基于ICF成年残疾人休闲体育活动与功能康复的Scoping综述

doi:10.3969/j.issn.1006-9771.2020.12.002

Abstract

Abstract:

Objective To analyze the categories and its relations of recreational physical activities and rehabilitation exercise for adult with disabilities based on the theory and method of International Classification of Functioning, Disability and Health (ICF).Methods An evidence-based scoping review had been implemented. We had developed the framework and coding approaches for recreational physical activities, rehabilitation exercise and functional improvement for the adults with disabilities based on evidence-based literature review. The literature related to recreational physical activities and rehabilitation exercise of adult with disabilities was searched by subject retrieval method. The retrieval database in Chinese included CNKI and Wanfang database, and the retrieval database in English included PubMed and Web of Science. The retrieval time was from establishment to July 31, 2020. The authors, countries, published time, published journals, research objectives, object of the study and their ages, data collection tool, and the key findings were extracted. Results A total of 2476 literatures were returned, and 18 of them were enrolled, which were published in 14 countries, and most were published in journals on topics related to medicine, public health, exercise and people with disabilities. They were mainly published from 2010 to 2020, and mainly used questionnaire survey, measurement and interviewing method. There were three typical recreational physical activities: physical fitness activities, skills activities and sports activities, mainly including Taiji Quan, wheelchair basketball, leisure outdoor activities, community recreational sports activities and rehabilitation exercises, etc. According to the framework of ICF, recreational physical activities promote functional rehabilitation for adults with disabilities, including physical functions (b1 mental function; b4 cardiovascular, blood, the function of the immune system and respiratory system; b5 digestion, metabolism and function of the endocrine system; and b7 nerve musculoskeletal function related to movement), and activities and participation (d1 study and application of knowledge; d2 the general tasks and requirements; d4 activity; d5 self-care; d7 interpersonal communication and interpersonal relationship; and d9 community, social and civic life). The evidences showed benefits of improvement in the fields of body mass index, body index, athletic ability, balance ability, and cognitive function. There were more gains at individual levels, including support, coping with stress, self-concept development, life satisfaction, happiness, exercise self-efficacy, health perception, etc. The environmental and personal factors had effects on the performance of activity and participation in recreational physical activities, including e1 products and technologies, e4 attitude, e3 support and interpersonal relationships, e5 service system and policy, as well as attitudes and support of family members and colleagues, interpersonal relationships, social support, transportation, equipment and facilities, and policies. Conclusion Rehabilitation exercise is an important part of health-related services. We scoped the recreational physical activities and its functional effects for adults with disabilities. The categories and structure of recreational physical activities and rehabilitation exercises were constructed based on ICF. Aligning rehabilitation exercises and relevant factors to ICF, the recreational activities and rehabilitation exercises had been reviewed and discussed and several recommendations for further studies had been drawn.

Key words: recreational physical activity, functional rehabilitation, International Classification of Functioning, Disability and Health, adult with disabilities, scoping review

CLC Number:

CUI De-gang,QIU Fen,QIU Fu-bing,HUANG Tian,LI Zhong-hao,ZHANG Ya-ru,ZHANG Xiao-qiang,HOU Ying. Recreational Physical Activity and Functional Rehabilitation for Adult with Disability Based on ICF: A Scoping Review[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(12): 1373-1382.

