第21屆 學齡前斜視兒童的動作能力：初步報告 Motor Competency in Preschoolers with Strabismus: Preliminary Results

學齡前斜視兒童的動作能力：初步報告

Motor Competency in Preschoolers with Strabismus: Preliminary Results

葉國光^1,2、劉文瑜^1,2*、楊孟玲³、劉峻秀³、鍾佳英¹

Kuo-Kuang Yeh^1,2, Wen-Yu Liu^1,2*, Meng-Ling Yang³, Chun-Hsiu Liu³, Chia-Ying Chung¹

¹長庚醫療財團法人林口長庚紀念醫院復健科、²長庚大學物理治療學系暨復健科學碩博士班、³長庚醫療財團法人林口長庚紀念醫院兒童眼科

¹Department of Physical Medicine and Rehabilitation, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, ²School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, ³Department of Children Ophthalmology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital

Background and Purpose: Strabismus occurs in approximately four percent in the preschoolers. Researches in Western countries have shown that children with visual disorders were obviously lagging behind their peers in their motor competence (throwing, catching, jumping skills). Zipori et al. (2018) reported 13 of 16 children with strabismus only without amblyopia in Canada demonstrated below average balance skills by the balance subtest of the Bruininks-Oseretsky Test of Motor Proficiency Second Edition (BOT-2). Vagge et al. (2020) reported 6 out of 23 patients with strabismus in Italy were suspect for developmental coordination disorder according to the Italian version of Developmental Coordination Disorder Questionnaire 2007. Hemptinne et al. (2020) reported, out of the 40 children with strabismus in Belgium, 21 were at risk of or already presented significant motor disabilities using the Movement Assessment Battery for Children, Second Edition (MABC-2). With respect to care models in early intervention between Taiwan and Western countries, the primary purpose of this study was to explore the performance of motor ability in preschoolers with strabismus in Taiwan using the BOT-2. Recently, Mancini et al. (2020) reported the short-form of BOT-2 overestimates the child's motor proficiency relative to the complete-form in a school-age attention deficit hyperactivity disorder sample. Consequently, to evaluate the consistency of scores obtained using the complete-form and short-form of the BOT-2 in preschoolers with strabismus was also explored. Methods: Forty preschoolers with strabismus aged 5-7 years were recruited from department of pediatric ophthalmology in Linkou Chang Gung memorial hospital. The exclusion criterions were these preschoolers combined with other ophthalmic diagnosis, neurological deficit, intellectual disability, and could not follow verbal commands. The BOT-2 is a commonly used diagnostic instrument in the evaluation of the development of psychometrics and used in the field of medicine focusing on children - e.g., by physical therapists, physical education teachers in adaptive teaching. The BOT-2 complete-form was administered to all children. The short-form scores of the BOT-2 were extracted from the relevant complete-form items. Descriptive statistics were conducted for data analysis. Results: In the subtests of “Fine Motor Precision”, “Fine Motor Integration”, "Manual Dexterity", "Upper-Limb Coordination", "Bilateral Coordination", "balance", "Running Speed and Agility", and “Strength”, these were 10%, 17.5%, 52.5%, 65%, 35%, 27.5%, 5%, and 2.5% strabismic preschoolers below average performance in the complete-form of the BOT-2. In the composites of “Fine Manual Control”, "Manual Coordination", "Body Coordination", and “Strength and Agility”, these were 15%, 70%, 32.5%, and 5% strabismic preschoolers below average performance in the complete-form of the BOT-2. As a categorical description for “Total Motor Composite”, there were 22.5% strabismic preschoolers by the complete-form but only 7.5% strabismic preschoolers by the short-form were classified as below average performance in the BOT-2. Conclusion: The preliminary results suggest the existence of a variety of motor difficulties in the group of preschoolers with strabismus. According to our finding, when training the motor abilities for preschoolers with strabismus, it recommends enhancing the fine motor skills that were not focus on writing skills (e.g., origami, threading, and ball catching) in daily life. The control group need to be recruited in the future study to confirm whether the present results were still consistent compared with strabismic preschoolers. The short-form of BOT-2 identified a lower proportion of motor difficulty in preschoolers with strabismus. Therefore, the complete-form of the BOT-2 were recommended to use for evaluating the motor proficiency in children with strabismus, especially in subtests of “Manual Dexterity”, “Upper-Limb Coordination”, and “Manual Coordination”.

Keywords: Preschooler, strabismus, motor ability, Bruininks-Oseretsky Test of Motor Proficiency Second Edition (BOT-2)