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標題: | 探討臺灣半側偏癱腦性麻痺孩童於視覺空間注意力與視知覺技巧的表現 Performance of Visual Spatial Attention and Visual Perceptual Skills in Children with Hemiplegic Cerebral Palsy in Taiwan |
作者: | Man Su 蘇曼 |
指導教授: | 王湉妮(Tien-Ni Wang) |
關鍵字: | 腦性麻痺,視覺空間注意力,視知覺,電腦化測驗,半側偏癱, Cerebral Palsy,visual spatial attention,visual perceptual skills,computerized assessment,hemiplegia, |
出版年 : | 2019 |
學位: | 碩士 |
摘要: | 前言:腦性麻痺為孩童於出生前、後,腦部遭受非進行性的損傷,其中最常見的動作損傷類型為半側偏癱。過去研究顯示半側偏癱腦性麻痺孩童有視覺空間注意力及視知覺技巧的缺損,但仍需要更全面的深入探討。
目的:本研究之目的如下(一)比較半側偏癱腦麻孩童與一般發展孩童之視覺空間注意力及視知覺技巧的表現,並進一步比較半側偏癱腦麻孩童在慣用側及非慣用測之視覺空間注意力的表現是否不同。(二)分析半側偏癱腦麻孩童與一般發展孩童的視覺空間注意力與視知覺技巧之關聯性。(三)比較左側偏癱及右側偏癱腦麻孩童之視覺空間注意力及視知覺技巧的表現。 方法:本研究納入30位半側腦麻孩童(平均年齡九歲七月±兩歲零月)和30位一般發展孩童(平均年齡八歲六月±一歲九月)。半側偏癱腦麻孩童包含15位左側偏癱(平均年齡十歲五月±一歲十一月)及15位右側偏癱腦麻(平均年齡八歲九月±一歲十月)。視覺空間注意力及視知覺技巧會分別以隨機視覺刺激覺察測驗(RVSDT)和電腦化視知覺技巧測驗(CVPSA)評估。所有受試者會在一週內完成兩項測驗。 結果:單因子共變數分析結果顯示半側偏癱腦麻孩童與一般發展孩童在視覺空間注意力及視知覺技巧皆呈現顯著差異。成對樣本T檢定分析結果顯示半側偏癱腦麻孩童在慣用側與非慣用側之視覺空間注意力表現並未呈現顯著差異。皮爾森相關分析顯示半側偏癱腦麻孩童的視覺空間注意力之遺漏率與視知覺總分有中到高度的相關,然一般發展孩童的視覺空間注意力之遺漏率與視知覺總分之相關性未達中等程度;半側偏癱腦麻孩童在視覺空間注意力之反應時間與視知覺總分之相關性未達中等程度,然一般發展孩童在視覺空間注意力之反應時間與視知覺總分則呈現中到高度的相關。單因子共變數分析結果顯示,左側偏癱與右側偏癱腦麻孩童在視覺空間注意力與視知覺技巧上並未呈現顯著差異。 結論:本研究證實臺灣半側偏癱腦性麻痺孩童有嚴重的視覺空間注意力與視知覺技巧損傷,半側偏癱腦麻孩童無論在慣用側與非慣用側空間區域皆存在視覺空間注意力之缺損,且當偏癱腦麻孩童越傾向遺漏視覺刺激,則在視知覺技巧上亦會出現困難。此外,本研究結果顯示左側偏癱和右側偏癱腦麻孩童在視覺空間注意力及視知覺表現上並未呈現差異。未來在研究及臨床上皆需評估半側偏癱腦麻孩童此兩項技巧,以利提供更個別化及更合適的治療方案。 Introduction: In hemiplegic cerebral palsy (CP), the most common type of CP, unilateral motor disability is caused by a non-progressive lesion of the immature brain. The performances of visual spatial attention (VSA) and visual perceptual skills (VPS) have often been reported to be impaired in children with hemiplegic CP, and they require comprehensive investigation. Objective: The aims of this study were (1) to compare the performances of VSA and VPS between children with hemiplegic CP and typically developing children (TDC) in Taiwan, as well as to compare the performances of VSA between the contralesional and ipsilesional fields in children with hemiplegic CP; (2) to examine the relationships of VSA and VPS in children with hemiplegic CP and TDC; and (3) to investigate the performance differences of VSA and VPS between children with left and right hemiplegic CP. Methods: Thirty children with hemiplegic CP (15 males and 15 females, mean age 9 y 7 mo ± 2y 0 mo) and 30 TDC (9 males and 21 females, mean age 8 y 6 mo ± 1y 9 mo) were recruited in this current study. In the CP group, 15 children with left hemiplegic CP (mean age 10 y 5 mo ± 1 y 11 mo) and 15 children with right hemiplegic CP (mean age 8 y 9 mo ± 1y 10 mo). VSA and VPS were measured with the Random Visual Stimuli Detection Task (RVSDT) and the Computerized Visual Perceptual Skills Assessment (CVPSA), respectively. Each participant was assessed with the RVSDT and CVPSA within one week. Results: Significant differences were found between the CP and TD groups in VSA and VPS, as analyzed by one-way mixed analysis of covariance (ANCOVA). In the CP group, there was no significant difference in VSA between dominant and non-dominant field as analyzed by paired t-test. The correlation of VSA and VP in the CP and TD group was analyzed by pearson’s correlation test. In the CP group, moderate to high correlations between the miss rates of VSA and total visual perceptual scores were observed (Peripheral Non-dominant r = -.66, p < .001; All peripheral r = -.66, p < .001), while the miss rates of VSA did not reach a moderate relation to total visual perceptual scores in the TD group. In the TD group, moderate to high correlations between the reaction times of VSA and total visual perceptual scores were found (Peripheral Non-dominant r = -.66, p < .001; All peripheral r = -.63, p < .001), while the relationship between the reaction times and total visual perceptual scores was relatively low in the CP group. Performance on visual spatial attention and visual perceptual skills did not differ between children with left hemiplegic CP and those with right hemiplegic CP as analyzed by ANCOVA. Conclusion: This study demonstrates that children with hemiplegic CP have difficulties in VSA and VPS. Children with hemiplegic CP seem not to perceive visual stimuli in both contralesional and ipsilesional space. The VSA problems appear to be accompanied by VPS impairment in this population. In addition, VSA and VPS might not be lateralized in children with hemiplegic CP, for children with right and left hemiplegia performed at equal levels. This study highlights the importance of considering both VSA and VPS in this population. Specialized and tailored treatments should be provided for both right and left hemiplegic CP. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/71541 |
DOI: | 10.6342/NTU201900191 |
全文授權: | 有償授權 |
顯示於系所單位: | 職能治療學系 |
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