Figures/Tables 3

分析架构与类别		内容定义
休闲体育活动形式	体适能类活动	与体适能相关的活动常包括：肌肉力量体适能活动,如哑铃、深蹲、纵跳、引体向上等;肌肉耐力体适能活动,如长跑、游泳、自行车等;心肺耐力体适能活动,如健步走、慢跑等各类有氧活动;柔韧性体适能活动,如瑜伽、普拉提、舞蹈等
	技能类活动	与技能相关的活动常包括：粗大/精细技能活动,如举起、拾起、推、拉、搬运、抓住等;基本动作技能活动,如走、跑、跳、投掷、爬等;移动/转移技能活动,如步行、移动自身、交通往来等
	运动项目类活动	与体育运动有关的体育活动项目常包括竞技类和休闲类两类。竞技类包括篮球、足球、排球、网球、乒乓球、羽毛球、游泳、自行车、举重、拳击、滑冰等;休闲类包括徒步、瑜伽、普拉提、舞蹈、健身体操、太极拳、跑步、飞镖、毽球、台球、保龄球、高尔夫、骑马、户外活动、日常生活活动等
休闲体育活动益处	身体功能	ICF中身体功能包括8大领域,休闲体育活动对成年人的益处主要体现在身体功能的保持和改善,包括精神功能,感觉和疼痛功能,发音和言语功能,心血管、血液、免疫和呼吸系统功能,消化、代谢和内分泌系统的功能,泌尿生殖和生育功能,神经骨骼肌肉和运动有关的功能,皮肤和有关结构的功能
休闲体育活动益处	活动和参与	ICF中活动和参与包括9大领域,休闲体育活动对成年人活动和参与上的益处是发展了相关的功能,保持、提高或改善了活动能力和社会适应性,包括学习和应用知识,一般任务与要求,交流,活动,自理,家庭生活,人际交往和人际关系,主要生活领域,社区、社会和公民生活
影响因素	用品和技术	参与休闲体育活动所需的器材辅具,如公共建筑和设施、交通工具、活动场地、器材、设施、辅助用具、各类球和球拍、瑜伽垫、哑铃、杠铃、护腕、护膝等
	自然环境和对环境的人为改变	参与休闲体育活动的运动环境,包括自然地理环境、空气质量、气候条件和开展活动项目的周围环境,常包括社区、单位、家庭等各种活动所涉及的场所和场地
	态度	参与休闲体育活动的心理环境,常包括家人、同伴、朋友社区成员、同事等的态度,社会观念、参与积极性、自我认知、自信、安全感、紧张、焦虑等
	支持和相互关系	参与休闲体育活动的社会环境,常包括家人、同伴、朋友社区成员、同事等的支持及相互关系等
	服务、体制和政策	参与休闲体育活动的社会环境,常包括体制和政策的完善、相关制度的建立、社区活动场所的开发与使用、社会关注、社会态度、信息传播与推广、资金管理与投资等
	个人因素	性别、年龄、种族、教育、职业、生活方式、锻炼习惯等

