臺灣博碩士論文加值系統

在日常生活中，同個時間進行兩件事是很常見的，例如一邊開車一邊講話，或是一邊走路一邊聽音樂等都屬於雙重任務。一般認為姿勢控制都已自動化，但許多研究發現，姿勢的控制也是需要有專注力的支持，像是老人、帕金森氏症等病人執行在不同的站姿下，同時進行認知任務時，他們的站姿表現會因為另一個任務而受到影響表現更差，然而有關姿勢控制的雙重任務對發展性協調障礙兒童為主的研究不多。發展性協調障礙兒童指的是一群沒有明顯的醫療問題或智能障礙，但卻出現明顯的動作協調缺失，而且此障礙非一般醫學疾病造成。過去關於發展性協調障礙兒童執行雙重任務時任務表現的研究呈現不一致的結果，有的研究結果顯示，在執行雙重任務時，兩個任務都受到負面的影響，也有結果顯示兩個任務都有正向的影響，或是其中之一任務呈現負面影像，但另一任務呈現正向影響；此外文獻較少比較不同的認知作業對發展性協調障礙兒童維持站立平衡的影響，因此本研究之目的為探討與比較視覺工作記憶與聽覺工作記憶對發展性協調障礙兒童和正常發展兒童在維持站立平衡之差異，同時也想比較此差異是否受到不同的站姿之影響。研究選取20位正常發展兒童及20為發展性協調障礙兒童，每位兒童均接受單純平衡控制及同時進行工作記憶任務的情況下的平衡控制，平衡控制有簡單的兩腳平行站及較困難的雙腳前後站，工作記憶任務分為視覺空間與聽覺兩種，平衡控制的表現以壓力中心的瞬間速度及軌跡表示，認知作業的表現則以答對率與反應時間表示，本研究以雙重任務虧損的差值﹝雙重任務減去單獨作業﹞表示雙重任務對站立平衡表現的影響。研究結果顯示，發展性協調障礙兒童與正常發展兒童的站立平衡皆受到同時執行認知任務的影響，且此影響有組別差異，此差異會受到站立姿勢的影響，但卻不因認知任務的不同而有差異。進一步分析，發展性協調兒童在雙腳前後站時，雙重任務是一種干擾，此干擾不因聽覺工作記憶或視覺空間工作記憶而有差異，然而正常發展兒童進行雙重任務時，他們的姿勢穩定度卻會增加，或許對正常發展兒童來說，雙重任務有助於增加他們的專注力，而增加姿勢穩定度。

It is very common to do two tasks at the same time in daily living, such as talking while driving, listening to music while walking. Doing two tasks at the same time is called dual task. Postural control used to be considered as an automatic process. However, many studies have shown that postural control needs attention, especially in the elderly, and persons with Parkinson’s diseases. Such information is limited in children and furthermore less in children with developmental coordination disorder (DCD). DCD refer to the difficulty in motor coordination and such difficulty cannot be explained by any general medical condition. Difficulty of motor skill and high variability of motor performance are main characteristics of children with DCD. Research results of the effects on the standing postural control in children with DCD are inconsistent. Some results show that performing a concurrent cognitive task will impair the postural control in children with DCD, but some show the opposite results. The concurrent cognitive task may be a visual-spatial working memory task, or an auditory working memory task. The effects may also be different. Therefore, the purpose of this research is to examine the effect of a dual task condition on the standing postural control in children with DCD. Twenty children with DCD and 20 typically developing (TD) children participated in the study. Two types of concurrent working memory tasks: visual spatial and auditory, and two kind of standing conditions: standard stance and tandem stance were the experiment tasks. The performance of standing postural control task was expressed with the velocity and trajectory of center of the pressure (COP). The cognitive task performance was expressed by accuracy and reaction time. We used the dual task costs (performance in dual task condition minus performance in single task condition) as the dependent variables for analyses. The results showed that there was group effect of dual task cost, and such effect was affected by standing postures, but not affected by working memory tasks. That is children with DCD showed worse standing stability in tandem stance condition while concurrently performing a working memory task, but TD children had better standing stability while concurrently performing a working memory task. However such effect was not different between performing a visual spatial task and performing an auditory task. In conclusion, children with DCD showed worse standing stability in dual task condition; TD children showed better standing stability in dual task condition. Dual task condition may enhance the attention in TD children, but not in children with DCD.

