第24屆 海報式論文醫療類【比較學齡前自閉症譜系障礙兒童的粗大動作表現及辨識特定動作技巧的生物力學缺失 Comparing gross motor performance in preschoolers with and without ASD and identifying the associated biome

黃珮淳¹、張子熙²、陳昭縈¹*
Pei-Chun Huang¹, Roy Cheung², Chao-Ying Chen¹*

¹長庚大學醫學院物理治療學系暨復健科學研究所、
²澳洲西雪梨大學健康科學研究所
¹School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
² School of Health Sciences, Western Sydney University, Sydney, Australia

Background and Purpose: In recent years, motor impairments in children with autism spectrum disorders (ASD) has gained increasing attention because it does not only affect children’s motor function but may also have negative impact on the performance in social communication, physical activity, and participation domains. However, more detailed information regarding the performance of different motor skill sets is less discussed in this population. There is also a lack of study investigating neuromotor control of key motor skills through biomechanical and muscle activation analysis in children with ASD, especially when they are at a younger age before school life. Therefore, the purpose of the study was to assess gross motor function and kinetic, kinematic, and muscle activation patterns of targeted motor skills and their associations in preschoolers with and without ASD. Methods: Fifteen 3-6 years old preschool-aged children with ASD and 15 age-/sex-matched children with typical development (TD) were planned to be recruited in this study. The stationary, locomotion, and object manipulation subtests of the Peabody Developmental Motor Scales-Second Edition (PDMS-2) are assessed to evaluate gross motor performance. Biomechanical data including kinetics and kinematics as well as electromyographic data are collected while subjects are performing running, jumping, and hopping. The Mann-Whitney U tests were used to compare the differences of raw scores, percentile, and quotient of overall gross motor performance and the three subtests of PDMS-2 between preschoolers with and without ASD. The Chi-squared tests were used to compare the distribution of subjects whose motor performance reach the average level or not based on the quotient of overall gross motor performance and the standard scores of the three subtests. The trend of biomechanical performance of targeted motor skills are described presently.

Results: Data from eight subjects with ASD (averaged age = 5.0 _­± 0.9 yrs; M:F = 7:1) and eight matched subjects (averaged age = 5.0 _­± 0.8 yrs; M:F = 7:1) were analyzed so far. Preschoolers with ASD showed significantly poorer overall gross motor performance on percentile (p = 0.021) and quotient (p = 0.021) than the control group. There is also a significantly lower percentile in the object manipulation subtest (p = 0.015) and a trend of lower percentile in the locomotion subtest in the ASD group when compared to the control group (p = 0.083). Similarly, there is a significantly larger number of preschoolers with ASD who showed below-average performance of the object manipulation subtest (p = 0.012) as well as a trend in the locomotion subtest (p = 0.055) than those with TD. Regarding the biomechanical performance, preschoolers with ASD had larger medial-lateral weight shifting during running based on hip joint movement in the frontal plane. Preschoolers with TD showed more extended hip and knee, and ankle position starting from take-off, which may indicate stronger force and power generated, during jumping and hopping.

Conclusion: The preliminary results indicated that preschoolers with ASD may have poorer motor performance, specifically in the locomotion and object manipulation domains. Our kinematic outcomes also supported that a few biomechanical features might be the underlying mechanism to affect their performance in the locomotion domain. With the completion of this study, we may further confirm the current findings to provide additional information to guide future assessment and early intervention in children with ASD. Future studies to focus on object manipulation performance, such as ball throwing, catching, and kicking skills, are also recommended to enhance treatment programs that target physical function in this population.

Keywords: Autism spectrum disorders, preschooler, motor, biomechanics