基于ICF-CY孤独症儿童青少年参与身体活动功能效果的系统综述

doi:10.3969/j.issn.1006-9771.2022.11.010

Abstract

Abstract:

Objective To establish the category and structure of sports activities of autistic children and adolescents, and systematically review the functioning effects of physical activity on autistic children and adolescents, using International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY).

Methods Randomized controlled trials (RCT) about the the health benefits of physical activity interventions for autistic children and adolescents were retrieved from CNKI, Wanfang Data, VIP, Web of Science, PubMed and EBSCO databases, from 2016 to 2022, and screened and reviewed.

Results A total of 13 RCT from seven countries were included finally, involving 437 participants (aged 3 to 13 years). The main sources were journals in fields of medicine, public health, autism, sports and other fields, published from 2018 to 2022. The types of physical activities that benefit children and adolescents with autism include physical fitness, skills and sports programs, including physical activity in daily life, recreational and leisure activities, sports training, school physical education programs and exercise rehabilitation; 30 to 90 minutes a time, one to three times a week, for six weeks to ten months, medium to high intensity. Physical activity might promote the functional recovery for autistic children and adolescents. For body function of emotional response, physical activity improved fear or anxiety, executive function, inhibition function, working memory, cognitive flexibility, social cognitive level, balance, flexibility, grip strength. For activities and participation of interaction, physical activity enhanced interpersonal interaction, communication, social skills, quality of life, well-being, social support, motor self-efficacy, participation in various leisure and sports activities, and range of mobility at level of activity and participation.

Conclusion The main disabilities of children and adolescents with autism manifest in dimensions of body function, activity and participation, and quality of life and well-being. The benefits of physical activity on children and adolescents with autism manifest the improvement of physical function, activity and participation, specifically motor skills, social communication and interaction, language skills, balance and coordination, control, attention, and executive function, as well as quality of life, social participation, self-efficacy and well-being.

Key words: autism, children, adolescents, physical activity, International Classification of Functioning, Disability and Health-Children and Youth Version, systematic review

CLC Number:

R749.93

SONG Beibei,WANG Yunting,WANG Dongming,BAI Kaixiang. Functional effects of physical activity on children and adolescents with autism based on ICF-CY: a systematic review[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(11): 1309-1317.

