学龄前孤独症谱系障碍儿童健康体适能水平及影响因素

A study of health fitness levels and influence factors of preschool children with autism spectrum disorders

目的:初步研究学龄前孤独症谱系障碍(autism spectrum disorder,ASD)儿童健康体适能水平,探讨ASD儿童健康体适能的影响因素,为其全面康复治疗和家庭运动指导提供参考。方法:选取ASD组儿童50例和正常组儿童50例,健康体适能水平采用身体质量指数、20m往返跑距离、网球掷远距离、立定跳远距离、等长俯卧撑时长、单脚站时长平均值、坐位体前屈距离7个指标,收集整理ASD儿童的影响因素情况。分析学龄前ASD儿童与正常儿童之间的健康体适能水平差异,采用多元线性回归模型分析性别、BMI、平均每天睡眠时间、平均每天久坐时间、平均每天TPA时间、平均每天MVPA时间、母亲文化水平、父亲文化水平、家庭收入、儿童主要看护人年龄对学龄前ASD儿童健康体适能影响。结果:组间对比分析结果显示ASD组网球掷远距离低于正常组(P<0.05),20m往返跑距离、等长俯卧撑时长和单脚站时长平均值显著低于正常组儿童(P<0.001),差异存在显著性意义。两组BMI、立定跳远距离和坐位体前屈距离成绩差异无显著性意义(P>0.05)。多元线性回归模型分析显示平均每天睡眠、总体力活动(total physical activity,TPA)、中高强度体力活动(moderate to vigorous intensity physical activity,MVPA)时间对20m往返跑距离有良好拟合作用(20m往返跑距离=﹣9.561+1.048×平均每天睡眠时间+0.076×均每天TPA时间+0.066×平均每天MVPA时间);平均每天TPA时间对等长俯卧撑时长有良好拟合作用(等长俯卧撑时长=﹣87.625+0.428×平均每天TPA时间);平均每天TPA、MVPA时间对单脚站时长平均值有良好拟合作用(单脚站时长平均值=6.627+0.094×平均每天总身体活动时间+0.071×平均每天中高强度活动时间)。结论:学龄前ASD儿童的心肺适能、运动适能、上肢肌肉适能低于正常儿童,综合康复干预方案应适当加入体适能训练。学龄前ASD儿童睡眠时间越长、TPA时间越长、MVPA时间越长可能心肺适能、运动适能越好,应增强学龄前ASD儿童睡眠时间和中高强度体力活动的有效时长。

Objective:To investigate the level of healthy fitness in preschool children with autism spectrum disorder(ASD),to explore the factors influencing healthy fitness in children with ASD,and to provide reference for their comprehensive rehabilitation treatment and home exercise guidance.Method:Fifty children in the ASD group and 50 children in the normal group were selected to test the health fitness level using seven indexes:body mass index,20m round-trip run,tennis long throw,standing long jump,isometric push-up,one-legged stance,and seated forward bend.The differences in health fitness levels between preschool children with ASD and normal children were analyzed using independent samples ttest,and the effects of gender,BMI,average daily sleep time,average daily sedentary time,average daily TPA time,average daily MVPA time,mother's education level,father's education level,family income,and age of child's primary caregiver on health fitness of preschool children with ASD were analyzed using multiple linear regression models.Result:Comparative analysis between groups showed that the ASD group had a much lower tennis ball toss than the normal group(P<0.05),and significantly lower scores in the 20-meter round-trip run,isometric pushups and one-leg stand test than the normal group(P<0.001),while the differences in body mass index,standing long jump and seated forward bend scores were not statistically significant(P>0.05).Multiple linear regression model analysis showed that the mean daily sleep,Total Physical Activity(TPA),and Moderate to Vigorous Intensity Physical Activity(MVPA)time had a good fit for the 20 m round-trip run(20 m round-trip run=﹣9.561+1.048×average daily sleep time+0.076×average daily TPA time+0.066×average daily MVPA time);average daily TPA time was well fitted for the isometric push-ups(isometric push-ups=﹣87.625+0.428×average daily TPA time);average daily TPA and MVPA times were well fitted for the single-leg stand(average duration of single-leg stand=6.627+0.094×average daily total physical activity time+0.071×average daily moderate-to-vigorous activity time).Conclusion:The cardiopulmonary fitness,motor fitness and upper limb muscle fitness of preschool children with ASD are lower than those of normal children,and physical fitness training should be included in the comprehensive rehabilitation intervention program.The longer sleep time,the longer TPA time and the longer MVPA time may suggest the better cardiorespiratory fitness and motor fitness of preschool children with ASD,and the effective duration of sleep time and moderate-to-vigorous physical activity of preschool children with ASD should be enhanced.