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系統識別號 U0026-0812200914145631
論文名稱(中文) 雙重作業對不同年齡層的受試者行走在不同地面時上肢動作變化的影響
論文名稱(英文) Age related changes of arm movements in dual task condition on different walking environment
校院名稱 成功大學
系所名稱(中) 物理治療研究所
系所名稱(英) Department of Physical Therapy
學年度 96
學期 2
出版年 97
研究生(中文) 謝耀徵
研究生(英文) Yao-Jheng Hsieh
電子信箱 t6695106@mail.ncku.edu.tw
學號 t6695106
學位類別 碩士
語文別 英文
論文頁數 71頁
口試委員 召集委員-白明奇
指導教授-黃英修
指導教授-卓瓊鈺
中文關鍵字 年齡  步態  挑戰性環境  上肢動作  雙重作業 
英文關鍵字 Dual task  Upper extremity  Challenging environment  Gait  Age 
學科別分類
中文摘要 研究背景與目的:老年人常因無法同時從事兩件事情而使平衡控制變差。然而,先前相關的研究大都專注於步態分析,較少注意到上肢的關節活動變化。實際上,前人的研究已指出,走路時上肢的關節活動變化情形,也可被視為是否走得平穩的指標。因此,本研究的目的乃在探討於雙重作業情境對於行走時上肢運動學變數的影響;同時,也想要研究不同軟硬度地面對於行走時上肢運動學變數的影響;最後,年齡族群和性別之間的差異也將被檢視。研究方法:本研究分別收取15位健康的老年人和年輕人,請他們分別行走於硬地或軟墊兩種情境,此為第一項作業情境。認知測驗包括辨認字體顏色,分別以兩種不同速度進行播放;以及倒數數字的記憶測試,此為第二項作業情境。因此,不同的作業情境以及在不同的地面上行走,總共有8種情境,每種情境需重覆行走3次。本研究利用5台紅外線攝影機以及25顆反光球記錄身體的運動學資料,之後利用Visual 3D和Matlab軟體做進一步的資料處理,以計算出關節活動變化情形和步態參數,統計方式則採用重複評量之多變量共變數分析,走路速度被視為一個共變數。結果:兩組受試者,在雙重作業的情境中較單一作業的情境中行走時,肘關節彎曲和軀幹彎曲出現代償性動作的幅度較高(p<0.05)。同時,兩組人於雙重作業的情境中,走路速度變慢、步長變短、站立期和擺盪期的時間增加(p<0.001)。在軟墊上行走較硬地面行走時,上肢關節和軀幹動作出現代償性動作的幅度也較高(p<0.05),上肢關節動作達到最大值的時間變長(p<0.05)。步態方面的表現,則發現兩組人行走在軟墊上時,走路速度變慢、步長變長、站立期的時間增加和擺盪期的時間減少(p<0.05)。關於不同年齡層之間的比較,老年人上肢關節或軀幹的動作變化幅度較年輕人小(p< 0.05)、走路速度較慢(p<0.001)、步長較短(p<0.05)、站立期和擺盪期的時間較長(p<0.05);此外,年齡和性別之間發現有交互作用,年老的女性上肢關節的動作幅度較年老的男性小(p<0.011),但是年輕人則為相反的(p<0.001)。結論:當執行雙重作業時,必須分心處理兩項作業情境,因而超出大腦總處理的容量,可能使其中之一或兩者的作業表現變差。而當行走在軟墊上時,可能因本體感覺受到干擾,造成需要較大的上肢關節或軀幹的動作幅度,來應付較具有挑戰性的環境。最後,本研究發現,相較於年老的男性,年老的女性上肢關節的動作幅度較小,可能與老年人為確保走路平穩,而調整動作控制有關,老年人(尤其是年老的女性)採取較保守的動作控制策略,因而其動作較為僵硬,動作幅度較小。
英文摘要 Background and purpose: Most of the previous studies investigated dual task effects on gait performance. Few of them focused on changes of arm movements. The purpose of this study was to investigate whether dual task paradigm would influence upper extremity movement during walking. Furthermore, we would like to examine the effect of different walking surfaces on the dual task gait. Effect of age and gender on dual task performance was also investigated. Methods: Fifteen healthy young adults and 15 older adults were included in this study. All participants were asked to perform both walking task alone (single-task condition) and in combination with cognitive task while walking (dual-task condition). In the single task condition, each subject was asked to walk on soft foam and hard floor separately. In the dual task condition, subjects were asked to perform Stroop test and digit span test while walking. Four task conditions (1single task, 3dual task) x two floor conditions were encountered. Results: Both groups had greater elbow and trunk movement in the sagittal plane under the dual task condition than the single task condition (p<0.05). All subjects had greater upper extremity and upper body movement on the soft floor than on the hard floor condition (all p<0.05). Furthermore, subjects also had faster pelvis movement from peak to peak and reached peak upper extremity movement later on the soft floor than hard floor (p<0.05). Among gender, the older females had smaller and later upper extremity movement than the older males (p<0.05). The opposite was true for the young adults (all p<0.001). Conclusion: When two tasks were performed together, attention demand may exceed the total capacity of the brain. One or both task performances might deteriorate in the dual task condition. When walking on the soft floor, somatosensory system was disturbed. Therefore, subjects might need greater upper extremity and upper body movements to compensate for this situation. Compared with the older males, the older females may use a more conservative strategy in different walking conditions.
論文目次 Abstract --------------I
Chinese abstract ------III
Acknowledge -----------V
Table of contents ------VI
List of tables --------VIII
List of figures --------IX
Introduction -------------------1
Methods 8
Subjects --------------------8
Apparatus -------------------8
Experimental procedure-------10
Data analysis --------------12
Statistical analysis---------13
Results 15
Gait velocity --------------15
Step length and step width --15
Stance time and swing time --15
Movement amplitude for different joints--16
Time to peak (%) ------------22
Cognitive task performance---25
Physiological test ----------25
Discussion ---------------------27
Conclusion ---------------------38
References ---------------------39
Appendix -----------------------69
Author’s background -----------71
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