运动及康复训练改善儿童平衡功能的Scoping综述

doi:10.3969/j.issn.1006-9771.2021.05.008

《中国康复理论与实践》 ›› 2021, Vol. 27 ›› Issue (5): 553-562.doi: 10.3969/j.issn.1006-9771.2021.05.008

运动及康复训练改善儿童平衡功能的Scoping综述

赵盼超¹,梁晓¹,张子华^1,²,李嘉慧¹,文蕊香¹,纪仲秋¹()

^1.北京师范大学体育与运动学院，北京市 100875
^2.铜仁学院大健康学院，贵州铜仁市 554300

收稿日期:2020-03-26 修回日期:2021-04-18 出版日期:2021-05-25 发布日期:2021-05-26
通讯作者: 纪仲秋 E-mail:jizhongqiu61@bnu.edu.cn
作者简介:赵盼超(1994-)，女，汉族，河北沧州市人，博士研究生，主要研究方向：运动生物力学和儿童动作发展|纪仲秋(1961-)，男，汉族，博士，教授，博士生导师，主要研究方向：运动生物力学与人因工程学。
基金资助:
教育部基础教育监测中心课题(JCXQ-C-H-2)

Exercise and Rehabilitation Training for Children's Balance: A Scoping Review

Pan-chao ZHAO¹,Xiao LIANG¹,Zi-hua ZHANG^1,²,Jia-hui LI¹,Rui-xiang WEN¹,Zhong-qiu JI¹()

^1.College of Physical Education and Sports, Beijing Normal University, Beijing 100875, China
^2.School of Sports and Health Science, Tongren University, Tongren, Guizhou 554300, China

Received:2020-03-26 Revised:2021-04-18 Published:2021-05-25 Online:2021-05-26
Contact: Zhong-qiu JI E-mail:jizhongqiu61@bnu.edu.cn
Supported by:
Ministry of Education Basic Education Monitoring Center(JCXQ-C-H-2)

摘要/Abstract

摘要： 目的

对儿童平衡能力的运动及康复训练方案进行Scoping综述分析。

方法

主题词检索儿童平衡能力和运动/康复训练相关文献，数据库包括中国知网、维普数据库、PubMed和Web of Science，检索时间为建库至2021年3月17日。提取作者、发表时间、国家、受试者类型和年龄、研究工具、干预方案和时间、研究结果。

结果

共检索到文献2679篇，最终纳入34篇，来自13个国家，主要来源于医学、运动科学、残疾人康复等领域期刊，发表时间主要在2010年以后。评估方法主要为测试法和量表法。测试法主要包括足底压力测试系统、测力台、平衡测试系统；量表法主要为Berg平衡量表、儿童平衡量表、粗大运动功能测评量表、儿科残疾评定量表、Bruininks-Oseretsky动作熟练度测试等。涉及的运动和康复训练包括平衡训练、交互式电脑游戏、虚拟现实干预和体育运动项目4类；对疾病患儿的干预包括力量训练、全身振动训练、Wii-Fit平衡视频游戏、虚拟现实跑步机训练等，对正常儿童的干预主要包括溜冰、太极拳、体操等项目。

结论

促进儿童平衡能力改善的研究国内外存在差异。国外对疾病患儿研究的类型较多，年龄范围较大，评价方法多样，干预方式较先进；而国内研究干预时间较长，受试者人数较多，同时对正常发育儿童研究较多。未来应增加对3岁前疾患儿童的关注，早发现，早治疗；在关注即刻干预期效果的同时，也应关注后续效果。

关键词: 儿童, 平衡, 运动, 康复, 综述

Abstract: Objective

To analyze the exercise and rehabilitation training programs for children's balance ability using scoping review.

Methods

The literatures about children's balance ability, exercise and rehabilitation training were retrieved from CNKI, VIP, PubMed and Web of Science, until 2021-03-17. The authors, published time, countries, objects and their ages, study tools, interventions and the time, and outcomes were extracted.

Results

A total of 2679 literatures were returned, 34 of which were enrolled, which came from 13 countries, and were almost published in journals of medicine, sports science, and rehabilitation and disabilities. The literatures were mainly published after 2010, investigate with measurements and scales. The measurements mainly included foot pressure system, force platform, Biodex balancer, etc.; and the scales mainly included Berg Balance Scale, Pediatric Balance Scale, Gross Motor Function Measure, Pediatric Evaluation of Disability Inventory, and Bruininks-Oseretsky Test of Motor Proficiency, etc. There were four typies of program: balance training, interactive computer games, virtual reality and sports events. Interventions for sick children included strength training, whole-body vibration training, Wii-Fit balance games and virtual reality treadmill training, etc. Sports for healthy children mainly included skating, Taiji Quan and gymnastics, etc.

