社福機構中成年智能障礙者姿態不良與相關因素初探

A Preliminary Study of Poor Posture and Its Associated Factors in Adults with Intellectual Disability in a Welfare Institution

張雯玲(Wen-Ling Chang)

智能障礙 ； 姿態 ； 頭前傾 ； 駝背 ； Intellectual disability ； posture ； forward head ； kyphosis

身心障礙研究季刊

13卷3期（2015 / 09 / 01）

141 - 152

繁體中文

目的：智能障礙者是許多疾病的高危險群，而台灣缺乏此族群相關流行病學調查。因此本研究為了瞭解本社福機構中成年智能障礙者姿態不良的比例及分布，分析個人基本資料與姿態的相關性。方法：採取橫斷面研究法（Cross-section study），蒐集本社福機構18歲以上智能障礙者之基本資料，並量測其頭前傾角度、駝背角度、雙肩角度差，經脊椎側彎篩檢及脊椎側彎X光影像檢查。以SPSS 20版統計套裝軟體進行檔案串檔與相關的描述及推論性統計分析，p值小於0.05為顯著差異。結果：研究樣本共137位智能障礙者，男性91位、女性46位，平均年齡30.9±9.5歲、體重58.2±12.5公斤、踝關節超音波骨質密度篩檢T值為-0.3±2.0；頭前傾角度平均50.7±13.4度，駝背角度平均28.5±9.3度，雙肩角度差平均2.5±2.9度。脊椎側彎篩檢出疑似脊椎側彎者，共38人；經X光影像檢查確認Cobb角度大於10度者，共15人。障礙級別與頭前傾角度呈顯著正相關（r = 0.175, p = 0.041）。結論：本社福機構之智能障礙者，障礙級別愈高、頭前傾角度愈大，且頭前傾及駝背角度皆較一般族群角度較大，顯示本機構中的智能障礙者存在姿態不良的問題。

Purpose: This study would describe the postural angles of forward head, kyphosis, uneven shoulder level, and scoliosis in persons with intellectual disability in welfare institute. Methods: This was a cross-section study. The study conducted in St. Joseph Social Welfare Foundation in Taiwan Hsinchu. Those with intellectual disability had measured the posture and collected the basic data. We used SPSS 20 to report on the relationship between the postural angles, scoliosis and age, gender, weight, level of disability and bone density. Results: 137 adults with intellectual disability participated (91males and 46 females; mean ± SD age 30 ± 9.5 years old; mean ± SD weight 58.2 ± 12.5 kg and mean ± SD T-score of bone density -0.3 ± 2.0). The average angles of forward head was 50.7 ± 13.4 degree, kyphosis was 28.5 ± 9.3 degree, difference of uneven shoulder level was 2.5 ± 2.9 degree. There were 38 individuals screened out scoliosis by Adam's test, and 15 among them with Cobb's angle more than 10 degree by X-ray. Forward head angle was shown significantly positive correlation with disability level (r = 0.175, p = 0.041). Conclusions: The more severe level of disability, the more serious of forward head angle, and the kyphosis angles were higher than normal people. This study was shown poor posture problems existed in those with intellectual disability in welfare foundation.

1. Brink, Y.,Louw, Q.,Grimmer, K.,Jordaan, E.(2014).The spinal posture of computing adolescents in a real-life setting.BioMed Central Musculoskelet Disorders,15,212.
2. Côté, P.,Kreitz, B. G.,Cassidy, J. D.,Dzus, A. K.,Martel, J.(1998).A study of the diagnostic accuracy and reliability of the Scoliometer and Adam's forward bend test.Spine,23(7),796-802.
3. Daneshmandi, H.,Bahiraei, S.,Karimi, N.,Babakhani, M.(2014).The relationship between alignment upper-limb and Postural control in adolescents with Down syndrome.La Pensee Journal,76(5),69-79.
4. Drzal-Grabiec, J.,Snela, S.,Rykala, J.,Podgorska, J.,Banas, A.(2013).Changes in the body posture of women occurring with age.BioMed Central Geriatrics,13,108.
5. Fon, G. T.,Pitt, M. J.,Thies, A. C.(1980).Thoracic kyphosis: range in normal subjects.American Journal of Roentgenology,134(5),979-983.
6. Gadotti, I. C.,Biasotto-Gonzalez, D. A.(2010).Sensitivity of clinical assessments of sagittal head posture.Journal of Evaluation in Clinical Practice,16(1),141-144.
7. Guan, X.,Fan, G.,Wu, X.,Zeng, Y.,Su, H.,Gu, G.,Zhou, Q.,Gu, X.,Zhang, H.,He, S.(2015).Photographic measurement of head and cervical posture when viewing mobile phone: A pilot study.European Spine Journal
8. Kado, D. M.(2009).The rehabilitation of hyperkyphotic posture in the elderly.European Journal of Physical and Rehabilitation Medicine,45(4),583-593.
9. Lancioni, G. E.,Singh, N. N.,O'Reilly, M. F.,Sigafoos, J.,Didden, R.,Pichierri, S.(2010).Automatic prompting and positive attention to reduce tongue protrusion and head tilting by two adults with severe to profound intellectual disabilities.Behavior Modification,34(4),299-309.
10. Nejati, P.,Lotfian, S.,Moezy, A.,Nejati, M.(2015).The study of correlation between forward head posture and neck pain in Iranian office workers.International Journal of Occupational Medicine and Environmental Health,28(2),295-303.
11. Ruivo, R. M.,Carita, A. I.,Pezarat-Correia, P(2015).The effects of training and detraining after an 8 month resistance and stretching training program on forward head and protracted shoulder postures in adolescents: Randomised controlled study.Manual Therapy
12. Van Maanen, C. J.,Zonnenberg, A. J.,Elvers, J. W.,Oostendorp, R. A.(1996).Intra/interrater reliability of measurements on body posture photographs.The Journal of Cranio-mandibular Practice,14(4),326-331.
13. 吳倉華(2011)。碩士論文(碩士論文)。台南市，國立成功大學。
14. 邱志鴻、廖麗文、于瑛輝、呂逸群、蔡明峰、李建輝(2003)。非腦性麻痺之智能不足患者脊柱側彎之盛行率：台北市一教養院院生分析研究。中華民國復健醫學會雜誌，31(2)，93-98。
15. 鄭斐馨(2011)。碩士論文(碩士論文)。台北市，國立陽明大學。