Figures/Tables 4

文献	国家	样本特征	干预情境	干预场所	活动方式	时间	评定工具	比较	结局
Caputo等^[9] (2018)	意大利	年龄6~13岁样本量26	体育活动	社区泳池	水上疗法	每次45 min，10个月内96次	试验干预儿童孤独症评定量表 Vineland适应性行为量表 HAAR检查表	相比未经过水疗训练，水上疗法效果更好	人际关系模仿躯体运动能力语言交流功能适应情绪反应活动水平游泳技能
Najafabadi等^[11] (2018)	伊朗	年龄5~12岁样本量26	体育活动	室内综合大厅	SPARK游戏和积极娱乐	每次40 min，每周3次，12周	试验干预 Bruininks-Oseretsky动作熟练度测验 ATEC GARS-2	相比常规康复治疗，SPARK疗法更有效	静态平衡动态平衡双边协调社会互动灵活性
Zhao等^[14] (2018)	中国	年龄5~8岁样本量41	体育课程	学校体育馆	身体结构化功能训练	每次60 min，每周2次，12周	试验干预 ABLLS-R SSIS-RS 家长半结构访问指南志愿者开放问卷	相比常规体育活动，结构化功能训练效果更佳	社交互动沟通行为身体活动
Sarabzadeh等^[12] (2019)	伊朗	年龄6~12岁样本量18	体育活动	体育馆	太极拳	每次60 min，每周3次，6周	试验干预 M-ABC	相比常规康复训练，太极拳训练效果更好	平衡运动协调注意力肌张力感知觉
Phung等^[18] (2019)	美国	年龄8~11岁样本量34	体育课程	社区	综合格斗	每次45 min，每周2次，13周	试验干预韦氏简明智力量表孤独症诊断观察量表	相比常规康复治疗，综合格斗疗效更优	执行功能情绪调节语言功能
Zanobini等^[10] (2019)	意大利	年龄3~8岁样本量25	体育课程	游泳馆	游泳	每次30 min，2周1次，12次	试验干预 ABC SRS HAAR检查表	相比常规康复训练，游泳效果更好	感知觉身体和物品使用社会沟通和自理孤独症行为社会动机
Arslan^[19] (2020)	土耳其	年龄9~11岁样本量28	体育活动	室内体育馆	结构化身体运动	每次60 min，每周3次，12周	试验干预 Bruininks-Oseretsky动作熟练度测验坐姿和伸展灵活性测试握力测试视觉和听觉反应时间测试	相比正常儿童，运动对孤独症儿童疗效更佳	跑步速度和敏捷性平衡性双侧协调立定跳远反应时间握力和灵活性柔韧性
Howells等^[20] (2022)	澳大利亚	年龄5~12岁样本量35	体育活动	社区	社区足球	每次60~90 min，每周1次，13周	试验干预 M-ABC-2 韦氏儿童智力量表 SRS-2 Vineland适应性行为量表	相比常规康复训练，社区足球效果更优	粗大运动平衡性灵活性
Zhao等^[15] (2021)	中国	年龄6~12岁样本量61	体育课程	马术中心	治疗性骑马	每次60 min，每周2次，16周	试验干预 SSIS-RS ABLLS-R	相比常规康复训练，骑马训练效果更好	社交能力社会互动沟通
Yang等^[16] (2021)	中国	年龄3~6岁样本量30	体育活动	康复机构	小篮球	每天40 min，每周5天，12周	试验干预 SRS-2 静息态功能磁共振成像	相比常规康复训练，小篮球运动疗效更佳	社会认知社会交往执行控制功能
Tabeshian等^[13] (2022)	伊朗	年龄6~12岁样本量23	体育课程	体育馆	太极拳	每次45 min，每周3次，12周	试验干预 GARS-2 Ravens测试	相比常规康复训练，太极拳训练效果更好	刻板行为行为调节
Tse等^[17] (2021)	中国	年龄8~12岁样本量62	体育活动	学校体育馆	自行车	每次60 min，每周5次，2周	试验干预伦敦塔测试 Corsi敲击测试正反向数字广度测验	相比骑固定自行车和常规训练，学骑自行车功能改善更明显	执行功能认知灵活性工作记忆抑制功能
Marzouki等^[21] (2022)	突尼斯	年龄6~7岁样本量28	体育课程	游泳池	水上游戏	每节课50 min，每周2节，8周	试验干预大肌肉运动发展测试量表 GARS-2 情绪调节量表	相比常规康复训练，水上游戏疗效更明显	粗大运动技能刻板行为情绪调节

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分析架构与类别		内容定义
身体活动形式	体育活动	体适能类与运动技能有关的体适能：灵敏性、平衡性、协调性、爆发力、反应速度等与身体健康有关的体适能：心肺耐力、肌肉力量、肌肉耐力、柔韧性、身体成份等技能类工具性运动技能：写字、绘图、打球、骑自行车等非工具性运动技能：打拳、唱歌、舞蹈等粗大运动技能：跑步、游泳、打球、举重等精细运动技能：雕刻、刺绣等连续性运动技能：弹琴、轮滑等非连续性运动技能：射箭、举重、投篮、按开关等运动项目类竞技类：田径、体操、篮球、足球、排球等休闲类：瑜伽、普拉提、骑马、户外活动等医疗类：医疗体操、气功、太极拳等
身体活动形式	体育课程	绳类游戏、球类游戏、团体游戏、热身操、传接棒等
健康效益	身体功能	精神功能(b1) 感觉功能和疼痛(b2) 发声和言语功能(b3) 心血管、血液、免疫和呼吸系统功能(b4) 神经肌肉骨骼和运动有关的功能(b7)
健康效益	活动与参与	学习和应用知识(d1) 活动(d4) 人际交往和人际关系(d7) 主要生活领域(d8) 社区、社会和公民生活(d9)

Functional effects of physical activity on children and adolescents with autism based on ICF-CY: a systematic review

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