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論文 |
論文
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染矢, 富士子 ; 西村, 吉行 ; 野村, 忠雄
概要:
金沢大学大学院医学系研究科機能障害学<br />肢体不自由児施設に入園または通園している脳性麻痺児(者)で, 11歳以上23歳までの60名についてADLの自立がどこまで到達しているか, その障害度に対応させて検討した.その結果, 食事, 排
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泄, 更衣動作は, 上肢運動年齢が約30ヵ月で自立, 入浴動作は約58ヵ月で自立するものが多く見られた.移動動作は, 独歩の場合は下肢運動年齢が約20ヵ月, 車いすのッ場合では10ヵ月が自立に必要であった.全例について, 新版K式発達検査の認知・適応領域のDQも測定しており, ADLの各動作にわたりDQの値が15以上でないと完全に自立をはかることが困難であった. Children with cerebral palsy (CP) exhibit physical disabilities with abnormal patterns of movement and perceptual-motor disorders. Some researchers have reported that independence in activities of daily living (ADL) of CP children is related to these factors.Examination of sixty such clients in our Children's Orthopedic Centers was carried out, with ages ranging from 11 to 23 years, using the motor age tests of both the upper and lower limbs and the revised K's Developmental Tests for cognitive-adaptive abilities. Independence in ADL was assessed on self-care activities, such as transfers, feeding, toileting, dressing and bathing. Also examined were fifteen 9- and 10-year-old CP children who had the possible ability to achieve independece in ADL. The motor age of the lower limb was higher than 20 months for them to be able to ambulate without support and was higher than 10 months to enable them to become independent with wheelchairs, walking frames, crutches or sticks. It was however difficult to distiguish borderlines of the motor age for the various ambulatory aids. CP child, whose developmental quotient in cognitive-adaptive abilities was below 15,required supervision to walk to a destination, even though he possesed a functional gait. The motor age of upper limb in most of the children was higher than 30 months to enable them to become independent in self-care activities and their developmental quotient was above 15,so that notification of micturition was possible. Bathing required more than 58 months in motor age of the upper limb and was tha last activity to achieve independence.
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論文 |
論文
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染矢, 富士子 ; 西村, 吉行 ; 野村, 忠雄
概要:
金沢大学大学院医学系研究科機能障害学<br />肢体不自由児施設で, 上下肢の運動年齢を10年以上, 新版K式発達検査の認知・適応領域の評価を1年以上記録してある脳性麻痺児について, どのような経緯をたどって発達がみられたかを検討した.その
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結果, 運動年齢は上下肢とも15歳ぐらいまでは発達していくものが多いが, 一度獲得した四肢の機能がその前後より低下していく例も多かった.そこで機能的予後を幼児, 学童期に予測するには, ある程度の幅を持って考えていく必要があると同時に, 獲得した機能の維持に注意していくことが重要である.認知・適応領域のDQは10歳ぐらいまで徐々に低下していく傾向がみられた. A study was carried out retrospectively to find out the developmental sequenece of children with cerebral palsy. Data were collected from 70 CP children in our centers, whose motor age of upper and lower limbs had been recorded for over ten years and 24 CP children whose cognitive-adaptive abilities had been assessed for over one year using the revised K's Developmental Test. The functional development of all the limbs in terms of motor age continued until about 15 years of age, though these were many cases in which the limb function deteriorated thereafter. The motor age of lower limb was higher than 9 months at five or six years old for children to be able to ambulate without support until fifteen years old. There existed also exception that motor age was 14 months at six years old for one child who could not move at all in the center without help because of the poor co-ordination of balance with progressive joint contracture. The motor age of upper limb was higher than 18 months at five years old and higher than 25 monts at ten years old for CP children to be independent in the most of activities of daily living. The developmental quotient of their cognitive-adaptive abilities deteriorated gradially until about ten years of age. It was sometimes difficult to predict precisely their functional prognosis during early childhood from motor age tests and the revised K's Developmental Tests. It was however important to maintain the function that had already been gained.
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