Conclusion

There are differences in the researches for children's balance ability at home and abroad. The abroad researches focus on the children with various diseases, in a larger age range, using more evaluation tools and more intervention methods. However, Chinese researches are usually for a longer intervention time, more subjects, and focusing more on healthy children. It is needed to pay more attention on children with diseases before three years old, for early diagnosis and treatment. Long-term effects should be observed other than immediateness after intervention.

Key words: children, balance, sports, rehabilitation, review

中图分类号:

赵盼超,梁晓,张子华,李嘉慧,文蕊香,纪仲秋. 运动及康复训练改善儿童平衡功能的Scoping综述[J]. 《中国康复理论与实践》, 2021, 27(5): 553-562.

Pan-chao ZHAO,Xiao LIANG,Zi-hua ZHANG,Jia-hui LI,Rui-xiang WEN,Zhong-qiu JI. Exercise and Rehabilitation Training for Children's Balance: A Scoping Review[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(5): 553-562.

图/表 3

图1

表1

外文文献的Scoping分析"

文献	国家	研究对象	年龄(岁)	样本量 (T/C, n)	评价工具	干预方法	干预时间	结果
Hsieh等^[21] (2020)	中国	脑瘫并发运动障碍患儿	6~10	28/28	Zebris FDM足底压力中心测试系统；PBS	T：平衡板电脑游戏 C：正常电脑游戏	12周	姿势摆动减小，平衡功能改善
Yaz?c?等^[22] (2019)	土耳其	先天性痉挛型偏瘫脑瘫患儿	5~12	12/12	单腿站立测试；PBS	T：标准物理治疗+机器人步态训练 C：标准物理治疗	12周	功能性步行、肌力、平衡、步速和耐力提高
Lazzari等^[23] (2016)	巴西	脑瘫患儿	4~12	10/10	测力台足底压力中心测试；计时起立-行走测试；PBS	T：连续经颅直流电刺激+虚拟现实训练 C：虚拟现实训练	2周	静态和功能平衡改善
Gatica-Rojas等^[24](2017)	智利	痉挛型偏瘫脑瘫/痉挛型双侧脑瘫患儿	7~14	16/16	AMTI测力台	T：任天堂Wii平衡板疗法 C：标准物理疗法	6周	偏瘫患儿站立平衡改善，干预结束后2~4周，疗效下降
El-Shamy^[25] (2017)	埃及	痉挛型双侧脑瘫患儿	8~12	15/15	Biodex平衡测试系统	T：传统理疗+减重平板训练 C：传统理疗	3个月	步态、平衡功能改善
Tarakci等^[26] (2016)	美国	脑瘫患儿，双瘫、偏瘫、运动障碍	5~18	19/19	功能性前伸试验；功能性侧伸试验；计时起立-行走测试；坐-立试验	T：神经发育疗法+Wii-Fit平衡视频游戏 C：神经发育治疗+常规平衡训练	12周	静态和动态平衡改善
Cho等^[27] (2016)	韩国	下肢痉挛型脑瘫患儿	4~16	9/9	GMFM；PBS	T：虚拟现实跑步机训练 C：常规跑步机训练	8周	步态、平衡、肌力和粗大运动功能改善
Grecco等^[28] (2013)	巴西	脑瘫患儿	3~12	7/8	BBS	T：跑步机步态训练 C：地面步态训练	7周	功能平衡改善
Brien等^[29] (2011)	加拿大	脑瘫患儿	13~18	4(前后对照)	CB&M平衡量表；6分钟步行测试	强化虚拟现实干预每天90 min	5 d	功能平衡和活动能力改善，持续至少1个月
Shumway-Cook等^[30] (2003)	美国	痉挛型双瘫和偏瘫脑瘫患儿	7~13	6(前后对照)	测力台足底压力中心测试	每天100次平台扰动训练	5 d	姿势控制能力改善，持续至少1个月
Elhinidi等^[31] (2016)	埃及	痉挛型偏瘫脑瘫患儿	9~15	15/15	Biodex平衡测试系统	T：常规物理治疗+双任务训练方案 C：常规物理治疗	6周	姿势稳定性改善
El-Basatiny等^[32](2015)	埃及	痉挛型偏瘫脑瘫患儿	10~14	15/15	Biodex平衡测试系统	T：常规物理治疗+逆向步行训练 C：常规物理治疗	12周	姿势稳定性改善
Duarte等^[33] (2014)	巴西	痉挛型脑瘫患儿	5~12	12/12	PBS；PEDI	T：跑步机训练+经颅直流电刺激 C：跑步机训练	2周	静态平衡和功能表现改善
Grecco^[34] (2013)	巴西	脑瘫患儿	3~12	17/18	6分钟步行试验；PEDI；BBS；GMFM	T：跑步机步态训练 C：地面步态训练	7周	T效果更优，并有较好的后续效果
Prosser等^[35] (2018)	美国	脑瘫患儿	1~3	21/21	GMFM；早期临床评估；测力台足底压力中心测试；三维加速度传感器	T：iMOVE疗法 C：传统疗法	12周	姿势稳定性改善
Eid^[36] (2015)	埃及	唐氏综合征患儿	8~10	15/15	Biodex平衡测试系统；测力计	T：常规物理治疗+全身振动训练 C：常规物理治疗	6个月	平衡和肌力改善
Gupta等^[37] (2011)	印度	唐氏综合征患儿	7~15	12/11	手持测功机；Bruininks-Oseretsky运动能力测试	T：正常活动+下肢渐进阻力训练和平衡训练 C：正常体育活动	6周	力量和平衡功能改善
Jelsma等^[38] (2014)	荷兰	发育协调障碍患儿(T)/正常发育儿童(C)	6~12	28/20	儿童运动协调能力评估量表；Bruininks-Oseretsky量表中的协调、平衡和跑步敏捷性测试	Wii-Fit平衡游戏干预	6周	动态平衡控制改善
Kordi等^[39] (2016)	伊朗	发育性协调障碍患儿	7~9	15/15	Bruininks-Oseretsky-2运动能力测试	T：力量训练(柔韧疗法+弹性运动) C：常规体育课程	12周	肌力、静态平衡改善，对动态平衡无效
Tsimaras等^[40] (2012)	希腊	轻度智力低下患儿	18	10/17	动态平衡能力测试台(16020 Stabilometer)	T：希腊传统舞蹈训练 C：不参加训练	16周	动态平衡功能改善
Andrysek等^[41](2012)	加拿大	单侧下肢截肢患儿	8~18	6/10	测力台足底压力中心测试；CB&M平衡量表	T： Wii-Fit平衡游戏 C：不参加训练	4周	姿势控制改善，但长期效果不清
Rine等^[42] (2004)	美国	感觉神经性听力损失与前庭障碍患儿	3~8.5	10/11	旋转椅测试；SMART平衡测试系统；皮博迪动作发展量表	T：协调训练、视觉运动训练、强调视觉和体感意识的平衡训练 C：语言发展训练	12周	姿势控制、动作发展改善
Keller等^[43] (2014)	德国	正常发育儿童	12~13	17/13	平衡测试装置	T：8节溜冰课 C：普通体育课	4周	平衡功能改善

