短型對掌拇指副木對腦性麻痺兒童手部功能的影響

摘 要 本研究旨在探討短型對掌拇指副木對腦性麻痺兒童手部功能的影響。研究採用實驗組控制組前後測設計，將20位腦性麻痺兒童依隨機取樣分為實驗組和控制組進行實驗與評估。實驗組10位受試者（17隻手）穿戴短型對掌拇指副木四週，早上3小時，下午3小時，晚上睡覺時亦需穿戴，並於每週於職能治療時間穿戴副木練習一次治療活動；控制組10位受試者（17隻手）每週於職能治療時間練習一次治療活動，持續四周。結果顯示腦性麻痺兒童穿戴短型對掌拇指副木確實能夠改善精細動作技巧、操作靈巧度、指腹捏力和側指捏力，實驗組的前後測分數差遠比控制組高，統計分析後達顯著差異，但是短型對掌拇指副木未能改善腦性麻痺兒童的痙攣問題，指尖捏力則是難以施測，無法比較其差異性。

Abstract Objective. Different kind of splints have been designed and used by occupational therapists to improve motor skills of upper extremities. This experimental — design study was used to assess the effectiveness of a short opponens thumb splint on hand function in children with cerebral palsy. Method. Four different measures were used: (a) the Peabody Developmental Fine Motor Scales-Second Edition, a measure of fine motor abilities; (b) the Modified Ashworth Scale, a clinical measure of spasticity; (c) the Box and Block Test, a test of gross manual dexterity; and (d) palmar, lateral and tip pinch strength. The children were fitted with short opponens thumb splints, which were worn 6 hr during the day and all night for 4 weeks. Results. After the application of short opponens thumb splints, statistical analysis of the data indicate that the children showed clinically significant improvement in fine motor skills, performance on the Box and Block Test scores, palmar, and lateral pinch strength However, a statistical unsignificant decrease in spasticity demonstrated by the Modified Ashworth Scale and tip pinch strength could not be measured. Conclusion. These results suggest that short opponens thumb splints may improve underlying aspects of hand function in children with cerebral palsy. Replication of this study with more subjects is recommended to confirm these results.