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系統識別號 U0026-2808201913072300
論文名稱(中文) 平板電腦遊戲對中風患者上肢動作及日常生活功能之成效
論文名稱(英文) Effect of tablet games on upper-extremity function and activities of daily living in patients with stroke.
校院名稱 成功大學
系所名稱(中) 職能治療學系
系所名稱(英) Department of Occupational Therapy
學年度 107
學期 2
出版年 108
研究生(中文) 黃子珉
研究生(英文) Tzu-Min Huang
學號 T76021039
學位類別 碩士
語文別 中文
論文頁數 74頁
口試委員 指導教授-張哲豪
口試委員-徐秀雲
口試委員-蔡怡萱
中文關鍵字 中風  平板電腦  遊戲  上肢功能  日常生活功能 
英文關鍵字 stroke  tablet games  upper-extremity function  activities of daily living 
學科別分類
中文摘要 背景與目的:中風患者上肢功能缺損,因而影響日常生活功能及社會參與,甚至於生活品質降低。平板電腦遊戲可否成為一個合適之治療媒介,提升病人主動參與,並能改善中風患者上肢動作與功能,進而促進患側在日常生活的使用。本研究旨探討藉由平板電腦遊戲上肢功能訓練合併傳統上肢功能訓練,應用在中風後患側上肢功能的訓練成效進行分析比較。

方法:本研究共招募9位中風患者作為研究對象,利用方便取樣的方法,透過國立台灣大學附設醫院竹東分院復健科轉介收案,每位患者接受每次介入一小時,一週3-5次,共計12次介入,並在介入前、介入後進行評估,評估內容包括上肢功能測量(傅格梅爾上肢評量、簡易上肢機能檢查)及動作活動日誌。過程中,患者進行30 分鐘的平板電腦遊戲上肢功能訓練及30分鐘的職能治療訓練,治療師皆在一旁提供指導及協助。

結果:9位患者在傅格梅爾上肢評量(p=0.007)、簡易上肢機能檢查常模分數(p=0.018)及動作活動日誌使用量(p=0.011)及生活品質(p=0.012),介入前後的比較中皆出現顯著進步。對於慣用手是否為患側手、使用智慧型手機平板經驗、玩遊戲應用程式經驗與成效無顯著差異。中風天數與動作活動日誌使用量結果 (r=-.689*)呈現中度相關。患者表示玩平板電腦遊戲時是享受的且覺得平板電腦遊戲能促進上肢動作功能。

結論:透過本研究,平板電腦遊戲合併傳統職能治療介入對腦中風患者上肢動作功能及日常生活功能是有幫助的。中風患者對於平板電腦遊戲作為介入媒介是可接受的,但需要進一步發展及探討平板電腦遊戲在中風復健治療中的療效範圍及作用機制。
英文摘要 Stroke patients with upper-extremity impairments will affect the daily activities, social participation and even the quality of life. In recent years, tablet games might be suitable for rehabilitation by facilitating hand movement. The aim of the study to utilizing tablet games training combined with convention occupational therapy may improve upper-extremity function and activities of daily living of stroke patients. Nine subacute stroke patients were recruited in this study. All participants received the intervention for one hour in every session, 3~5 sessions per week. A complete intervention includes 12 sessions. Researchers evaluated the participant’s performances two times, pre- and post- intervention, during the studying period. Assessments include Fugl-Meyer Assessment(FMA-UE), Simple Test for Evaluating Hand Function(STEF) and motor activity log(MAL). The occupational therapists will provide guidance and assistance in every training session. The results showed the FMA-UE, STEF and MAL mean scores had significant improvement between pre- and post-intervention. The days post-stroke affects the amount of use of patients more-affected arm during the functional activities. Participants reported enjoying the experience and thought the apps may have potential for stroke rehabilitation to improve performance of the stroke-affected hand. In conclusion, this study showed that the tablet games training with convention occupational therapy helps stroke patients improve their UE motor function and activities of daily living after receiving a 12 hours intervention. The tablet games can used be acceptable tools in rehabilitation.
論文目次 摘要 I
致謝 V
目錄 VI
第一章、 緒論 X
第一節、 研究動機及重要性 X
第二節、 研究目的及假設 12
第二章、 文獻回顧 13
第一節、 中風患者之上肢動作問題及復原進展 13
第二節、 現行上肢復健之介入方式 14
第三節、 平板電腦復健領域之應用 15
一、平板電腦 15
二、平板電腦應用於復健領域 16
三、平板電腦應用於上肢復健訓練 17
四、平板電腦常用之手勢 20
第四節、 理論基礎 21
第三章、 研究方法 22
第一節、 研究對象 22
第二節、 研究工具 23
第三節、 研究架構與流程 26
第四節、 統計分析 27
第四章、研究結果 28
第一節、描述性統計資料 28
第二節、上肢動作功能及日常生活功能量表評估 29
一、 不分組介入前後測各項量表的差異 29
二、 分組介入前後測各項量表的差異 30
第三節、年齡及中風天數與各量表結果之關係 33
第四節、平板電腦遊戲易用性評估量表及滿意度量表 34
第五章、討論 35
第一節、 描述性統計資料 35
第二節、 上肢動作功能及日常生活功能量表評估 36
一、 不分組介入前後結果的差異 36
二、 分組介入前後的結果差異 39
第三節、 年齡及中風天數與各量表結果之關係 40
第四節、平板電腦遊戲易用性評估量表及滿意度量表 41
第五節、臨床上使用平板電腦遊戲後之優缺點 43
第六章、結論 46
第一節、總結 46
第二節、臨床應用及發展 47
第三節、研究限制及未來研究建議 48
參考資料 49

表目錄 52
表一、基本人口學描述性統計資料 (N=9) 52
表二、受試者基本資料 53
表三、介入前後測分數差比較(N=9) 54
表四、慣用手偏癱兩組成效之比較 55
表五、慣用手偏癱前後測差之分析結果 56
表六、智慧型手機/平板電腦之經驗與介入成效之比較 57
表七、智慧型手機/平板電腦之經驗前後測差之分析結果 58
表八、遊戲應用程式之經驗與介入成效之比較 59
表九、遊戲應用程式之經驗前後測差之分析結果 60
表十、中風天數與介入成效之相關性關係 61
表十一、年齡與介入成效之相關性 61
表十二、滿意度量表分數 61

圖目錄: 62
圖一、平板電腦常用手勢 62
圖二、簡易上肢機能檢查 63
圖三、研究收案流程圖 64
圖四、中風天數與MAL-AOU的關係 65
圖五、系統易用性量表分數圖 65
附錄 66
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