《中国康复理论与实践》

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (11): 1286-1295.doi: 10.3969/j.issn.1006-9771.2023.00.002

• 循证研究 • 上一篇    下一篇

残疾儿童水中运动康复的健康与功能效益：基于ICD-11和ICF的系统综述的系统综述

廖婷1, 丛芳2,3, 黄昆仑4()   

  1. 1.武汉体育学院水中康复与健身研究中心，湖北武汉市 430079
    2.中国康复研究中心北京博爱医院，北京市 100068
    3.首都医科大学康复医学院，北京市 100068
    4.深圳大学体育学院，广东深圳市 518060
  • 收稿日期:2023-10-04 修回日期:2023-10-09 出版日期:2023-11-25 发布日期:2023-11-30
  • 通讯作者: 黄昆仑(1985-)，女，硕士，副教授，硕士研究生导师，主要研究方向：体育与健康、大学生身体活动、运动康复。E-mail： huangkunlun@szu.edu.cn
  • 作者简介:廖婷(1982-)，女，汉族，湖北武汉市人，博士，副教授，主要研究方向：体育与健康、水中运动康复、适应性体育。
  • 基金资助:
    1.教育部人文社会科学研究项目(1926);2.湖北省教育科学技术研究计划重点项目(D20204103);3.湖北省高校优秀中青年科技创新团队资助项目(T202203)

Health and functional benefits of aquatic exercise rehabilitation for children with disabilities: a systematic review of systematic reviews based on ICD-11 and ICF

LIAO Ting1, CONG Fang2,3, HUANG Kunlun4()   

  1. 1. Aquatic Therapy Aand Fitness Center, Wuhan Sports University, Wuhan, Hubei 430079, China
    2. Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China
    3. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China
    4. Physical Education Institute of Shenzhen University, Shenzhen, Guangdong 518060, China
  • Received:2023-10-04 Revised:2023-10-09 Published:2023-11-25 Online:2023-11-30
  • Contact: HUANG Kunlun, E-mail： huangkunlun@szu.edu.cn
  • Supported by:
    Humanities and Social Science Research Project of the Ministry of Education(1926);Hubei Education Science and Technology Research Key Project(D20204103);Excellent Young and Middle-aged Scientific and Technological Innovation Teams in Hubei Universities(T202203)

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摘要：

目的 采用ICD-11和ICF的理论架构和编码方法，参照PRISMA指南，对有关残疾儿童参与水中运动康复的健康和功能效益的系统综述进行系统综述。

方法 采用主题词与关键词组合检索方式，检索2014年1月至2023年8月中国知网、PubMed、Web of Science、Embase发表的有关残疾儿童参与水中运动康复的系统综述，并进行系统综述。

结果 最终纳入7篇英文系统综述，来自6个国家，包括伊朗、巴西、西班牙、澳大利亚、美国、波兰；涉及69项随机对照试验，共1 825例参与者；主要来源于儿科物理和作业治疗、物理治疗与康复以及残疾儿童等领域期刊，发表日期主要集中在2014年至2023年。主要疾病包括智力残疾(唐氏综合征、轻度或高功能孤独症谱系障碍、Asperger综合征)、脑瘫(痉挛性脑瘫、痉挛性四肢瘫)、发育性精神协调障碍、注意力缺陷多动障碍等。纳入研究的样本中，功能障碍主要涉及意识功能(b110)、睡眠功能(b134)、注意力功能(b140)、记忆功能(b144)、心理运动功能(b147)、高水平认知功能(b164)、活动(d4)、人际交往和人际关系(d7)、社区生活(d910)、娱乐和休闲(d920)等。在身体活动领域，主要存在参与身体活动不足，很少参与水中运动，整体发展水平、身体发育、动作发展和运动能力发展水平较低。水中运动康复方案主要包括游泳练习，水中抗阻及呼吸训练，水中行走、跑步、跳跃，浅水站立运动，水中有氧活动、力量训练和耐力练习以及水上游戏、水疗项目。水中运动康复的干预强度为低至中等，干预频率为每次15~100 min，每周1~6次，持续6~40周。水中运动康复对残疾儿童的健康与功能效益主要体现在改善心肺功能，增强呼吸肌力量，改善核心肌肉力量，提升平衡与协调功能，提高有氧耐力，增强柔韧性，提升步行速度；降低体质量，优化体质量指数，降低体脂百分比以及腰围和腰高比；提高认知和智力功能，改善睡眠质量；对于孤独症谱系障碍儿童还可以促进沟通交流活动，减少重复刻板行为，提高游泳运动技能和能力，增加水中身体活动行为。

结论 水中运动康复能够改善残疾儿童的身体功能，促进活动与参与，提高整体健康、生活质量和福祉。

关键词: 残疾, 儿童, 水中运动, 康复, 水疗, 健康, 功能效益, 系统综述

Abstract:

Objective To conduct a systematic review of systematic reviews on benefits of health and functioning for children with disabilities in aquatic exercise rehabilitation, in reference to the PRISMA guidelines, based on ICD-11 and ICF.

Methods Systematic reviews about aquatic exercise rehabilitation for children with disabilities were searched in PubMed, Web of Science, Embase and CNKI from January, 2014 to August, 2023. A systematic review was conducted.

Results Seven English reviews were included from Iran, Brazil, Spain, Australia, USA and Poland, involving 69 randomised controlled trials with a total of 1 825 participants. They were mainly from the journals in the fields of pediatric physics and occupational therapy, physical therapy and rehabilitation, and children with disabilities, and the publication date was mainly from 2014 to 2023. The main types of diseases were intellectual and developmental disability (Down's syndrome, mild or high-functioning autism spectrum disorder, Asperger's syndrome), cerebral palsy (spastic cerebral palsy, spastic quadriplegia), developmental mental coordination disorder, attention deficit hyperactivity disorder, etc. The main impariment of functioning were consciousness function (b110), sleep function (b134), attention function (b140), memory function (b144), psychomotor function (b147), high-level cognitive function (b164), mobility (d4), interpersonal interactions and relationships (d7), community life (d910), recreation and leisure (d920). In the field of physical activity, the main barriers included insufficient participation in physical activity, less participation in aquatic exercise, low overall level of development, physical development as well as motor development and motor ability. The aquatic exercise rehabilitation program mainly included swimming exercises; water resistance and breathing training; water walking, running, jumping; shallow standing exercises; water aerobic activities, strength training and endurance exercises; as well as water games and spa programs. The intervention intensity of aquatic sports rehabilitation was low to moderate, and the frequency was 15 to 100 minutes a time, one to six times a week, lasting six to 40 weeks. The health and functional benefits of aquatic sports rehabilitation for children with disabilities were mainly reflected in improving cardiopulmonary function, enhancing respiratory muscle strength, improving core muscle strength, improving balance and coordination function, improving aerobic endurance, enhancing flexibility, and improving walking speed; reducing body mass, optimizing body mass index, reducing body fat percentage, waist circumference and waist-to-height ratio; improving cognitive and intellectual function, and improving sleep quality. For children with autism spectrum disorder, it could also promote communication activities, reduce repetitive stereotyped behaviors, improve swimming skills and abilities, and increase aquatic physical activity behaviors.

Conclusion Aquatic exercise rehabilitation can improve the body functions of children with disabilities, promote activity and participation, and enhance their overall health, quality of life and well-being.

Key words: disabilities, children, aquatic exercise, rehabilitation, hydrotherapy, health, functional benefit, systematic review

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