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系統識別號 U0026-2408201116274900
論文名稱(中文) 按摩治療對於發展遲緩嬰幼兒之療效探討
論文名稱(英文) Effects of Massage Therapy on Infants and Toddlers with Developmental Delay
校院名稱 成功大學
系所名稱(中) 職能治療學系碩博士班
系所名稱(英) Department of Occupational Therapy
學年度 99
學期 2
出版年 100
研究生(中文) 盧維芃
研究生(英文) Wei-Peng Lu
學號 T76981019
學位類別 碩士
語文別 中文
論文頁數 62頁
口試委員 口試委員-吳菁宜
口試委員-林玲伊
指導教授-黃雅淑
中文關鍵字 發展遲緩  按摩  替代性療法 
英文關鍵字 developmental delay  massage  complementary and alternative medicine 
學科別分類
中文摘要 研究目的
本研究的目的旨在了解按摩對於發展遲緩嬰幼兒之療效。

研究方法
本研究共收集了30位,3歲以下,體重低於50% 生長曲線之動作發展遲緩嬰幼兒。排除條件為染色體和基因異常、嚴重視覺或聽覺缺損及肌肉張力過強。依照個案的年齡、肌肉張力、動作發展遲緩程度先加以分層,再隨機分配至按摩及控制組,每組各為15位個案。按摩組個案接受每次20分鐘,1週2次,12週(共24次)的按摩介入計劃。控制組則無按摩介入。兩組在實驗期間都仍繼續接受其原先的復健治療。每位個案在按摩計畫開始前及結束後均接受身體組成(體重、身長、頭圍、皮脂厚度)和嬰幼兒綜合發展測驗的評估,並請其家長填寫嬰兒氣質問卷、嬰幼兒感覺處理剖析量表及嬰幼兒日常生活功能問卷。另外,在研究期間,每週電訪或面訪家長以收集每位個案之健康狀況資料。

結果
以按摩介入前後,兩組在各連續變項的改變量乃採用獨立樣本T檢定來做分析。結果顯示按摩組個案在認知(p=.013)、語言(p=.046)、動作(p=.005)、發展測驗總分(p=.022)及感覺敏感象限(p=.014)的改變量均顯著高於控制組。而在身體組成、氣質、夜間或每日總睡眠時間,兩組則無明顯地差異。在按摩介入後,兩組個案於各類別變項呈現改善的狀況則採用chi-square法加以比較。結果發現兩組在睡眠、飲食和排便狀態均無明顯地差異。此外,在按摩期間,兩組個案的健康狀況(出現症狀、看醫生、住院的發生比例)亦無明顯的差別。

結論
本研究結果証實按摩治療可有效的促進發展遲緩嬰幼兒的發展及感覺調節。因此建議臨床治療人員及發展遲緩兒之家長可將按摩納入常規的介入計畫中,以提升兒童的發展。另外,在本研究中,按摩在部分變項(如:發展-精細動作、氣質-趨避性,注意力分散度、感覺處理-觸覺、身體組成-身高、肩胛下皮脂厚度等),雖已達到中度以上之效果量,卻未達到顯著統計差異,此結果有可能是受到樣本數過小所致,因此建議未來研究應增加其樣本數,以確定按摩在這些變項的療效。
英文摘要 Purpose
The purpose of this study was to examine the effects of massage therapy on infants and toddlers with developmental delay

Method
Thirty participants diagnosed with developmental delay, aged between 1 and 3 years old, and weighed below the 50th percentile growth curve were included in this study. Exclusion criteria were chromosomal or genetic abnormality, severe visual or auditory impairment, and severe hypertonia. Participants were stratified by age, muscle tone, and motor levels and then randomly assigned to the massage group (n=15) or the control group (n=15).
Participants in the massage group received 20 min massage therapy twice a week for 12 weeks. Massage was not given to the participants in the control group. During the study time, the two groups of participants continued to go their rehabilitation classes as they did before the study.
Each participant received the developmental assessment and body composition evaluation (weight, height, head circumstance, and skinfold) and their mother was asked to fill out the daily activity performance questionnaire, the infant temperament questionnaire, and the infant/toddler sensory profile before and after the massage therapy. Mothers were asked to report their child’s health condition in the past week by face-to-face or phone interview once a week duration the study time.
The change in each outcome variable between the two groups was analyzed by independent t tests, chi-square or the Fisher exact probability tests.

