脑瘫患儿引导式教育康复效果及相关因素分析

发布时间：2018-06-30 00:29

  本文选题：脑瘫儿童 + 引导式教育　； 参考：《吉林大学》2012年硕士论文

【摘要】：目的：了解天津市残疾人康复中心开展引导式教育三年来的工作成效，评价引导式教育康复效果，分析相关影响因素，探讨《脑瘫儿童综合能力发展评估表》在实际工作中的应用价值，促进脑瘫儿童取得更好康复效果。 方法：选取2009-2011年在天津市残疾人康复中心进行CE训练的脑瘫患儿作为研究对象，分别用体能、精细动作、语言、社交、智能、生活自理六大能区发育龄和发育商提高情况对于CE进行综合评估；从普通幼儿园选取30名健康儿童作为研究对象，评价《脑瘫儿童综合能力发展评估表》的重测信度和治疗师间的信度；以《北京-Gesell发育量表》作为校标，通过测试两表对应能区的相关性，评价《脑瘫儿童综合能力发展评估表》的校标效度；对可能影响CE的相关因素进行分析。 结果： ①基本情况：脑瘫儿童研究对象共72例，男34例，占47.2%；女38例，占52.8%。普通幼儿研究对象共30例，其中男18例，占60%；女12例，占40%。 ②《脑瘫儿童综合能力发展评估表》信度效度：治疗师间测试结果Spearman相关系数r_s值介于0.981~1.000之间； P＜0.001。重测结果Spearman相关系数r_s值介于0.957~0.981之间；与《北京-Gesell发育量表》对应能区之间Spearman相关系数r_s值介于0.858~0.973之间，P＜0.001。 ③引导式教育康复效果：六大能区的发育龄有效率介于84.7%~91.7%之间；发育商有效率介于70.8~76.4%之间。 ④相关因素对康复效果的影响：训练时间与体能、精细动作、社交/游戏、智能和语言沟通康复效果成正相关(P＜0.05)；以下因素分析均为排除训练时间影响后的结果：入园月龄＜48个月与≥48个月之间在体能、精细动作和生活自理等方面康复效果差异无统计学意义(P＞0.05)；≥48个月脑瘫患儿社交/游戏、智能和语言沟通效果好于＜48个月组(P＜0.05)。痉挛型脑瘫患儿六方面的康复效果好于非痉挛型，差异有统计学意义(P＜0.05)；不伴发其它残疾脑瘫儿童体能、精细动作、社交/游戏、智能、生活自理和语言沟通方面康复效果优于伴发其它残疾儿童(P＜0.05)；早产脑瘫儿童在精细动作、社交/游戏、生活自理、智能及语言沟通方面的康复效果好于非早产脑瘫儿童(P＜0.05）。 结论：①引导式教育康复方法能有效促进脑瘫儿童综合能力康复，表现为促进体能、精细动作、语言、社交、智能、生活自理六大能区发育龄和发育商提高。②《脑瘫儿童综合能力发展评估表》具有较高的信度与效度，，可以作为日常康复评估之用，但部分内容还需要标化修订。③总体来讲，训练时间、入园月龄、脑瘫类型、伴发残疾、致残危险因素等是影响康复效果的重要因素，但影响方面不同。I训练时间与康复效果成正相关，训练时间越长，康复效果越好。II入园月龄对康复训练效果有一定影响，大年龄组脑瘫儿童部分康复效果好于小年龄组。III痉挛型脑瘫儿童康复效果优于非痉挛型。IV不伴发残疾的脑瘫儿童的康复效果好于伴发残疾的脑瘫儿童。V早产脑瘫儿童康复效果好于非早产脑瘫儿童。
[Abstract]:Objective : To study the effect of guiding education for the disabled rehabilitation center of Tianjin in three years , evaluate the effect of guiding education and analyze the influencing factors , and discuss the application value of the comprehensive ability development evaluation chart of the children with cerebral palsy , and to promote the better rehabilitation effect of cerebral palsy children .

Methods : The children with cerebral palsy who underwent CE training in the rehabilitation center of the disabled in Tianjin from 2009 to 2011 were selected as the research subjects , and the comprehensive evaluation of CE was carried out with physical , fine action , language , social , intelligence , life self - care , developmental age and development quotient .
30 healthy children were selected from ordinary kindergartens as the research subjects , and the reliability of retest reliability and therapist was evaluated in the evaluation of comprehensive abilities of children with cerebral palsy .
Taking Beijing - Gesell development scale as the calibration standard , the correlation of the corresponding energy regions of the two tables was tested , and the calibration validity of the comprehensive ability development evaluation chart of the children with cerebral palsy was evaluated .
Analysis of factors that may affect CE .

Results :

( 1 ) Basic information : 72 cases of cerebral palsy children were studied , 34 cases were male , accounting for 47.2 % ;
38 cases were female , accounting for 52.8 % . Among them , there were 30 males and 18 females , accounting for 60 % .
12 cases were female , accounting for 40 % .

( 2 ) The reliability and validity of the evaluation of comprehensive ability of children with cerebral palsy : The correlation coefficient of man - man correlation coefficient between therapists and therapists ranged from 0.981 to 1.000 ;
The correlation coefficient r _ s was 0.957 ~ 0.981 .
The correlation coefficient ( r _ s ) was between 0.858 and 0.973 ( P < 0.001 ) .

( 3 ) The effect of guiding education was that the effective rate of development was between 84.7 % and 91.7 % .
The effective rate of development quotient ranged from 70.8 % to 76.4 % .

( 4 ) The influence of related factors on rehabilitation effect : training time is positively correlated with physical fitness , fine action , social / game , intelligence and language communication and rehabilitation effect ( P < 0.05 ) ;
The following factors were analyzed in order to eliminate the effect of training time : there was no significant difference in physical fitness , fine movement and living self - care between < 48 months and 鈮

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