数字赋能技术促进智力与发展性残疾儿童身体活动和健康的系统综述

doi:10.3969/j.issn.1006-9771.2024.05.001

摘要/Abstract

摘要：

目的系统综述数字赋能技术(DET)促进智力与发展性残疾(IDD)儿童身体活动和健康的效益。

方法从PubMed、Embase、Web of Science、PsycINFO和中国知网中，检索2014年至2023年DET在IDD儿童身体活动中的应用相关文献，对文献进行质量评价，对高质量随机对照研究(RCT)进行系统综述。

结果最终纳入8项RCT，来自中国、美国、意大利、韩国4个国家，涉及376例儿童，主要来源于智力残疾应用、发展性残疾研究、临床医学等领域期刊。发表时间主要集中在2018年至2023年。研究对象年龄7~18岁，涵盖智力残疾(包括唐氏综合征)、孤独症和其他发展性残疾。采用的技术包括可穿戴技术、移动健康指导和监测的云计算技术、虚拟现实和增强现实，以及动感游戏技术，设备包括主动视频游戏、Fitbit智能设备、Wii Fit平衡游戏、Stepmania节奏视频游戏、Xbox Kinect系统、VZFit传感器和CoTras认知康复电脑游戏等，虚拟身体活动包括拳击、田径、保龄球、乒乓球、沙滩排球、足球、棒球、滑雪、网球、高尔夫、飞镖、美式足球、射击、跳跃、慢跑和跳绳等。干预频率为每次20~45 min，每周1~5次，持续4~12周；在家庭、特殊教育学校和康复机构中进行。健康效益主要体现在提高身体活动水平、改善身体功能，以及提高运动功能和日常生活活动能力。

结论将DET应用到身体活动领域，能提高IDD儿童在虚拟环境下、学校、社区以及康复机构中的身体活动参与水平，改善上下肢活动功能、粗大运动功能和肌肉力量，提高静态平衡功能、运动协调和感觉运动功能，减少久坐行为发生，提升认知、日常生活活动能力和社交能力。

关键词: 智力与发展性残疾, 儿童, 青少年, 数字赋能技术, 身体活动, 系统综述

Abstract:

Objective To systematically review the benefits of digital empowerment technologies (DET) in promoting physical activity and health among children with intellectual and developmental disabilities (IDD).

Methods Literature was retrieved from PubMed, Embase, Web of Science, PsycINFO and CNKI, for randomized controlled trials (RCT) published from 2014 to 2023 on the application of DET in physical activity among children with IDD. The quality was assessed, and high-quality RCT was systematically reviewed.

Results Eight high-quality RCT were included, originating from four countries, namely China, the United States, Italy and South Korea, with 376 children with IDD, main published in the journals about intellectual disability applications, developmental disability research and clinical medicine, from 2018 to 2023. The children aged seven to 18 years, suffered from intellectual disabilities (including Down syndrome), autism and other developmental disabilities. The technologies could be summarized in wearable technology, cloud computing guided and monitored by mobile health, virtual reality and augmented reality, and active video gaming technologies. The devices involved active video games, Fitbit smart devices, Wii Fit balance games, Stepmania rhythm video games, Xbox Kinect system, VZFit sensors and CoTras cognitive rehabilitation computer games. The virtual physical activities included boxing, track and field, bowling, table tennis, beach volleyball, football, baseball, skiing, tennis, golf, darts, American football, shooting, jumping, jogging and jump rope; 20 to 45 minutes a time, one to five times a week, for four to twelve weeks. The interventions could be conducted in homes, special education schools and rehabilitation institutions. The health benefits mainly reflected in improved levels of physical activity, enhanced motor function and increased motor and daily life capacity.

Conclusion Application of DET in physical activity may increase the participation of children with IDD in virtual environments, schools, communities and rehabilitation institutions; improve upper and lower limb motor function, gross motor function, and muscle strength; enhance static balance, motor coordination and sensorimotor function; reduce the sedentary behavior; and improve cognitive, daily living skills and social abilities.

Key words: intellectual and developmental disabilities, children, adolescents, digital empowerment technology, physical activity, systematic review

中图分类号:

R749.93

魏晓微. 数字赋能技术促进智力与发展性残疾儿童身体活动和健康的系统综述[J]. 《中国康复理论与实践》, 2024, 30(5): 497-504.

WEI Xiaowei. Effect of digital empowerment techniques on physical activity and health for children with intellectual and developmental disabilities: a systematic review[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(5): 497-504.

