【作者】 陈小明；

【导师】 苏敏；

【作者基本信息】 苏州大学 ， 康复医学与理疗学， 2024， 硕士

【摘要】 目的:考察常规训练、踏车有氧运动和篮球有氧运动三种方法对注意缺陷多动障碍(ADHD)儿童的干预效果,比较这三种方法的干预疗效,并探讨临床症状和执行功能的相关性。方法:选取2022年10月至2023年9月收治符合ADHD诊断标准的儿童73例,年龄6-10岁,按照1:1:1的比例随机分为常规组、踏车组、篮球组。常规组以小组课形式进行常规的注意力训练,踏车组以骑踏动感单车的有氧运动形式进行训练,篮球组以小组篮球运动进行有氧训练。踏车组和篮球组均为中等强度有氧运动形式,三组儿童每次训练40分钟,每周3次,连续16周,共48次训练。干预前后分别以Conners父母用症状问卷(PSQ)和注意缺陷多动障碍筛查量表(SNAP-IV)评估ADHD儿童临床症状的改善情况,以Stroop色词、大小奇偶数、n-back任务、中国韦氏儿童智力量表-第四版(WISC-IV)中的背数和译码、视听整合持续测试(IVA-CPT)评估ADHD儿童抑制控制、转换、刷新、工作记忆和认知灵活性等维度执行功能改善情况,并比较三组间的疗效差异及临床症状和执行功能的相关性。结果:1、PSQ问卷:干预16周后,常规组在冲动多动和多动指数两个因子方面较干预前差异具有统计学意义(P<0.05);踏车组在学习问题、冲动多动和多动指数的因子上较干预前差异具有统计学意义(P<0.05);篮球组在焦虑、学习问题、冲动多动和多动指数因子上较治疗前差异均具有统计学意义(P<0.05)。篮球组与常规组比较,在学习问题、冲动多动和多动指数三个因子方面组间差异均具有统计学意义(P<0.05);与踏车组比较,在冲动多动和多动指数两个因子上组间差异均具有统计学意义(P<0.05)。2、SNAP-IV问卷:干预16周后,常规组在注意力不足和多动冲动两个因子方面较干预前差异均具有统计学意义(P<0.05);踏车组和篮球组在注意力不足、多动冲动和对立违抗因子均较干预前差异具有统计学意义(P<0.05)。篮球组较踏车组在注意力不足和多动冲动因子上差异具有统计学意义(P<0.05);踏车组较常规组在对立违抗因子上组间差异具有统计学意义(P<0.05)。3、Stroop色词、大小奇偶数、n-back任务:干预16周后,踏车组和篮球组在Stroop色词、大小奇偶数和n-back任务中的反应时、正确率方面较干预前差异均具有统计学意义(P<0.05);篮球组较常规组和踏车组在反应时和正确率方面组间差异均有统计学意义(P<0.05);n-back任务中踏车组在正确率方面较常规组具有统计学意义(P<0.05)。4、背数和译码:干预16周后,踏车组和篮球组在背数和译码方面较干预前差异均具有统计学意义(P<0.05)。篮球组较常规组和踏车组在背数方面组间差异均有统计学意义(P<0.05);在译码方面较常规组具有统计学意义(P<0.05)。5、IVA-CPT:干预16周后,三组儿童的综合控制力商数和综合注意力商数较干预前差异均具有统计学意义(P<0.05)。篮球组较常规组和踏车组在综合控制力商数和综合注意力商数组间差异均有统计学意义(P<0.05)。6、核心症状和执行功能的相关性:SNAP-IV问卷中冲动多动和注意力不足因子与Stroop测试的正确率、大小奇偶数测试的正确率、IVA-CPT测试的综合注意力商数和韦氏测试的背数呈负相关,与Stroop测试的反应时、大小奇偶数的反应时呈正相关,差异具有统计学意义(Spearman秩相关分析,P<0.05)。此外SNAP-IV问卷中冲动多动因子与n-back测试中的反应时呈正相关,与n-back测试中的正确率、IVA-CPT测试中的综合控制力商数呈负相关,差异具有统计学意义(Spearman秩相关分析,P<0.05)。结论:三组在改善ADHD儿童注意缺陷和多动冲动核心症状方面均有效果。踏车和篮球的有氧运动方式均可以改善ADHD儿童的执行功能。篮球组较常规组在核心症状和执行功能方面均有显著的疗效优势,较踏车组在抑制控制、转换、刷新和工作记忆方面有较好的改善。踏车组较常规组在抑制控制和刷新方面有一定的疗效优势。ADHD儿童的核心症状与抑制控制、转换、刷新、工作记忆有显著的相关性。更多还原