表1

表2

中文文献的Scoping分析"

文献	研究对象	年龄 (岁)	样本量 (T/C, n)	评价工具	干预方法	干预时间	结果
侯晓晖等^[10] (2013)	痉挛型脑瘫患儿	9~10	12/12	BBS	T：常规康复+Halliwick技术下游泳训练 C：常规康复疗法	4个月	平衡功能改善
王军等^[11] (2018)	痉挛型脑瘫患儿	2~6	49/48	BBS	T：常规训练+悬吊运动训练 C：常规训练	6个月	平衡功能改善
杨李^[12] (2009)	脑瘫患儿，包括痉挛型、不随意运动型、共济失调型、肌张力低下型、混合型	1~13	60/55	GMFM	T：引导式教育结合Frenkel训练法 C：常规平衡训练	6个月	平衡功能改善
杜佳音等^[13] (2017)	痉挛型双瘫脑瘫患儿	5~12	14/14	BBS	T：常规康复+下肢康复器训练 C：常规康复	3个月	平衡功能改善
陈娟娟等^[14] (2020)	并发感觉统合失调的脑瘫患儿	4~6	33/32	BBS；Tetrax平衡仪	T：小组感觉统合训练模式 C：一对一感觉统合训练模式	3个月	平衡功能改善
李伟艳等^[15] (2013)	中度智力障碍患儿	9~13	11/9	三维测力台、前庭功能转椅	T：核心肌力训练 C：无介绍	12周	平衡功能改善
程嘉等^[16] (2005)	注意缺陷多动障碍患儿	10~14	29/29	NeuroCom平衡仪	T：Balance Master的各种训练 C：常规体育活动	2~4个月	姿势稳定性提高
姜桂萍等^[17] (2016)	正常发育儿童	3~6	30/30	Tekscan足底压力测试系统	T：动作发展视角下韵律性身体活动 C：一般韵律性身体活动	1年	静态平衡功能改善
王佳丽等^[18] (2016)	正常发育儿童	5	34/34	Footscan平衡仪测试系统	滚翻组(T)：滚翻运动拍球组(C)：拍球运动	9周	静态平衡功能改善
米思奇等^[19] (2016)	正常发育儿童	10~11	24/24	BioDex平衡测试仪	T：24式太极拳 C：正常体育活动	12周	平衡功能改善，主要体现在前后方向
马俊杰等^[20] (2001)	正常发育儿童	4~6	31/35	PJ-I电脑型人体平衡功能检测仪	T：正常体育活动+体操运动 C：正常体育活动	3个月至两年	平衡功能改善

表2

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运动及康复训练改善儿童平衡功能的Scoping综述

Exercise and Rehabilitation Training for Children's Balance: A Scoping Review

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