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研究生:林子崴
研究生(外文):Lin Tzu-Wei
論文名稱:自主動作之感覺經驗對預期性姿勢調控習得過程之影響
論文名稱(外文):Sensory Experience of Voluntary Movement on Acquisition of Anticipatory Postural Adjustment
指導教授:連恒裕
指導教授(外文):Lien Hen-Yu
學位類別:碩士
校院名稱:長庚大學
系所名稱:復健科學研究所
學門:醫藥衛生學門
學類:復健醫學學類
論文種類:學術論文
論文出版年:2005
畢業學年度:93
語文別:中文
中文關鍵詞:姿勢動作預期性姿勢調控雙手操作性提重任務感覺經驗
外文關鍵詞:PostureMovementAnticipatory postural adjustmentsBimanual load-lifting taskSensory experiencedesignissue
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摘要

預期性的姿式調控會出現於由自主動作所產生對於身體姿勢的干擾之前以降低由於動作執行對於姿勢或平衡所造成的干擾。其通常可以藉由過去由於自主動作表現所對於姿勢或平衡系統所造成干擾的經驗而習得,但自主動作姿勢感覺經驗如何去幫助或影響預期性姿式調控的產生仍然是一個備受爭議的課題。因此本研究的目的便要驗證自主動作姿勢感覺經驗對於產生預期性姿式調控的重要性。實驗的設計會使用複合雙因子的實驗設計,徵召三十位沒有神經肌肉疾病的健康受試者參與本次實驗。實驗會以雙手操作性提重任務來觀察預期性姿式調控,在三種動作姿勢感覺情境下執行(包含吻合與感覺衝突的動作姿勢感覺情境),各執行六回合,每回合七次,進行共四十二次的預期性姿勢調控的觀察。以維持姿勢任務側肘關節相對最大角位移幅度與相對最大角位移速來觀察習得預期性姿式調控的表現程度。所蒐集的資料會使用重複量測雙因子變異數分析之統計方式來分析在不同的動作姿勢感覺情境之下習得預期性姿式調控的差異。
研究結果顯示,不同自主動作的執行感覺經驗會影響受試者的預期性姿式調控表現程度(df=2,F=7.24,p<.05),當動作執行與姿勢維持的感覺情境相符時,受試者較易習得預期性姿勢調控。而當雙手所獲得的感覺訊息相衝突時,其維持姿勢的能力在剛開始學習時將明顯不如感覺訊息相吻合時的表現,但是經過多次的練習之後維持姿勢能力也同樣會有明顯的改善,但始終不及吻合情境下之水準。因此,本研究認為吻合的自主動作感覺經驗會透過本體感覺與皮膚感覺的回饋訊息而促進預期性姿勢調控的習得;另一方面,相互衝突的自主動作感覺經驗將延緩預期性姿勢調控的習得,此時中樞神經系統會利用姿勢干擾後的回饋訊息來作為產生與調節預期性姿勢調控的依據。
Abstract

Anticipatory postural adjustment (APA) occurs prior to the onset of voluntary movement to prevent disturbances to posture or equilibrium. It is acquired by learning from past experience of execution. However, how sensory experience helps or affects acquisition of APA is still a controversial issue. The purpose of this study was to investigate the importance of sensory experience derived from voluntary activation of movement on acquisition of APA. A mixed research design was adapted to reveal the influence of sensory experience from execution of voluntary movement on acquisition of APA. Thirty healthy adults without known neuromuscular disorders were recruited to participate in this study. APA was investigated with bimanual load-lifting task (BLLT) under 3 sensory conditions [sensory matched (1) or conflicted condition (2) between movement & postural arm]. Participants were random assigned to 3 different test conditions. A total of 42 trials were collected in 6 blocks. Percentage of maximal angular amplitude (MA %) and maximal angular velocity (MV %) of postural arm during unloading in acquisition series were adapted as an index of APA performance. Two-way repeated measures of ANOVA used to differentiate change of APA performance under different experimental conditions. The results showed that the acquisition of APA were significantly different between 3 sensory conditions (df=2, F=7.24, p<.05). Subjects practiced under sensory matched condition could acquire APA more easily than whom under conflicted one. Thus, the APA performance in acquisition series under matched condition was always better than conflicted condition to stabilize posture maintenance except last two acquisition blocks. These results suggest that matched sensory experience derived from voluntary movement would promote APA acquisition by proprioceptive and/or cutaneous feedbacks. On the other hand, conflicted sensory experience delay the acquisition of APA. However, APA could still be acquired when sensory information derived from voluntary movement is incorrect. CNS of human may utilize sensory feedbacks results from activation of voluntary movement on postural perturbation to generation and regulation of APA.