Results
The results revealed that the massage group got more improvement in the cognition(p=.013), language(p=.046), and motor(p=.005) subtest and the developmental test (p=.022) than that of the control group. A significant difference was found in the change score in the sensory sensitivity domain (p=.014) of the infant/toddler sensory profile between the two groups. There were no significant difference between the two groups in other outcome variables including body composition, temperament, daily sleep, feeding, and defecation function, and health condition.

Conclusion
The results confirmed that massage therapy improves the developmental function and sensory modulation of infants and toddlers with developmental delay. These findings suggest that health professions and parents apply the massage therapy to children with developmental delay to facilitate their development and sensory processing.
論文目次 目 錄
中文摘要 ..................................................ii
英文摘要 ..................................................iv
致謝......................................................vi
表目錄.....................................................x
圖目錄.....................................................x

第壹章 研究動機與重要性......................................1
第貳章 文獻回顧 ............................................3
第一節、 發展遲緩兒童........................................3
一、 定義...............................................3
二、 盛行率 ............................................3
三、 病因...............................................4
四、 類別….............................................4
五、 可能伴隨的問題......................................5
第二節、 按摩治療...........................................7
一、 定義..............................................7
二、 歷史發展...........................................7
三、 要素和手法.........................................7
四、 可能的療效與機制....................................8
第三節、 按摩治療對嬰幼兒療效的實證研究.......................11
一、 健康嬰幼兒.........................................11
二、 特殊狀況的嬰幼兒...................................11
三、 嬰幼兒療效結果總結..................................15
第四節、 按摩治療對發展遲緩嬰幼兒的實證研究....................16
第参章 研究方法............................................18
第一節、 研究設計...........................................18
第二節、 研究對象...........................................18
第三節、 研究工具...........................................19
一、 嬰幼兒綜合發展測驗.................................19
二、 身體組成評估......................................19
三、 日常生活功能問卷...................................20
四、 健康狀況問卷......................................21
五、 嬰兒氣質問卷......................................21
六、 嬰幼兒感覺處理剖析量表-中文版......................23
第四節、 按摩計劃..........................................25
第五節、 研究流程..........................................28
第六節、 統計分析..........................................30
第肆章 結果..............................................31
第一節、 基本人口學資料.....................................31
第二節、 按摩治療對於發展遲緩嬰幼兒的療效.....................31
一、 發展.............................................32
二、 身體組成..........................................32
三、 感覺處理..........................................32
四、 氣質..............................................33
五、 日常生活功能.......................................33
六、 健康狀況...........................................34
第伍章 討論...............................................35
第一節、按摩對發展的影響....................................35
第二節、按摩對身體組成的影響.................................37
第三節、按摩對感覺處理的影響.................................38
第四節、按摩對氣質的影響....................................38
第五節、按摩對日常生活功能的影響.............................39
第六節、按摩對健康狀況的影響................................40
第陸章 研究限制...........................................41
第柒章 結論和臨床應用......................................42
參考文獻..................................................43

附件一、日常生活功能問卷...................................57
附件二、按摩日誌..........................................60
附件三、基本資料表........................................61



表目錄
表1、按摩基本技巧、目的及手法................................49
表2、基本人口學資料........................................51
表3、按摩對發展遲緩嬰幼兒各項發展之療效......................52
表4、按摩對發展遲緩嬰幼兒身體組成之療效.......................53
表5、按摩對發展遲緩嬰幼兒感覺處理之療效.......................54
表6、按摩對發展遲緩嬰幼兒氣質之療效...........................55
表7、按摩對於發展遲緩嬰幼兒睡眠時數之療效.....................56
表8、按摩對於發展遲緩嬰幼兒健康狀況之療效......................56


圖目錄
圖1、研究流程圖............................................29
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