THE EFFECT OF ADAPTED SPORTS IN QUALITY OF LIFE AND BIOPSYCHOSOCIAL PROFILE OF CHILDREN AND ADOLESCENTS WITH CEREBRAL PALSY

ABSTRACT Objective: The participation in sports and recreational activities promotes inclusion and the quality of life (QOL) for people with some type of disability. This study aims to evaluate and describe the effect of adapted sports (AS) on the QOL and biopsychosocial profile of children/adolescents with cerebral palsy (CP). Methods: Forty-seven children/adolescents with CP were evaluated and referred to AS (soccer and swimming). The QOL was evaluated by the Pediatric Outcome Data Collection Instrument (PODCI) and the biopsychosocial profile by the Behavior Checklist for Children/Adolescents (CBCL). These instruments considered the influence of gender, age, race, social income, education and topography of spasticity. Results: Seventeen children/adolescents who practiced AS were re-evaluated after one year. There was significant improvement in the dimensions of transfers and mobility (p=0.009), upper extremity function (p=0.021) and global function (p=0.004) of IARRP. There was significant improvement considering the attention disorder syndrome (p=0.026), and the attention deficit hyperactivity disorders (p=0.008) in the Diagnostic and Statistical Manual of Mental Disorders (DSM)-oriented analysis (CBCL). Children/adolescents with diplegia obtained greater benefit than those with hemiplegia in relation to the comfort and pain (p=0.02) and global dimension (p=0.027) (PODCI). The boys had higher scores in total competence (p=0.048); the extremely poor group obtained higher levels in the breaking rules syndrome (p=0.008). Conclusions: The AS had a positive effect on the QOL and biopsychosocial profile of children/adolescents with CP in this sample, especially considering the global and upper extremity function, capacity for transfers and mobility, and benefits in the problems related to difficulties in attention.

摘要
研究目的：参与体育与休闲活动可提升各类残障人士的社会包容性与生活质量（Quality of Life, QOL）。本研究旨在评估并描述适应性运动（Adapted Sports, AS）对脑性瘫痪（Cerebral Palsy, CP）儿童/青少年的生活质量及生物-心理-社会特征的影响。
研究方法：本研究纳入47名确诊CP的儿童/青少年，对其进行初始评估后安排参与适应性运动项目（足球与游泳）。采用儿科结局数据收集工具（Pediatric Outcome Data Collection Instrument, PODCI）评估其生活质量，采用儿童/青少年行为量表（Behavior Checklist for Children/Adolescents, CBCL）评估其生物-心理-社会特征。分析过程考量了性别、年龄、种族、社会经济收入、受教育程度及痉挛型瘫痪分型等因素的影响。
研究结果：其中17名参与适应性运动的儿童/青少年在随访1年后接受了二次评估。结果显示，IARRP量表的转移与移动维度（p=0.009）、上肢功能维度（p=0.021）及整体功能维度（p=0.004）均出现显著改善。基于精神障碍诊断与统计手册（Diagnostic and Statistical Manual of Mental Disorders, DSM）的CBCL分析显示，注意障碍综合征（p=0.026）与注意缺陷多动障碍（p=0.008）相关维度的得分显著提升。在PODCI量表的舒适度与疼痛维度（p=0.02）及整体维度（p=0.027）方面，双瘫型CP患儿的获益显著优于偏瘫型患儿。男性患儿的总胜任力得分更高（p=0.048）；社会经济收入极低组患儿的违规综合征得分显著更高（p=0.008）。
研究结论：本研究样本显示，适应性运动对CP儿童/青少年的生活质量及生物-心理-社会特征具有积极影响，尤其体现在整体功能与上肢功能、转移与移动能力的提升，以及注意相关问题的改善方面。