目錄
指導教授推薦書
口試委員審定書
授權書 …………………………………………………………iii
誌謝 ……………………………………………………………..……...iv
中文摘要 ………………………………..…………………………....…v
英文摘要 ……………………………………………………..…….….vii
目錄 ………………………………………………………..…………...ix
圖目錄 ………………………….……………………………..……….xv
表目錄 ………………………………………………………..………xvii
第一章 前言 ……………………………………………………………1
第一節 研究背景與動機 ..…………..……………..……….……….1
第二節 名詞解釋 …………………………………………...……….5
第三節 研究問題 …………………..……………………….……….6
第四節 定義研究問題 …………………………..………….……….6
第五節 研究假說 ……………………………..……………………..7
第二章 文獻回顧 ………………………………………………………8
第一節 自主動作中預期性姿勢調控的角色 …………..………..…8
第二節 預期性姿勢調控之組織架構模式 …………………..……10
壹 平行架構模式 ………………..……………….…………...11
貳 階層架構模式 …………………………..…….…………...13
參 中樞控制 ………………………….……………………….14
(一) 基底核的角色 …………….…..…………...….….......14
(二) 運動前區的角色 …………..…..….……...….…....… 15
肆 結論 ……………………………………..…...…………... 15
第三節 預期性姿勢調控的觀察與量測方法 ……………….....….17
壹 有效觀察預期性姿勢調控的實驗方式 ………......….….17
(一) 由站姿或坐姿下執行肢段快速動作的實驗方式 ….17
(二) 由雙手操作性提重任務觀察預期性姿勢調控之呈 .18
貳 測量方式 …………………………………….…………..18
(一) 肌電圖的觀察 …………...………………………......19
(二) 加速規的應用 ……………...…………………..…....19
(三) 電子量角器的應用 ………...………………..………20
(四) 力板的應用 ………………...………..………………20
參 預期性姿勢調控觀表現程度之察指標 ………………..20
(一) 定義起始時間點 ….………...…….…...……….…...20
(二) 最大角位移幅度 ……………………...…...…..……21
(三) 最大角位移速度 ……………………………....……22
肆 結論 ……………….....…………...……………………..24
第四節 影響預期性姿勢調控的因素 ……………………………25
壹 內在動作因素 …………………………….……………..25
(一) 自主動作幅度的影響 ……………………………...25
(二) 執行自主動作速度的影響 ………………………...25
(三) 干擾程度的影響 …………………………………...26
貳 外在環境因素 ………………………….………………..26
參 結論 ………………………….…………………………..27
第三章 方法 …………………………..………………………………28
第一節 實驗設計 …………………………………………………28
第二節 受試者 ……………………………………………………28
第三節 使用工具 …………………………………………………29
壹 電子量角器 ……...…………………….…...…………..29
貳 肌電圖訊號蒐集系統 ……………………...…………..31
第四節 研究步驟 …………………...……………..………………31
壹 控制試驗 ………..…………………………………….…34
貳 習得試驗 ……………………………………………...…35
第五節 資料處理與統計分析 ……………………………………36
壹 資料處理 …………………………………..…….………36
(一) 相對最大角位移幅度 ……………....…..….……….36
(二) 相對最大角位移速度 …………………...………….37
貳 統計分析 …………………………….………………….39
第四章 結果 …………………………..………………………………41
第一節 受試者基本資料 ……………………….………………..41
第二節 不同感覺情境對習得預期性姿勢調控之影響:相對最大角位移幅度變化 ….………………………………….…..42
第三節 不同感覺情境對習得預期性姿勢調控之影響:相對最大角位移速度變化 ………..…………………...……….…48