图/表 4

表1

图1

表2

表3

纳入文献基本特征"

纳入文献	国家	样本特征	健康及功能状况	干预场所	干预情境	干预技术	干预频率	比较	结局
Lau等^[11](2020)	中国	8~18岁 n = 203	轻度智力残疾	特殊教育学校	体育课程	AVGs，包括拳击、田径、保龄球、乒乓球、沙滩排球、足球、棒球、滑雪、网球、高尔夫、飞镖和美式足球等	中等~剧烈；每次30 min，每周2次，共12周	与常规身体活动相比	身体活动水平无显著影响身体功能无显著影响
Ahn^[12](2021)	韩国	8~12岁 n = 13	轻度智力残疾	康复机构	运动康复	Wii VR视频游戏和CoTras认知康复电脑游戏，包括射击、跳跃，敲打鼹鼠、跷跷板、手眼协调相关活动其他身体活动：跑步	中等~剧烈；每次20 min，每周3次，共4周	干预前后比较	身体活动水平未提及身体功能 BOT-2总分改善空间关系和视觉运动速度、运动减少视觉知觉和一般视觉知觉改善
Wang等^[13](2022)	中国	11~18岁 n = 30	轻度智力残疾	特殊教育学校	体育课程	Xbox Kinect系统，包括酷跑、打鼹鼠、抓礼物、赛车、足球其他身体活动：慢跑、跳绳等	中等~剧烈；每次40 min，每周3次，共8周	干预前后比较	身体活动水平未提及身体功能下肢功能和肌力改善
Kwon等^[14](2022)	韩国	11~18岁 n = 52	轻度智力残疾	特殊教育学校	体育课程	基于ICT的运动游戏程序其他身体活动：奔跑、水平跳跃、跳跃、反手投掷和运球技能、踢腿、体操和模仿活动	中等~剧烈；每次45 min，每周1次，共12周	与传统体育课程组、久坐行为组比较干预前后比较	身体活动水平未提及身体功能粗大运动功能(跳跃、反手投掷和运球)改善立定跳远能力提高
Case等^[15](2019)	美国	10~16岁 n = 14	孤独症	特殊教育学校	体育课程	计算机视频演示技术，包括粗大运动技能练习	强度未提及；每次30 min，每周5次，共5周	与常规身体活动相比	身体活动水平未提及身体功能无显著影响
Senette等^[16] (2018)	意大利	7~10岁 n = 6	轻至中度智力残疾唐氏综合征	康复机构	运动康复	Stepmania的节奏视频游戏、Fitbit智能设备，包括认知运动训练，如步行、协调动作练习等	强度未提及；每次45 min，每周3次，共5周	干预前后比较	身体活动水平未提及身体功能注意力、听觉记忆和空间记忆能力提升身体协调性与平衡能力改善
Park等^[17](2022)	韩国	8~13岁 n = 35	轻度智力残疾	康复机构	运动康复	基于认知功能和社交技能的VR训练系统其他身体活动：水平跳跃、跑步、跳高、步行练习、杠铃栏、踏步练习、踢球、投球、平衡练习和动物运动	中等强度；每次30 min，每周3次，共8周	与传统VR技术组比较	身体活动水平未提及身体功能运动协调性(延伸水平跳跃、跳跃和过臂投掷)改善
Lee等^[18](2023)	韩国	7~12岁 n = 23	发展性残疾	康复机构	运动康复	VZFit传感器和Oculus Quest护目镜其他身体活动：骑自行车	低~剧烈；每次40 min，每周2次，共12周	与传统康复干预比较干预前后比较	身体活动水平学校、社区、社会身体活动参与频率增加身体功能运动技能评分增加3.2分粗大运动功能评分增加11.3分

表3

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纳入文献	资格标准	随机分配	分配隐藏	基线相似	被试施盲	治疗师施盲	评估者施盲	被试流失率≤ 15%	意向治疗分析	组间统计比较	报告点测量和变异量值	总分
Lau等^[11](2020)	√	√	√	√		√		√		√	√	7
Ahn^[12](2021)	√	√	√	√	√	√		√	√		√	8
Wang等^[13](2022)	√	√	√	√		√		√	√	√	√	8
Kwon等^[14](2022)	√	√	√	√	√	√	√	√	√	√		9
Case等^[15](2019)	√	√	√		√	√		√	√	√		7
Senette等^[16](2018)	√	√	√	√	√			√	√		√	7
Park等^[17](2022)	√	√	√	√	√	√		√	√	√	√	9
Lee等^[18](2023)	√	√	√	√		√		√	√	√	√	8