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系統識別號 U0026-0812200914170534
論文名稱(中文) 單一視覺與聽覺線索對巴金森病人動作效應:與線索敏感度相關
論文名稱(英文) The Effect of Single Visual and Auditory Cues on Movement Kinematics in Patients with Parkinson’s Disease:Correlation with Visual and Auditory Sensitivity
校院名稱 成功大學
系所名稱(中) 職能治療學系碩博士班
系所名稱(英) Department of Occupational Therapy
學年度 96
學期 2
出版年 97
研究生(中文) 卓柏宏
研究生(英文) Po-Hung Chou
電子信箱 b91409013@ntu.edu.tw
學號 T7695105
學位類別 碩士
語文別 中文
論文頁數 106頁
口試委員 口試委員-黃文柱
口試委員-郭立杰
指導教授-馬慧英
口試委員-林克忠
中文關鍵字 動作分析  線索敏感度  單一外在線索  巴金森病 
英文關鍵字 cuing sensitivity  parkinson’s disease  single external cuing  movement analysis 
學科別分類
中文摘要 背景及目的:一般認為,外在線索有助於巴金森病患動作表現的提升,但鮮少有研究利用單一知覺線索做為媒介;另外也少有研究針對巴金森病人本身對知覺線索的敏感度做討論。所以本研究目的有三:(1)評量單一聽覺及視覺線索對巴金森病患動作的效益;(2)探討巴金森個案在伸手抓握動作上是否會較一般老年人依賴外在線索;(3)外在聽覺及視覺線索對巴金森病患的動作效益是否和病患對聽覺及視覺敏感度取向有關。

方法:22 位巴金森病人及 22 位年齡配對健康成年人參與研究。個案先進行IVA+PLUS的測試以取得反應取向,之後進行伸手抓握的動作測試,所有受測者皆必須在三種情境下進行動作:a.沒有任何線索;b. 單一聽覺線索;c. 單一視覺線索。個案被隨機分配到三種不同的情境順序。

結果與結論: (1)單一外在聽覺及視覺線索能有效提升巴金森病患的伸手抓握動作。(2)巴金森病患在伸手動作較控制組個案依賴外在線索;在抓握動作則兩組無顯著差異。(3)在部分伸手抓握動作運動學變數上,聽覺取向個案在提供聽覺線索的情境下動作上獲得較大的效益;而視覺取向個案在提供視覺線索的情境下動作上會有較大的效益。研究結果建議在未來提供巴金森病患外在線索時,個案對於聽覺及視覺敏感度可能是一項重要的考量因素。
英文摘要 Purpose: It has been reported that external cuing could improve parkinson’s disease(PD) patients’ movement, but there is few research on the effects of single cuing and cuing sensitivity. So the purposes of this study were to (1) examine the effect of single auditory and visual cues on upper extremity movement in PD, (2) examine if PD’s movement depend on external cues more than normal ageing people’s, and (3) evaluate the association between the cueing effect and the auditory and visual sensitivity in PD.

Methods:22 PD patients and 22 age-matched control subjects participated in this study. IVA+PLUS was used to discriminate the subjects’ auditory and visual sensitivity. All subjects reached and grasped a bottle in 3 conditions:(1)no cue, (2)single auditory cue, and (3)single visual cue.

Results & conclusion:First, single auditory and visual cuing could improve PD’s reaching and grasping movement. Second, we found that PD patients’ reaching movement depended on external cues more than control group’s , but not the grasping movement. Finally, there are some associations between sensitivity and the effects of external cuing in PD patients. A more auditory-sensitive PD patient would benefit more from auditory cueing than from visual cueing. A more visually-sensitive PD patient would benefit more from visual cueing than from auditory cueing. The results of this study suggest the importance of taking into consideration of auditory and visual sensitivity of PD patients when providing external cues to them.
論文目次 中文摘要.....................I
Abstract.....................II
誌謝.........................IV
目錄.........................VI
表目錄.......................IX
圖目錄........................X
附錄目錄.....................XI
第一章、緒論..................1
第一節、動機與目的..........1
第二節、研究重要性..........3
第二章、文獻回顧..............4
第一節、巴金森病及其腦部缺損及其動作障礙......4
第二節、外在知覺線索對巴金森病動作的影響......9
壹、聽覺線索對於巴金森病病患動作上的影響.....9
貳、視覺線索對於巴金森病病患動作上的影響....17
参、單篇研究對於兩種外在線索對巴金森病患動作效益比較..21
肆、單一知覺線索對於巴金森病病患動作上的影響.....23
第三節、外在線索敏感度.......................25
第四節、文獻回顧總結與研究假設...............29
第三章、研究方法學...........31
第一節、研究設計.............................31
第二節、研究受測者...........................32
第三節、研究工具.............................34
壹、臨床篩檢工具.........................34
貳、Integrated Visual and Auditory Continuous Performance Test............................36
參、動作分析儀器.........................37
第四節、研究流程..........................39
第五節、重要參數定義及資料處理...............41
第六節、資料分析與統計方法...................44
第四章、研究結果.............46
第一節、基本人口學資料............................46
第二節、巴金森病人與控制組基本伸手抓握動作差異....47
第三節、單一聽覺線索對巴金森病人伸手抓握效益......48
第四節、單一視覺線索對巴金森病人伸手抓握效益......50
第五節、巴金森病人對外在線索依賴性................52
第六節、線索敏感度對外在線索效益的影響............54
第五章、討論.................56
第一節、兩組基本抓握動作比較......................56
第二節、單一聽覺線索對巴金森病人伸手抓握動作效益..58
第三節、單一視覺線索對巴金森病人伸手抓握動作效益..60
第四節、巴金森病人對外在線索依賴性................62
第五節、線索敏感度對外在線索效益的影響............64
第六章、結論.................67
第一節、單一外在線索對巴金森病人伸手抓握動作效益..67
第二節、巴金森病患對外在線索敏感度................68
第三節、線索敏感度與外在線索效益..................69
第四節、臨床應用及學術發展........................70
第五節、研究限制與檢討............................71
第六節、未來研究建議..............................72
參考文獻............................................73
自述……………………...............……………………...................................................107
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