Efficacy of Foot Reflexology in Gross Motor Development, Swallowing and Chewing in Preschool Children with Cerebral Palsy

[[abstract]]腦性麻痺兒童常伴隨身體功能障礙（Physical dysfunction），無法獨立執行日常生活，將對於家庭、社會及國家皆造成沉重的負擔。本研究目的主要是探討足反射區按摩對腦性麻痺兒童粗動作發展及疾病臨床表徵（吞嚥、咀嚼和流口水）的改善成效。採單組前後測設計（one-group pretest-posttest design），研究對象採立意取樣，取自北部某社區為醫師診斷腦性麻痺之患者共30位，研究介入措施為由照顧者每日施予個案一次足部按摩，參與之照顧者先經由研究者教導足反射區按摩法，並逐一檢核照顧者執行足反射區按摩之每一步驟，以確保每位照顧者按摩方式之正確及一致性。研究評量工具包括粗動作發展量表（Gross Motor Function Measure ,GMFM）及疾病臨床表徵評量表。以SPSS for window 及SAS套裝軟體進行資料建檔及統計分析，並以百分比、平均值、標準差及Kruskal-Wallis test、Mann-Whitney U及GEE（Generalized Estimating Equation）等分析法。結果顯示足反射區按摩對改善腦性麻痺兒童粗動作發展及疾病臨床表徵有顯著成效。研究結果建議提供腦性麻痺兒童另一種居家自我復健方式參考，未來能將足反射區按摩法列為護理必修或選修課程，進而以不同的研究設計，來探討足反射區按摩於相關疾病之適用範疇與照護成效。 Cerebral palsy is associated with physical dysfunction, lack of independence in daily life. It imposes a heavy burden on the family, society and country of its sufferers. This study the effect of foot reflexology on the gross motor development of children with cerebral palsy, with a view to improving their clinical symptoms. An experiment was performed with a one-group pretest-posttest design. Thirty children with cerebral palsy, diagnosed by a physician in northern Taiwan, were purposively sampled. The intervention was as follows. Every subject was given foot reflexology once daily by a caregiver who had been instructed by the researcher. Each step that was performed by the caregivers was monitored to ensure that the children received correct and consistent treatment. The results of the study were evaluated by GMFM and measurement of clinical symptoms. SPSS for Windows and SAS were used to establish a data profile and perform statistical analysis. Data were expressed as percentages, means (with standard deviation), and Kruskal-Wallis test, Mann-Whitney U and GEE were used for analysis. The results of this study demonstrated that foot reflexology clearly improved the gross motor development and clinical symptoms of children with cerebral palsy. The results suggest that another domestic self-rehabilitation method for such children is available. We suggested the inclusion of foot reflexology as a required or elective course for nurses in the future. Furthermore, different experimental designs should be used to study the applications and effects of foot reflexology on patients with related diseases