赵非一　段怡汝　夏小芥　沈骏良　李爱群　张浙元　燕海霞　许红

摘 要：为进一步指导及优化临床作业治疗方案，探讨以体育游戏模式对发展障碍儿童进行感觉统合训练干预后，患儿感觉统合失调症状的康复效果。23名有不同发展障碍的儿童接受为期4周，以体育游戏治疗为主的感觉统合训练，每周训练5 d（周一至周五），每天训练60 min。训练内容包括触觉训练、前庭平衡觉训练以及本体感觉训练。治疗前后及治疗结束后4周末（即第8周）通过简式儿童感觉处理能力剖析量表、Conners教师用评定量表以及DeGangi-Berk感觉统合测量工具进行评分。结果发现：（1）患儿经体育游戏训练后，各项感觉统合能力均有改善，存在显著性差异（P<0.05）；（2）训练具有远期效应，随访时受试儿童能力评分相比治疗前仍存在显著性差异（P<0.05）；（3）受训后，不同年龄组别间感觉统合能力的改善程度存在显著性差异（P<0.05），改善幅度由高到低依次为4～7岁组、8～11岁组、12～15岁组；（4）与训练刚结束时比较，随访时尽管感觉处理能力剖析量表与Degangi-Berk总积分显示有显著性差异（P<0.05），但3组量表各因子评分差异均无统计学意义（P>0.05）。试验过程中，所有受试儿童未出现不良反应，社会效度佳。结果表明，体育游戏型感觉统合训练对发展障碍儿童临床康复近期、远期疗效明显，且年龄越小，疗效越佳。

关 键 词：运动医学；体育游戏；感觉统合训练；作业治疗；发展障碍儿童

中图分类号：G804.5 文献标志码：A 文章编号：1006-7116（2016）04-0127-08

Evaluation of the therapy effects of sports games based on sensory integration theory on the clinical rehabilitation of children with development disabilities

ZHAO Fei-yi1，DUAN Yi-ru1，XIA Xiao-jie2，SHEN Jun-liang3，LI Ai-qun4，

ZHANG Zhe-yuan5，YAN Hai-xia6，XU Hong1

（1.Shanghai Municipal Hospital of TCM，Affiliated to Shanghai TCM University，Shanghai 200071，China；

2.Department of Education，East China Normal University，Shanghai 200062，China；3.Faculty of Medical Sciences，University of Groningen，Groningen 9700 AB，Netherlands；4.Periodical Press，Wuhan Sports University，Wuhan 430079，China；5.School of Haiyan Clinical Medicine，Zhejiang Pharmacevtical College，Haiyan 314300，China；6.Basic Medical，Shanghai University of Traditional Chinese Medicine，Shanghai 201203，China）

Abstract： In order to further guide and optimize clinical operating therapy plans， and to probe into the effects of rehabilitation of children with development disabilities from their sensory integration disorder symptoms after they are intervened by sensory integration training via a sports game mode， the authors carried out 4-week sensory integration training based mainly on sports game therapy on 23 children with different development disabilities， 5 days a week （Monday through Friday）， 60 minutes a day. The training contents include tactile sense training， vestibular balance sense training and proprioceptive sense training. Before and after the therapy and 4 weeks after the therapy （i.e. at the end of week 8）， the authors scored the children by using Simplified Children Sensory Processing Ability Analysis Form， Conners Evaluation Form Used by Teachers and DeGangi-Berk Sensory Integration Measurement Tool， and revealed the following findings： 1） after sports game training， various sensory integration abilities of the children with development disabilities were all improved， and there were significant differences （P<0.05）； 2） the training had a long-term effect： there were still significant differences （P<0.05） in the tested childrens ability scores measured in a follow-up visit， as compared with those measured before the therapy； 3） after the training， there were significant differences （P<0.05） in the degree of improvement of sensory integration ability between the groups of children of different ages， the magnitudes of improvement ranging from big to small were the aged 4～7 group， the aged 8～11 group and the aged 12～15 group； 4） although the total scores measured by Simplified Children Sensory Processing Ability Analysis Form and DeGangi-Berk Sensory Integration Measurement Tool in a follow-up visit were significantly different （P<0.05） as compared with those measured right after the training was completed， the differences in the scores for various factors in the three measurement forms were all statistically insignificant （P>0.05）. During the experiment， all the tested children had no adverse reaction， which means that the social validity is good. The said findings indicate that sports game type sensory integration training has significant near-term and long-term effects on the clinical rehabilitation of children with development disabilities， and the younger the children are， the better the therapy effect will be.

Key words： sports medicine；sports game；sensory integration training；operating therapy；children with developmental disabilities

美国疾病控制与预防中心将发展障碍定义为：一组不同且多样化的、由于精神心理和（或）身体损害造成的严重慢性综合征[1-2]，包括注意力缺陷多动障碍、自闭症谱系障碍、小儿脑性瘫痪、视力和听力障碍、精神心理发育迟缓、言语迟缓、唐氏综合症及其他先天性畸形等。流行病调查显示，在美国18岁以下的儿童及青少年中，17%受到不同程度发展障碍的影响；卫生经济学证实，发展障碍儿童相比其他正常同龄儿童入院率更高，给个人及社会医疗大环境都造成了严重经济负担[3]。……