problem (1.97 ±0.58 vs.1.60 ±0.67),psychosomatic problems(0.61 ±0.49 vs.0.29 ± 0.35),activity/ hyperactivity (1.46 ± 0.69 vs.1.09 ± 0.55) and anxiousness (1.05 ± 0.63 vs.0.62 ± 0.47) as well (P ＜ 0.05) ; the standing balance dysfunction improved for most of the children,total effective rate was 87.9％,no significant difference was found among the three subtypes (P ＞ 0.05).Conclusion DDAT is a safe and efficient intervention for the ADHD children with standing balance dysfunction,the improvement on hyperactivity symptom was better than that on inattention symptom.This study shows that an exercise-based treatment programme for cerebellum function improves symptoms of ADHD and balance function.