任务导向训练改善发育性协调障碍儿童基本动作技能效果的系统评价

Systematic review of the effect of task-oriented training on fundamental movement skills in children with developmental coordination disorder

摘要

目的 系统分析任务导向训练对发育性协调障碍(DCD)儿童基本动作技能的影响,为促进DCD儿童基本动作技能改善提供依据。方法 通过中国知网、PubMed等中外文数据库检索任务导向训练改善DCD儿童基本动作技能效果的随机对照试验,检索时间为2010年1月—2024年9月。 由2名研究者独立进行文献筛选、数据提取和质量评价。采用物理治疗证据数据库(PEDro)量表评价纳入文献的方法学质量,对训练类型、训练参数及结局指标进行定性综合分析。结果 最终纳入14篇文献,共纳入DCD 儿童300例,对照组297例。PEDro量表平均得分为6分(满分为11分),研究质量中等或较好。不同类型的任务导向训练能显著改善DCD儿童的基本动作技能,其中,基本动作技能训练可以有效改善粗大和精细动作技能;任天堂体感训练、跆拳道训练、特定任务平衡训练、蹦床训练及水中运动疗法均能改善稳定性技能。训练时间、频率和周期是影响基本动作技能效果的重要因素,目前证实有效的干预研究多采用每次30~45min,每周1~2次,8~12周的任务导向训练方案。结论 任务导向训练不仅能提高DCD儿童的粗大和精细动作技能,还能在中枢神经系统的可塑性中发挥重要作用。但这一效应的潜在机制、影响因素及剂量关系仍需进一步探究。

Abstract

Objective To systematically analyze the effect of task-oriented training on fundamental movement skills in children with developmental coordination disorder (DCD), so as to provide reference for promoting fundamental movement skills in these children. Methods Randomized controlled trials on the effect of task-oriented training on fundamental movement skills of DCD children were retrieved from Chinese and foreign databases such as CNKI and PubMed from January 2010 to September 2024.Two reviewers independently performed study selection, data extraction, and quality assessment.The methodological quality of included studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale.A qualitative synthesis was conducted to analyze training types, intervention parameters, and outcome measures. Results Fourteen RCTs were included, involving 300 children with DCD aged 4 - 12 years and 297 controls.The mean score of PEDro was 6 (out of 11), indicating moderate to good methodological quality.The included studies demonstrated that various types of task-oriented training improved fundamental movement skills in children with DCD.Specifically, fundamental movement skills training improved gross and fine motor skills, while Nintendo Wii training, taekwondo training, task-specific balance training, trampoline training, and aquatic therapy improved stability skills.Regarding intervention parameters, training programs of 30 - 45 minutes per session, 1 - 2 times per week, for 8 - 12 weeks were most commonly reported in the included studies. Conclusions Task-oriented training not only improves gross and fine motor skills in children with DCD, but also plays an important role in the central nervous system and plasticity.However, the underlying mechanisms, influencing factors and dose-effect relationships of this effect still need to be further explored.

关键词

任务导向训练 / 发育性协调障碍 / 儿童 / 基本动作技能 / 系统综述

Key words

task-oriented training / developmental coordination disorder / children / fundamental movement skills / systematically review

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基金资助

国家社会科学基金一般项目(22BTY051)