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系統識別號 U0026-1608201017363100
論文名稱(中文) 分析巴金森氏病個案在騎馬機上的坐姿平衡表現:探討身體質心移動軌跡及與傳統平衡評估之相關性
論文名稱(英文) Analysis of Sitting Balance Performance in Parkinson’s Disease with Horseback Riding Exercise Machine: Excursion of COM, Correlation with Traditional Balance Measures
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 98
學期 2
出版年 99
研究生(中文) 趙晏莉
研究生(英文) Yen-Li Chao
學號 t7697104
學位類別 碩士
語文別 中文
論文頁數 104頁
口試委員 指導教授-馬慧英
口試委員-黃文柱
口試委員-郭立杰
口試委員-林呈鳳
中文關鍵字 巴金森氏病  坐姿平衡  騎馬機 
英文關鍵字 Parkinson’s disease  sitting balance  horseback riding exercise machine 
學科別分類
中文摘要 研究指出巴金森氏病個案的軀幹有功能上的缺陷,而此缺陷似乎不只影響站姿時的平衡表現也會影響坐姿時的平衡表現,然而目前研究多以站姿下的評估為主。騎馬機是一個可提供乘坐者外在坐姿干擾的創新儀器,然而目前相關研究多以介入為主,沒有研究探討受測者在騎馬機乘坐時的運動學資料。因此本研究的目的有兩點:(1)探討巴金森氏病個案於騎馬機的各運動學參數表現與健康控制組的差異,(2)了解受測者在騎馬機上的各運動學參數與傳統平衡評估工具之間的相關性(坐姿平衡表現、整體平衡表現及平衡信心)。
研究招募了21位巴金森氏病受測者及19位年齡配對之健康受測者。受測者進行以下評估工具的資料收集:疾病嚴重程度使用巴金森症狀衡量表;坐姿平衡表現使用軀幹損傷量表、坐姿多方向伸取測驗及軸向旋轉角度;整體平衡表現使用柏格氏平衡量表;平衡信心使用特定活動平衡信心量表。另外受測者須乘坐由不同速度(快速/慢速)及馬鞍傾斜角度(水平/前傾/後傾)所組成的6種騎馬機情境。
研究發現巴金森氏病組的質量中心軌跡面積偏差值較健康控制組大。此外,較大的質量中心軌跡面積偏差值與較差的平衡表現有關。研究嘗試描述巴金森氏病個案在乘坐騎馬機時的運動學表現,且研究中所使用的運動學參數(質量中心軌跡面積偏差值)似乎是有效的平衡表現指標。本研究提供未來研究使用騎馬機為介入時的基礎。
英文摘要 Research has indicated that people with Parkinson's disease (PD) have deficient trunk control, and this deficit seems to influence balance not only in standing, but also in sitting. However, research in this field has mainly focused on standing balance. Horseback riding exercise machine is an innovated instrument that provides external perturbation for riders in sitting position. Although it has been used as intervention modality, there has been no research examining subject’s kinematic performance when riding on it. Therefore, the purpose of this study was(1) to compare kinematic performance on horseback riding exercise machine between people with PD and healthy controls, and(2)to understand the relationships between kinematic parameters on horseback riding machine and traditional balance measures (sitting balance, overall balance and balance confidence).
21 people with PD and 19 age-matched controls were recruited. Participants were tested by the following assessments: Unified Parkinson’s Disease Rating Scale (UPDRS)for disease severity; Trunk Impairment Scale(TIS), Seated Multi- directional Reach Test(SMRT) and axial rotation for sitting balance performance; Berg Balance Scale(BBS)for overall balance performance; Activities-specific Balance Confidence Scale(ABC scale)for balance confidence. Participants also rode on the machine under six conditions with varied speeds (fast and slow) and tilting angles(level, anterior tilt, and posterior tilt).
We found that people with PD had larger deviation of center of mass(COM)trajectory area than controls in all conditions. In addition, larger deviation of COM trajectory area was associated with worse balance performance. In conclusion, this study depicts the kinematic performance of people with PD when riding on the machine and the kinematic parameter we derived(deviation of COM trajectory area) appears to be a valid indicator of balance performance. This study provides foundation for future research to use horseback riding machine as intervention.
論文目次 中文摘要 I
ABSTRACT II
誌謝 IV
目次 V
表目錄 VII
圖目錄 IX
第一章、緒論 1
第一節、研究動機及目的 1
第二節、研究重要性 3
第二章、文獻回顧 4
第一節、巴金森氏病及其平衡表現 4
第二節、巴金森氏病坐姿平衡能力的評估 11
第三節、騎馬機 15
第四節、文獻回顧總結與研究問題 19
第三章、研究方法 20
第一節、研究設計 20
第二節、研究對象 21
第三節、研究工具 22
第四節、研究流程 31
第五節、重要參數定義 33
第六節、資料分析與統計方法 36
第四章、研究結果 37
第一節、受測者基本資料及平衡相關評估工具表現 37
第二節、巴金森氏病組與健康控制組在騎馬機上各參數上的表現 41
第三節、騎馬機上各參數的表現與坐姿平衡相關評估工具的相關性 54
第四節、騎馬機上各參數的表現與整體平衡相關評估工具的相關性 72
第五節、受測者在騎馬機上各參數的表現與平衡信心的相關性 75
第五章、討論 78
第一節、巴金森氏病組與健康控制組的平衡相關評估工具表現 78
第二節、巴金森氏病組與健康控制組在騎馬機上各參數上的表現 80
第三節、受測者在騎馬機上各參數與坐姿平衡相關評估工具的相關性 85
第四節、受測者在騎馬機上各參數與整體平衡相關評估工具的相關性 89
第五節、受測者在騎馬機上各參數與平衡信心的相關性 89
第六章、結論 90
第一節、總結 90
第二節、臨床應用及學術發展 92
第三節、研究限制及未來研究建議 93
參考文獻 94
英文參考文獻 94
中文參考文獻 104
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