Association between 24 h movement behaviors and fundamental motor skills of children with autism spectrum disorder in Jinan
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摘要:
目的 使用成分数据分析法探究孤独症谱系障碍(ASD)儿童24 h活动与基本动作技能(FMS)的相关性，以及各活动等时替代后FMS的预期变化，为提高ASD儿童FMS水平提供参考依据。 方法 2023年10月至2024年4月，采用整群随机抽样方法，抽取济南市7所特殊教育学校301名6~10岁ASD儿童，使用加速度计和粗大肌肉动作发展测试调查其24 h活动和FMS水平，使用R软件对成分数据进行描述性统计、多元线性回归和等时替代效益分析。 结果 ASD儿童中高强度体力活动(MVPA)时间占比与FMS总分、移动技能和物体控制技能得分均呈正相关(β值分别为12.42，6.32，6.10，P值均 < 0.01)。将15 min MVPA替代睡眠(SLP)，ASD儿童的FMS总分、移动技能和物体控制技能得分分别增加3.66，1.91，1.75分；将15 min MVPA替代久坐行为(SB)，ASD儿童的FMS总分、移动技能和物体控制技能得分分别增加3.72，1.88，1.83分；将15 min MVPA替代低强度体力活动(LPA)，ASD儿童的FMS总分、移动技能和物体控制技能得分分别增加3.32，1.57，1.74分(P值均 < 0.05)。此外，将15 min LPA替代SB，ASD儿童的移动技能得分增加0.28分(P < 0.05)。“剂量-效应”分析显示，MVPA替代SLP、SB、LPA均可提升ASD儿童的FMS水平，且MVPA与SLP、SB、LPA的相互替代效应具有不对称性；LPA替代SB可提升ASD儿童的移动技能水平。 结论 24 h活动中，MVPA、LPA时间对ASD儿童基本动作技能增加有积极作用。学校和家庭应优化ASD儿童24 h活动时间分配，以促进ASD儿童FMS水平的提升。 Abstract:Objective To study the association between 24 h activities and Fundamental Motor Skills (FMS) among children with autism spectrum disorder (ASD) using compositional data analysis, and the expected changes in FMS after isochronous substitution of each activity, in order to provide reference basis for improving FMS levels in children with ASD. Methods From October 2023 to April 2024, a total of 301 children with ASD aged 6-10 from 7 special education schools in Jinan, were investigated by cluster random sampling, and 24 h movement behaviors were calculated based on accelerator data. Test of Gross Motor Development-2 was used to assess FMS. R software was used to perform the descriptive statistical, multiple linear regression and isochronous substitution analyses. Results The proportion of moderate-vigorous physical activity (MVPA) in children with ASD was positively related with FMS scores, locomotor, and object control skills (β=12.42, 6.32, 6.10, P < 0.01). Reallocating 15 min from sleep (SLP) to MVPA resulted in respective increases of 3.66, 1.91, and 1.75 points in FMS scores, locomotor skills, and object control skills (P < 0.05). Reallocating 15 min from sedentary behavior (SB) to MVPA resulted in respective increases of 3.72, 1.88, and 1.83 points in FMS scores, locomotor skills, and object control skills (P < 0.05). Reallocating 15 min from light physical activity (LPA) to MVPA resulted in respective increases of 3.32, 1.57, and 1.74 points in FMS scores, locomotor skills, and object control skills (P < 0.05). Moreover, reallocating 15 min from SB to LPA resulted in an increase of 0.28 points in locomotor skills (P < 0.05). Dose-response analysis revealed that substitution of MVPA for SLP, SB, and LPA in children with ASD enhanced their FMS levels, and their substitution was asymmetrical; and substitution of LPA for SB enhanced locomotor skills level. Conclusions Among the 24 h movement behaviors, increasing the time spent on MVPA and LPA have positive impacts on the FMS of children with ASD. Schools and families should optimize the allocation of 24 h activity time in children with ASD, so as to promote the improvement of FMS levels of children with ASD. -
Key words:
- Motor activity /
- Autistic disorder /
- Motor skills /
- Child
1) 利益冲突声明 所有作者声明无利益冲突。2) 丁佳宁和原雅青为共同第一作者 -
图 1 ASD儿童MVPA与LPA、SLP和SB相互替代对FMS总分的影响
Figure 1. Impacts of mutual substitution between MVPA and LPA, SLP and SB on FMS total score among children with ASD
图 2 ASD儿童MVPA与LPA、SLP和SB及LPA与SB相互替代对移动技能的影响
Figure 2. Impacts of mutual substitution of MVPA and LPA, SLP, SB as well as LPA and SB on mobile skills among children with ASD
图 3 ASD儿童MVPA与LPA、SLP和SB相互替代对物体控制技能的影响
Figure 3. Impacts of mutual substitution between MVPA and LPA, SLP and SB on object control skills among children with ASD
表 1 济南市ASD儿童24 h活动时间与FMS的线性回归分析(β值，n=301)
Table 1. Linear regression analysis on 24 h activity time and FMS among children with ASD in Jinan(β, n=301)
自变量 FMS总分 移动技能 物体控制技能 SLP -6.58 -5.55 -1.02 SB -8.86 -3.97 -4.89 LPA 3.02 3.20 -0.18 MVPA 12.42** 6.32** 6.10** R2值 0.47 0.40 0.44 模型P值 ＜0.01 ＜0.01 ＜0.01 注：**P＜0.01。 
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表 2 济南市ASD儿童24 h活动时间15 min等时替代的FMS预测值变化[β值(95%CI)，n=301]
Table 2. Changes in FMS prediction values of 15-minute isochronous substitution for 24 h activity time among children with ASD in Jinan[β(95%CI), n=301]
增加 减少 FMS总分 移动技能 物体控制技能 SLP SB 0.05(-0.67~0.78) -0.03(-0.47~0.41) 0.08(-0.28~0.45) SLP LPA -0.34(-1.08~0.39) -0.33(-0.78~0.11) -0.01(-0.38~0.36) SLP MVPA -5.42(-8.01~-2.82)* -2.80(-4.38~-1.22)* -2.61(-3.93~-1.29)* SB SLP -0.04(-0.77~0.68) 0.03(-0.41~0.48) -0.08(-0.45~0.28) SB LPA -0.39(-0.87~0.08) -0.30(-0.59~-0.01)* -0.09(-0.33~0.15) SB MVPA -5.47(-7.96~-2.97)* -2.77(-4.29~-1.25)* -2.69(-3.96~-1.42)* LPA SLP 0.33(-0.38~1.05) 0.32(-0.11~0.76) 0.01(-0.35~0.37) LPA SB 0.38(-0.07~0.84) 0.28(0.01~0.56)* 0.09(-0.13~0.33) LPA MVPA -5.09(-7.80~-2.37)* -2.48(-4.14~-0.83)* -2.60(-3.98~-1.22)* MVPA SLP 3.66(1.88~5.45)* 1.91(0.82~3.00)* 1.75(0.84~2.66)* MVPA SB 3.72(2.04~5.40)* 1.88(0.85~2.90)* 1.83(0.98~2.69)* MVPA LPA 3.32(1.39~5.24)* 1.57(0.40~2.74)* 1.74(0.76~2.72)* 注：*P＜0.05。
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