【Abstract】 Objective:To investigate and compare the intervention effect of routine training,cycling aerobic exercise and basketball aerobic exercise in children with attention deficit hyperactivity disorder(ADHD),and to explore the correlation of clinical symptoms and executive function.Methods:From October 2022 to September 2023,73 children of ADHD were enrolled.They were randomly divided into regular group,cycling group and basketball group according to the ratio of 1:1:1.The regular group conducts regular attention training in the form of group class,the cycling group conducts aerobic training in the form of spinning cycling,and the basketball group conducts aerobic training in group basketball.Both the cycling and basketball groups were moderate intensity aerobic exercise.Children in the three groups trained for 40 minutes,three times a week for 16 weeks for 48 times.Improvement of clinical symptoms in children with ADHD by Conners Parent Symptom Questionnaire(PSQ)and Attention Deficit Hyperactivity Disorder Screening Scale(SNAP-IV),To evaluate the improvement of inhibition control,conversion,refresh,working memory and cognitive flexibility in ADHD children,And to compare the difference in efficacy and the correlation of clinical symptoms and executive function among the three groups.Results:1.PSQ questionnaire:After 16 weeks of intervention,the regular group was statistic-ally significant in impulsivity/hyperactivity and hyperactivity index compared with pre-intervention(P<0.05);the cycling group was statistically significant in learning problems,impulsive/hyperactivity and hyperactivity index compared with pre-intervention(P<0.05);the basketball group was statistically significant in anxiety,learning problems,impulsive/hyperactivity and hyperactivity index compared with pre-treatment(P<0.05).Compared with the regular group,the learning problem,impulsivity/hyperactivity and hyperactivity index in the basketball group was statistically significant(P<0.05),Compared with the cycling group,the impulsivity/hyperactivity and hyperactivity index in the basketball group was statistically significant(P<0.05).2.SNAP-IV questionnaire:After 16 weeks of intervention,the regular group was statistically significant in attention deficit and impulsivity/hyperactivity(P<0.05);the attention,impulsivity/hyperactivity and oppositional defiant were statistically significant between the cycling and basketball groups(P<0.05).The basketball group showed significant differences in attention deficit,impulsivity/hyperactivity defiant than the regular group(P<0.05).Compared with the regular group,the oppositional defiant in the cycling group was statistically significant(P<0.05).3.Stroop Color word,size parity,n-back task:After 16 weeks of intervention,the time and accuracy differences in the Stroop color words,size parity and n-back task were significant in the cycling and basketball group(P<0.05);compared with the regular and cycling group,the time and accuracy in the basketball group was statistically significant(P<0.05);n-back tasks were statistically significant in terms of accuracy compared to the regular group(P<0.05).4.Recite numbers and decode:After 16 weeks of intervention,the recite numbers and decode were statistically significant between the cycling and basketball groups(P<0.05).Compared with the regular and cycling group,the recite numbers in the basketball group was statistically significant(P<0.05).5.IVA-CPT:After 16 weeks of intervention,the combined control force quotient and the combined attention quotient in the three groups were statistically significant(P<0.05).Compared with the regular and cycling group,the combined control force quotient and the combined attention quotient in the basketball group was statistically significant(P<0.05).Compared with the regular group,the combined control force quotient and the combined attention quotient in the cycling group was statistically significant(P<0.05).6.Correlation of core symptoms and executive function:the impulsivity/hyperactivity and attention deficit factors in the SNAP-IV questionnaire were negatively associated with the accuracy rate of Stroop test,the accuracy rate of size parity test,the combined attention quotient of IVA-CPT test and recite numbers,positively associated with the response of the test of Stroop,with statistically significant differences(spearman rank correlation analysis,P<0.05).In the SNAP-IV questionnaire,the response of the test of size parity test,the response of the test and accuracy rate of the n-back test,and the combined control force quotient of the IVA-CPT test were negatively correlated,which were statistically significant(spearman rank correlation analysis,P<0.05).Conclusion:The three groups were effective in improving the core symptoms of attention deficit and impulsivity/hyperactivity in children with ADHD.The aerobic exercise mode of both cycling and basketball can improve the executive function of children with ADHD.The basketball group had significant efficacy advantages over the regular group in both core symptoms and executive function,and better improvement in inhibitory control,conversion,refresh and working memory over the cycling group.The cycling group has some efficacy advantage over the regular group in inhibitory control and refresh.Core symptoms in children with ADHD were significantly associated with inhibitory control,conversion,refresh,and working memory.更多还原