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系統識別號 U0026-2308201112452900
論文名稱(中文) 帕金森患者於虛擬接球活動之動作表現:球速、距離及方向之效應
論文名稱(英文) Motor performance in virtual ball catching activities in patients with Parkinson ’s disease:Effects of speed, distance, and direction
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 99
學期 2
出版年 100
研究生(中文) 蘇桂瑢
研究生(英文) Guei-Jung Su
電子信箱 t76981051@mail.ncku.edu.tw
學號 t76981051
學位類別 碩士
語文別 中文
論文頁數 95頁
口試委員 指導教授-馬慧英
口試委員-吳菁宜
口試委員-林呈鳳
口試委員-黃文柱
中文關鍵字 帕金森病  虛擬實境  動作分析 
英文關鍵字 Parkison’s disease  virtual reality  motion analysis 
學科別分類
中文摘要 帕金森患者因基底核退化,以至於動作出現問題,如:僵硬、動作遲緩、姿勢不穩等症狀。而外在線索提示有助於帕金森患者動作表現,虛擬實境系統可給予參與者身歷其境的感覺,易控制實驗情境,減少實驗變異。故本研究探究在不同虛擬接球測試中,帕金森患者與健康者動作表現有何差異。
21位帕金森患者及21位年齡及性別配對之健康者參與研究。各組先進行功能性伸臂測試,再進行虛擬接球測試。虛擬接球測試共包含三個小實驗,實驗一:固定中間接球、100%手臂長,測試2種不同球飛行時間(0.8秒、1.2秒);實驗二:球飛行時間1.2秒,固定中間接球,測試2種伸臂距離(100%手臂長、140%手臂長)之動作表現;實驗三:接球距離為100%手臂長、球飛行時間1.2秒,測試隨機不同接球方向(中間、側邊)之表現,每種情境共接受15次測試,並以15次試驗進行統計分析。
研究結果發現,在不同球飛行時間中,帕金森患者動作表現會隨著球速變快,而提升動作表現。在不同伸臂距離中,所有參與者並未隨著干擾平衡程度不同而調整身體壓力中心之後移幅度。但當接球距離越遠,帕金森患者之身體壓力中心向前移動幅度也隨之增加。最後,於不同接球方向中,兩組之間在左右方向之平衡表現未有明顯差異,但帕金森患者在側邊接球時的動作品質較健康控制組差。
英文摘要 Due to the degeneration of basal ganglia, patients with Parkinson’s disease (PD) often have movement difficulties, such as rigidity, bradykinesia, and postural instability. External cueing helps patients with PD improve motor performance. A virtual reality system can provide participants with the feeling of immersion and can be used to control experimental conditions and to reduce variation. The purpose of this study was to explore the differences of motor performance between patients with PD and healthy participants in different virtual ball catching tests.
This study recruited 21 people with PD and 21 age- and gender-matched healthy controls. Each subject was tested with the functional reach test first, and then the ball catching test in virtual reality. The virtual ball catching test included three experiments. Experiment I: in the situation of fixed ball direction (middle) and 100% arm length, each subject had to catch balls in two flying times (0.8 and 1.2 seconds). Experiment II: in the situation of 1.2-second ball flying time and fixed ball direction (middle), each subject had to catch balls in two reaching distances (100% and 140% of arm lengths). Experiment III: in the reaching distance of 100% arm length and 1.2-second ball flying time, each subject had to catch balls randomly coming from three directions (middle, right, and left). Each subject did 15 trials for each condition, and all the 15 trials were included in statistical analyses.
We found that in the experiment of different ball flying times, as the ball flew faster, the movement in patients with PD was enhanced. In the experiment of different reaching distances, the participants did not adjust their center of pressure (COP) backward movement according to the degree of interference. But when the reaching distance was longer, the patients with PD had larger forward COP movement. Finally, in the experiment of different ball directions, the balance performance in the medial-lateral direction was not significantly different between the two groups. However, when catching balls in the right/left, the patients with PD had worse quality of movement than did the healthy control group.
論文目次 第一章 、前言 1
第二章 、文獻回顧 2
第一節 、帕金森疾病與姿勢控制 2
壹、 流行病學 2
貳、 帕金森患者之臨床症狀 3
參、 帕金森病與姿勢控制之關係 4
肆、 預期性姿勢調節(Anticipatory Postural Adjustments, APA) 6
伍、 雙手協調(Bimanual coordination) 9
第二節 、外在線索提示對帕金森患者動作之影響 12
壹、 步態 13
貳、 上肢動作表現 14
第三節 、虛擬實境系統 15
壹、 虛擬實境系統介紹及常見種類 15
貳、 虛擬實境之復健應用 17
第四節 、接球任務 19
第五節 、總結與研究目的 21
第六節 、研究假設 22
第三章 、研究方法 23
第一節 、研究設計 23
第二節 、參與者 32
貳、 健康參與者篩選標準及排除條件 34
第三節 、儀器設備 35
壹、 臨床評估工具 35
貳、 評量工具 36
參、 虛擬實境系統 38
肆、 運動學分析系統(kinematic analysis system) 40
伍、 動力學分析系統(kinetic analysis system) 41
第四節 、實驗流程 42
第五節 、資料分析 46
第四章 、研究結果 47
第一節 、基本人口學資料及臨床評估 47
第二節 、不同球飛行時間之動作表現 49
第三節 、不同接球距離之動作表現 55
第四節 、不同球飛行方向之動作表現 61
第五章 、討論 67
第一節 、球速對帕金森患者之動作效應及組別差異 68
第二節 、接球距離對帕金森患者之動作效應及組別差異 72
第三節 、接球方向對帕金森患者之動作效應及組別差異 77
第四節 、臨床應用、研究限制及未來研究方向 82
第六章 、結論 83
參考文獻 84
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