Chapter 1 Background and Significance 1
1.1 Developmental Coordination Disorder 1
1.2 Dual tasks 2
1.2.1 Postural Control 3
1.2.2 Working Memory 4
1.3 Purposes and Hypotheses 6
Chapter2 Methods 8
2.1 Participants 8
2.2 Equipment 8
2.2.1 Movement Assessment Battery for Children Second Edition 8
2.2.2 Peabody Picture Vocabulary Test – Revised 9
2.2.3 Portable Multicomponent Force Plate for Biomechanics 9
2.2.4 Laptop and Software 10
2.2.5 Display Device 10
2.3 Dual Task 10
2.3.1 Standing Posture Control Task 10
2.3.2 Cognitive Working Memory Task 11
2.4 Procedure 13
2.5 Data Analysis 15
Chapter 3 Results 17
3.1 Characteristic of Participants 17
3.2 Performance of Standing Postural Control 18
3.3 Dual Task Cost 23
3.4 Accuracy and Reaction Time of Cognitive Task 27
Chapter 4 Discussion 28
Chapter 5 Conclusion 31
References 32

Alloway, T. P., Gathercole, S. E., ＆ Pickering, S. J. (2004). The automated working memory assessment.
Alloway, T. P., Rajendran, G., ＆ Archibald, L. M. D. (2009). Working memory in children with developmental disorders. J Leaning Disabil, 42(4): 372-328. doi: 10.1177/0022219409335214.
Alloway, T. P. (2007). Working memory, reading, and mathematical skills in children with developmental coordination disorder. J Exp Child Psychol, 96(1):20-36.
Altmann, L. J., Stegemöller, E., Hazamy, A. A., Wilson, J. P., Okun, M. S., McFarland, N. R., Wagle Shukla, A., ＆ Hass, C. J. (2015). Unexpected dual task benefits on cycling in Parkinson disease and healthy adults: a neuro-behavioral model. PLoS One, 10(5):e0125470. doi: 10.1371/journal.pone.0125470.
APA (1994). Diagnostic and Statistical Manual of Mental Disorders (fourth edition).
Baddeley, A. D., ＆ Hitch, G. (1974). The psychology of learning and motivation: Advances in research and theory. Working memory. In G. A. Bower (Ed.), (Vol. 8, pp. 47–89). New York: Academic Press.
Barra, J., Bray, A., Sahni, V., Golding, J. F., ＆ Gresty, M. A. (2006). Increasing cognitive load with increasing balance challenge: recipe for catastrophe. Exp Brain Res, 174(4):734-45.
Biotteau, M., Chaix, Y., ＆ Albaret, J. M. (2015). Procedural learning and/or developmental dyslexia. Hum Mov Sci, 43:78-89. doi: 10.1016/.humov.2015.07.005.
Boonyong, S., Siu, K. C., van Donkelaar, P., Chou L. S., ＆ Woollacott, M. H. (2011). Development of postural control during gait in typically developing children: the effects of dual-task conditions. Gait Posture, 35(3):428-34. doi: 10.1016/j.gaitpost.2011.11.002.
Cherng, R. J., Huang, J. T., ＆ Hwang, I. S. (2005). The effect of a concurrent attentional task on the standing stability of children. FJPT, 30(4):155-161
Cherng, R. J., Liang, L. Y., Chen, Y. T., ＆ Chen, J. Y. (2009). The effects of motor and a cognitive concurrent task on walking in children with developmental coordination disorder. Gait Posture, 29(2), 204-207. doi: 10.1016/j.gaitpost.2008.08.003.
Easton, R. D., Greene, A. J., DiZio, P., ＆ Lackner, J. R. (1998). Auditory cues for orientation and postural control in sighted and congenitally blind people. Exp Brain Res, 118 (4), pp. 541–550. PMID:9504849
Estil, L. B., Ingvaldsen, R. P., ＆ Whiting, H. T. (2002). Spatial and temporal constraints on performance in children with movement co-ordination problems. Exp Brain Res, 147(2):153-61.
Geuze, R. H. (2005). Postural control in children with developmental coordination disorder. Neural Plast, 12(2-3):183-96; discussion 263-72. PMID:16097486
Geuze, R. H. (2003). Static balance and developmental coordination disorder. Human Movement Science, 22, 527-528Henderson, S. E., ＆ Sugden, D. A. (2007). Movement assessment battery for children (2nd ed.). London, UK: The Psychological Corporation. Hum Mov Sci, 27(2):200-14. doi: 10.1016/j.humov.2008.02.011.
