| Summary: | 碩士 === 淡江大學 === 數學學系 === 88 === “Cerebral palsy” is a term used to describe a group of chronic conditions affecting body movement and muscle co-ordination. It is caused by damage to one or more specific areas of the brain. Children who have cerebral palsy (CP) may not be able to walk, talk, eat or play in the same ways as most other kids. Although cerebral palsy is not “curable” in the accepted sense, training and therapy can help improve physical function and promote the quality of life. Physical therapists may help children with CP learn to walk, use their wheelchair, stand by themselves, or go up and down stairs safely. Moreover, besides the physical function problem, there were more than one impediment for most of the CP children. Before the physical therapy, the physiotherapist will evaluate the capability of gross motor, fine motor, speech, intelligence, vision, and hearing of CP children.
In this paper we try to evaluate the treatment effects of physiotherapy based on the gross motor development quotient (GMDQ) and rates of independent sit and walk. We used the generalized linear models to establish a prediction model for GMDQ through the generalized estimating equations (GEE) method to take into account the dependent data problem. The survival analysis methods were used to evaluate the rates of independent sit and walk. And, we obtained the following results:
(1)The larger the treatment age, the lower the GMDQ will be; For those CP children with seizure and/or visual impairment, the GMDQ was lower compare to those without.
(2)The rate of independent sit was higher for those CP children with higher GMDQ in 18 or 24 months of chronological age.
(3)The rate of independent walk was higher for those CP children with higher GMDQ in 18 or 24 months of chronological age. For those CP children who can walk and/or crawl independently, the rate of independent walk was also significantly higher than those not able to walk or crawl.
第一章 緒論 1
第二章 研究內容 5
2.1 研究動機 5
2.2 研究目的 7
第三章 統計方法 9
3.1 粗動作發展商數方面 9
3.2 獨坐及獨走率的評估方面 10
3.2.1 Kaplan-Meier Estimate 的方法 10
3.2.2 Cox’s Proportional Hazards Model 的方法 11
第四章 發展商數的評估 12
4.1 分析結果 12
4.1.1 單一因子分析 12
4.1.2 多重因子分析 15
第五章 獨坐及獨走率的評估 19
5.1 Kaplan-Meier Estimate 的方法 19
5.2 Cox’s Proportional Hazards Model 的方法 23
5.2.1 單一因子分析 23
5.2.1.1 獨坐率的單因子評估 24
5.2.1.2 獨走率的單因子評估 26
5.2.2 多重因子分析 29
5.2.2.1 獨坐率的多重因子評估 29
5.2.2.2 獨走率的多重因子評估 30
第六章 結論 32
6.1 粗動作發展商數評估方面 32
6.2 獨坐及獨走率的評估 32
6.3 結語 34
參考文獻 35
附圖 36
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