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研究生(外文):Yu-Chung Chen
論文名稱(外文):Ball Training on Improving Walking Ability and Ability of Performing Dual-task in Individuals With Stroke
指導教授(外文):Yea-Ru Yang
外文關鍵詞:strokedual-taskball trainingwalking ability
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文獻回顧與研究目的: 步行能力的缺陷與執行雙重任務能力的不足是中風患者常見的問題。球的治療訓練不僅可以改善中風患者的步行能,也可能可以改善中風患者的執行雙重任務的能力,因為球的治療訓練可以在患者行走當下同時施予的。然而,目前並沒有相關的研究去探討球的治療訓練之療效。本研究的目的便是探討球的治療訓練對於改善中風患者步行力與執行雙重任務能力之療效。研究方法: 本研究採單盲設計兼隨機分派含控制組之研究設計。控制組的患者將不接受任何的物理治療訓練,而治療組的患者則接受一次三十分鐘,一個禮拜三次,並持續四個禮拜球的治療訓練。受試者的步行能力是藉由使用步行測試儀測量包含空間及時間上的步態參數來表現。所測的步態參數包括步速、步頻、好壞腳步長、好壞腳單腳支撐時間佔步態週期的百分比,和好壞腳雙腳支撐時間佔步態週期的百分比等八個步態參數。步態的評估會在收取時及治療後或四個禮拜後,進行兩次的評估。每次的評估會在患者自選速度、端上有四個塑膠杯盤子走路、解釦子走路及最快速度等四種狀況下評估。使用單因子多變量變異數分析來檢測四種狀況下,組間前後測在八個步態參數的差異。使用雙因子多變量變異數分析來檢測執行雙重任務與單一任務時組間及前後測在八個步態參數的差異。結果與討論: 本研究最後共有十四位實驗組的中風患者,及八位控制組中風患者資料作最後統計分析。實驗組的中風患者經過球的治療訓練後,在自選速度、端上有四個塑膠杯盤子走路及最快速度等三種狀況在某些步態參數上比起控制組患者有顯著進步情形。但實驗組的中風患者經過球的治療訓練後,在執行雙重任務所受的影響與控制組患者比較並沒有顯著差異。實驗組的中風患者在治療過程期間有良好的動機與高出席率,對於球的治療訓練之反應也是好的。結論: 球的治療訓練確實可以改善中風患者某些方面的步行能力,但對於改善執行雙重任務的能力則尚無顯著發現。
Background and Purpose : Insufficient walking ability and dual task decrement are common problems in individuals with stroke. Gait training using a ball maybe could improve the ability of performing dual-task in individuals with stroke since patients need to walk and accept ball training at the same time. However, the effect of ball training is not investigated. The purpose of this study will examine the effectiveness of ball training on improving walking ability and performing dual-task in individuals with stroke. Methods : This study was a single blinding and randomized control trial. Subjects in control group did not receive any routine physical therapy treatment . Subjects in the experimental group received a 30-min ball training, three times a week for a total of four weeks. Gait was measured using GAITRite, an instrumented walkway. Eight gait parameters of interest were velocity, cadence, paretic and nonparetic step length, paretic and nonparetic single-limb support (% gait cycle), paretic and nonparetic double-limb support (% gait cycle). Measures were made before and at the end of the four weeks of intervention. All subjects were requested to walk at four conditions, such as self-selected walking speed, walking while carrying a tray with four plastic glasses on it, walking while unbuttoning the buttons of the shirt, and the fastest speed. One-way MANOVA was used to compare group differences of the eight gait parameters for the four conditions. Two-way (group*time) MANOVA was used to analyse dual task decrement of the eight gait parameters. The level of significance was established at p < 0.05. Results and Discussion : Fourteen subjects in the experimental group and eight subjects in the control group were included in the final results. Experimental group had significant improvements for some gait parameters in self-selected walking speed, walking while carrying a tray with four plastic glasses on it and fastest speed conditions. Experimental group had no significant improvements on performing dual-task ability than control group. Subjects in the experimental group had high motivation and good attendance, and the ball training feedback was good. Conclusion : Ball training maybe improve some aspects of walking ability, but not on performing dual-task ability in individuals with stroke.
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