研究	国家	受试者	残疾类别	方法与工具	休闲体育活动方式	功能康复结果	影响因素
Rosly等^[14](2018)	澳大利亚	肢体残疾者	肢体残疾	问卷调查体育活动量简表、运动障碍量表	体适能类、技能类、运动项目类活动：休闲时间体育活动	未涉及	用品和技术(e1)(器材辅具)：器材设施、交通支持和相互关系(e3),服务、体制和政策(e5)(社会环境)：人际关系、社区、政策个人因素：年龄、种族、健康状况
Moss等^[19](2020)	英国	身体残疾的俱乐部成员	肢体残疾	半结构化访谈	运动项目类活动(竞技类)：社区俱乐部的轮椅篮球	精神功能(b1)、神经肌肉骨骼和与运动有关的功能(b7)：改善身心健康,独立性,自我接受人际交往和人际关系(d7)：积极的社会互动	未涉及
Doistua等^[20](2020)	西班牙	残疾青年	未分类	问卷调查	体适能类、技能类、运动项目类活动：积极的休闲活动	一般任务和要求(d2)、社区、社会和公民生活(d9)：促进自我管理精神功能(b1)：幸福感、生活满意度	未涉及
Yoon等^[21](2018)	韩国	弱智成年人	智力残疾	实验干预简易机体功能评估法	体适能类活动(肌肉力量、肌肉耐力)：抗阻训练	精神功能(b1)：改善认知功能神经肌肉骨骼和与运动有关的功能(b7)：改善身体功能	未涉及
Cha等^[22](2020)	韩国	智障人士	智力残疾	实验干预准实验设计	运动项目类活动(休闲类)：太极拳	消化、代谢和内分泌系统(b5)：改善体质量指数,降低空腹血糖心血管、血液、免疫和呼吸系统功能(b4)：增加高密度脂蛋白	未涉及
Michalsen等^[23] (2020)	挪威	智障人士	智力残疾	小组访谈	体适能类、技能类、运动项目类活动：休闲活动,体育活动	未涉及	支持和相互关系(e3)(社会环境)：人际关系、社会支持、交往互动
Han等^[24](2019)	美国	残疾人	未分类	问卷调查：应对策略、社会支持和休闲参与度	体适能类、技能类、运动项目类活动：休闲活动、体育活动	学习和应用知识(d1)：应对压力,解决问题人际交往和人际关系(d7)：获得社会支持	未涉及
Mihaila等^[25](2020)	美国	智障成年人	智力残疾	每天日记深入描述在7 d内的平均每日休闲活动	运动项目类活动(日常生活活动)：日常休闲体育活动	社区、社会和公民生活(d9)：自我发起,主动参与	态度(e4)(心理环境)、支持和相互关系(e3)(社会环境)：家庭成员、同事个人因素：家庭生活习惯
Bahmani等 ^[26](2019)	伊朗	多发性硬化症导致肢体残疾者	肢体残疾	问卷测量脑电图	体适能类、技能类、运动项目类活动：定期参加休闲运动(每次60分钟)	精神功能(b1)：改善睡眠,抑郁,疲劳,异常感觉、认知能力	未涉及
Avvai等^[27](2015)	瑞典	残疾者	未分类	问卷调查弗朗西依活动指数评估参与度	运动项目类活动(休闲类)：家庭杂务,休闲/工作和户外活动	神经肌肉骨骼和与运动有关的功能(b7)：提高步行能力人际交往和人际关系(d7)、社区、社会和公民生活(d9)：社交活动的能力	未涉及
Liu-Ambrose等 ^[28](2015)	加拿大	慢性脑卒中致残者	肢体残疾	问卷调查	体适能类、技能类、运动项目类活动：运动加娱乐活动(2节运动加1节休闲活动)	精神功能(b1)：改善执行功能,选择性注意和工作记忆	未涉及
Blauwet等^[29] (2019)	美国	残疾人	未分类	文献资料法	体适能类、技能类、运动项目类活动：社区体育活动参与(体育锻炼、娱乐活动)	神经肌肉骨骼和与运动有关的功能(b7)：促进神经恢复	未涉及
Kim等^[30](2018)	韩国	肢体残疾人	肢体残疾	问卷调查休闲活动涉入量表、领悟社会支持评定量表、生活满意度量表	体适能类、技能类、运动项目类活动：休闲活动	人际交往和人际关系(d7)、社区、社会和公民生活(d9)、精神功能(b1)：促进社会支持、健康感知、生活满意度	未涉及
Fiorelli等^[31](2019)	巴西	智障残疾人	智力残疾	实验干预问卷调查	体适能类活动(肌肉力量、肌肉耐力)：高强度间歇训练与连续中等强度训练	精神功能(b1)：改善认知表现	未涉及
Okrzymowska等^[32] (2019)	波兰	残疾游泳者	未分类	实验干预	体适能类活动(心肺耐力)：吸气式肌肉训练	心血管、血液、免疫和呼吸系统功能(b4)：肺通气参数和呼吸肌力量显著改善	未涉及
李宁^[33]	中国	社区残疾人	未分类	实验干预 Barthel指数测定	运动项目类活动(休闲类)：健康体操	活动(d4)、自理(d5)：提高日常生活能力	未涉及
Krops等^[34](2020)	荷兰	肢体残疾人	肢体残疾	问卷调查 Activ8加速度计和改编的SQUASH评估增进健康的体育活动的简明问卷测量身体活动	体适能类(心肺耐力)、技能类活动(移动/转移技能)：Activity Coach +	消化、代谢和内分泌系统(b5)：改善了体质量指数神经肌肉骨骼和与运动有关的功能(b7)、活动(d4)：改善了步行能力、运动能力、活力、平衡能力	未涉及
Clement等^[35] (2018)	法国	肢体残疾人	肢体残疾	客观测量内隐和外隐刻板印象	体适能类、技能类、运动项目类活动：参加体育活动(娱乐性的体育活动、体育锻炼)	精神功能(b1)、神经肌肉骨骼和与运动有关的功能(b7)：获得热情和能力,运动自我效能,减少内隐刻板印象	未涉及

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Recreational Physical Activity and Functional Rehabilitation for Adult with Disability Based on ICF: A Scoping Review

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