Horak, F. B., ＆ Nashner, L. M. (1986). Central programming of postural movements: adaptation to altered support-surface configurations. J Neurophysiol, 55(6):1369-81
Horak, F. B., Shumway-Cook, A., Crowe, T. K., ＆ Black, F.O. ( 1988). Vestibular function and motor proficiency of children with impaired hearing, or with learning disability and motor impairments. Dev Med Child Neurol, 30(1):64-79.
Kerr, B, Condon, S. M., ＆ McDonald, L. A. (1985). Cognitive spatial processing and the regulation of posture. J Exp Psychol Hum Percept Perform, 11:617–622.
Laufer, Y., Ashkenazi, T., ＆ Josman, N. (2007). The effects of a concurrent cognitive task on the postural control of young children with and without developmental coordination disorder. Gait Posture, 27:347–51.
Little, C. E. ＆ Woollacott, M. (2014). EEG measures reveal dual-task interference in postural performance in young adults. Exp Brain Res. 233(1):27-37. doi: 10.1007/s00221-014-4111-x.
Macpherson, J. M., ＆ Inglis, J. T. (1993). Stance and balance following bilateral labyrinthectomy. Prog Brain Res, 97:219-28.
Mainenti, M. R., De Oliveira, L. F., De Melo Tavares De Lima M. A., ＆ Nadal, J. (2007). Stabilometric signal analysis in tests with sound stimuli. Exp Brain Res, Aug; 181(2):229-36.
Olivier, I., Cuisinier, R., Vaugoyeau, M., Nougier, V., ＆ Assaiante, C. (2007). Dual-task study of cognitive and postural interference in 7-year-olds and adults. Neuroreport, 18(8):817-21.
Olivier, I., Cuisinier, R., Vaugoyeau, M., Nougier, V., ＆ Assaiante, C. (2010). Age-related differences in cognitive and postural dual-task performance. Gait Posture, 32(4):494-9. doi: 10.1016/j.gaitpost.2010.07.008.
Rosenblum, S., ＆ Livneh-Zirinski, M. (2008). Handwriting process and product characteristics of children diagnosed with developmental coordination disorder. Hum Mov Sci, 27(2):200-14. doi: 10.1016/j.humov.2008.02.011.
Shumway-Cook, A., ＆ Woollacott M. H. (1985). The growth of stability: Postural control from a developmental perspective. J Mot Behav, 17(2):131-47.
Shumway-Cook, A., ＆ Woollacott, M. H. (1990). Changes in posture control across the life span--a systems approach. Phys Ther, 70(12):799-807.
Shumway-Cook, A., ＆ Woollacott, M. H. (2000). Attentional demands and postural control: the effect of sensory context. J Gerontol A Biol Sci Med Sci, 55(1):M10-6.
Tsai, C. L., Chang, Y. K., Hung, T. M., Tseng, Y. T., ＆ Chen, T. C. (2012). The neurophysiological performance if visuospatial working memory in children with developmental coordination disorder. Dev Med Child Neuro, 54(12):1114-20. doi: 0.1111/j.1469-8749.2012.04408.x.Tsai, C. L., Pan, C. Y., Cherng, R. J., ＆ Wu, S. K. (2009). Dual-task study of cognitive and postural interference: a preliminary investigation of the automatization deficit hypothesis of developmental co-ordination disorder. Child Care Health Dev, 35(4):551-60. doi: 0.1111/j.1365-2214.2009.00974.x.
Vaivre-Douret, L. (2014). Developmental coordination disorders: State of art. Neurophysiol Clin, 44(1):13-23. doi: 10.1016/j.neucli.2013.10.133.
Visser, J. (2003). Developmental coordination disorder: a review of research on subtypes and comorbidities. Hum Move Sci, 44(1):13-23. doi: 10.1016/j.neucli.2013.10.133.
Wilmut, K., Brown, J. H., ＆ Wann, J. P. (2007). Attention disengagement in children with developmental coordination disorder. Disabil Rehabil, 15; 29(1):47-55
Zwicker, J. G., Missiuna. C., ＆ Boyd, L. A. (2009). Neural correlates of developmental coordination disorder: a review of hypotheses. J Child Neurol, 24(10):1273-81. doi: 10.1177/0883073809333537.
陸莉、劉鴻香 (2005)。畢保德圖畫詞彙測驗─指導手冊(再版)。台北市：心理出版社。
廖華芳、王儷穎、劉文瑜、陳麗秋、黃靄雯 (2011)。小兒物理治療學。台北市：和風書局有限公司。