測量: 動作發展里程碑
嬰兒(2-24個月大)

Hammersmith嬰兒神經檢查(HINE)是一種簡單且可計分的方法,用來判斷2個月至2歲嬰兒的病徵。 HINE包括3個部分,內含26個項目,可用來評估不同面向的神經功能7,8:

  • 第1部分:神經系統檢查,評估腦神經功能、姿勢、活動力、張力、反射力、反應力
  • 第2部分:發育指標(頭部控制、坐姿、自主性抓握、踢、滾動、爬行、站立、行走能力)
  • 第3部分:行為評估(意識狀態、情緒狀態、社會取向)

HINE第二部分(動作發展里程碑)包括8個項目,以5個分數來標示不同程度,分別是0 到4分。0分表示無活動力,最高分數為4分9

  • 有些項目的最高得分為2或3分(見下表)

 

HINE第二部分的計分圖表說明動作發展里程碑9

HINE第二部分的研究中,一般正常的249個嬰兒所達到的動作發展里程碑7

達成的年齡

% 達到里程碑

動作發展里程碑

達成的年齡

12個月

% 達到里程碑

90%

動作發展里程碑

能保持對頭部的控制
翻身坐起(轉動)
能做鉗狀抓握
能玩自己的腳
由俯臥轉向仰臥(再轉回俯臥)
用雙手與膝蓋爬行

79%

能在沒有支撐下站立

51%

行走

達成的年齡

18個月

% 達到里程碑

90%

動作發展里程碑

在沒有支撐下站著/行走

在嬰兒型SMA(I型)中,動作發展里程碑的達成很罕見

一項對於病發於1至8個月嬰兒型的SMA患者(I型, n = 33) 的回溯性研究顯示,症狀嚴重的嬰兒中沒有任何人能達到重要的動作發展里程碑,例如滾動身體、獨立坐起、爬行、站立或步行。

嬰兒型SMA中極少案例能夠達到動作發展里程碑。患有SMA最嚴重病症(早發)的嬰兒可能在HINE第二部分中所有8個項目的評估都為0分。9

REFERENCES 

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SMA患者的基本活動能力與病情進展如何決定日常活動與生活方式?

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