第五章 討論 ………………..………..………………………………51
第一節 預期性姿勢調控之表現…………..………….…....…….51
壹 預期性姿勢調控影響因子之控制與觀察………………51
貳 以預期性姿勢調控為姿勢控制策略以改善姿勢穩定…54
參 以姿勢性肌肉活化時機觀察預期性姿勢調控之表現…54
第二節 不同自主動作感覺經驗影響習得預期性姿勢調控之可能原因 …………....………………………………………..56
壹 由體感覺輸入訊息透過回饋機制而行成固定的感覺經驗
…………………………………………………...……56
貳 預期性姿勢調控習得之控制機制 ……………...……...60
第三節 感覺情境對學習預期性姿勢調控之影響 …………….64
第四節 研究限制 ……………………………………………….67
壹 樣本大小之限制 …………………………………...…...67
貳 感覺訊息之界定 …………………………..…………....68
第六章 結論 ……………………………………………….………….69
參考文獻 ………………………………………………………………70
附錄 ……………………………………………………………………76
附錄一 受試者健康調查表 ……………………………………...76
附錄二 受試者同意書 ……………………………………..….....77
附錄三 愛丁堡手側化問卷 ……………………………………...79
附錄四 實驗備製於量測肘關節姿勢變異之再測信度 ………...80
附錄五 個別感覺情境組中習得回合間相對最大角位移幅度成對
比較之統計數據 …………………………………...…....83
附錄六 個別感覺情境組在各習得回合相對最大角位移幅度成對
比較之統計數據 ……...……………………………....…86
附錄七 各別感覺情境組中習得回合間相對最大角位移速度成對
比較之統計數據 …………………………………...…....89
附錄八 個別感覺情境組別受試者的肘關節伸張的角度與角速
度變化之統計分析結果………………………………...92
附錄九 個別感覺情境下維持姿勢側肱三頭肌方均根肌電訊號
的活化時機 ……………………………..……………...93
附錄十 留存測試與轉移測試之實驗流程與結果 ……….........94
附錄十一 個別感覺情境組留存百分比極轉移百分比成對比較之
統計數據 …………………………………….…...........99
圖目錄
圖1-1-1. 雙手操作性提重任務 ………….......…..……………...……..2
圖2-1-1. 預期性的姿勢調控 .……………….…..…….………..……...8
圖2-2-1. 兩種控制架構模式 .………………………….....…...……...11
圖2-2-2. 中樞系統對預期性的姿勢調控的協調控制 ………...…….16
圖3-3-1. 電子量角器擺放位置 …………...……………………….....30
圖3-4-1. 三組動作姿勢感覺情境的實驗計 ……………………...….32
圖3-4-2. 實驗設計 …………………………..…………..……….…...33
圖3-4-3. 實驗流程 …………………....................................................34
圖3-4-4. 控制系列 …………………....................................................35
圖3-4-5. 習得系列 …………………....................................................36
圖3-5-1. 以APA或增加關節僵硬程度作為改善姿勢MA與MV表
現程度之策略……...……………………………..…………38
圖4-2-1. 個別感覺情境下在六個連續習得回合中相對最大角位移幅
度變化量之折線圖 ………………………...………………43
表目錄
表4-1-1. 受試者基本資料 ……………………………………………42
表4-2-1. 個別感覺情境對習得預期性姿勢調在六個連續習得回合中
相對最大角位移幅度之重複量測變異數分析 ……...……44
表4-2-2. 個別感覺情境下不同習得回合間相對最大角位移幅度結果
顯著性 ……………………………………...………………44
表4-2-3. 個別感覺情境間在相同習得回合相對最大角位移幅度差
異結果顯著性 …………………………………….….……..46
表4-3-1. 個別感覺情境下習得回合相對最大角位移速度之重複量測
單因子變異數分析 …………...……………………………49
表4-3-3. 個別感覺情境下不同習得回合間相對最大角位移速度結果
顯著性 ………………………………………..…………….49
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