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研究生:蔡沛潔
研究生(外文):Tsai, Pei-Jei
論文名稱:雙重任務對中風病患姿勢穩定度與視覺空間任務之影響
論文名稱(外文):A study of dual-task effects on postural stability and visuospaital task in stroke patients
指導教授:陳貞夙陳貞夙引用關係
指導教授(外文):Chern, Jen-Suh
學位類別:碩士
校院名稱:長庚大學
系所名稱:臨床行為科學研究所
學門:社會及行為科學學門
學類:心理學類
論文種類:學術論文
論文出版年:2007
畢業學年度:96
語文別:中文
論文頁數:101
中文關鍵詞:雙重任務姿勢穩定度視覺空間任務
外文關鍵詞:dual taskpostural stabilityvisuospatial task
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在日常生活中,同時執行兩種或兩種以上的任務十分常見,稱之為雙重任務。回顧文獻中,雙重任務較少針對中風病患,以及認知任務為視覺空間操作情境,本研究的目的是探討同時性的視覺空間操作任務與姿勢任務之間的交互作用對中風病患認知及或姿勢控制表現的影響。研究中採用重複量測之研究設計,共分為三個子實驗,其中子實驗一、二分別為19位、14位中風受試者,均需在三種姿勢任務(與肩同寬站立、健側在後跟尖站立、患側在後跟尖站立)下,分別從事單一任務,及從事兩種認知任務:基礎及高階視覺空間任務(分別包括簡單及複雜程度)。子實驗三另收集5位年齡與性別配對之健常人接受施測。研究中採用壓力中心之總移動路徑長、壓力中心在前後與左右方向最大位移、對稱性代表姿勢穩定度,利用認知任務之作答正確率及正確作答之反應時間代表視覺空間任務之表現。統計分析採用重覆量數雙因子及單因子相依樣本變異量分析法。研究結果發現,中風患者在執行雙重任務時,其姿勢穩定度反而會增加,但雙重任務對認知任務的影響則不顯著。比較中風患者與健常受測者之差異,本研究中的兩組無顯著差異,但在認知任務上的表現,可看出中風患者在反應時間上有高於健常受測者之現象。此結果可提供臨床治療時訓練中風病患參考,提醒臨床治療者中風病患造成之姿勢穩定度的改變。
The dual task paradigm is an often encountered situation in daily living. The competition of attentional demands of both the postural and suprapostural task could influence the performance of either task, especially in neurological patients. The purpose of the study was to investigate the interference that occurs between concurrent performance of postural task and the visuaospatial tasks. There are three experiments in the study. Stroke subjects numbers in the first experiments were 19 in experiment 1, 14 in experiment 2. Subjects performed 3 postural tasks (shoulder-width double stance, tandem stance with the sound side at the back, and tandem stance with the affected side at the back), with single task and dual task. In dual task conditions, subjects performed 2 visuospatial tasks (2 levels of basic and advanced visuospatial task). In experiment 3, there are extra 5 age and sex matched control subjects. Dependent variables in postural stability were: medial-lateral and anterior-posterior center of pressure (CoP) trajectory pathway, and CoP trajectory total pathway. Parameters in visuospatial tasks were mean reaction time in correct answers on each task condition. Repeated-measures two-way analysis of variance was used with significant level setting at α =.05. The results showed that when stroke patient perform dual task conditions, the postural stability were be increased but not on visuospatial parameters. However there are no significant differences on postural task performance between two groups. The results can give a hint in training stroke patients in clinical settings.
指導教授推薦書………………………………………………………………
口試委員會審定書……………………………………………………………
長庚大學授權書……………………………………………………………… iii
誌謝…………………………………………………………………………… iv
中文摘要……………………………………………………………………… v
英文摘要……………………………………………………………………… vi
目錄…………………………………………………………………………… vii
第一章 緒論………………………………………………………………… 1
第一節 研究背景與問題……………………………………………… 1
壹 腦中風及神經缺損與影響…………………………………… 1
貳 雙重任務研究的不足………………………………………… 1
第二節 研究目的……………………………………………………… 4
壹 子實驗一的研究目的………………………………………… 5
貳 子實驗二的研究目的………………………………………… 5
參 子實驗三的研究目的………………………………………… 5
第三節 重要名詞解釋………………………………………………… 6
壹 姿勢穩定度…………………………………………………… 6
貳 姿勢搖晃……………………………………………………… 6
參 壓力中心……………………………………………………… 7
肆 雙重任務……………………………………………………… 7
伍 雙重任務干擾………………………………………………… 7
第四節 變項定義……………………………………………………… 8
壹 自變項………………………………………………………… 8
貳 依變項………………………………………………………… 8
第二章 文獻回顧…………………………………………………………… 10
第一節 健常人姿勢控制的機制……………………………………… 10
壹 姿勢控制的機制……………………………………………… 10
貳 姿勢反應的量測……………………………………………… 12
參 不同站姿對姿勢反應的影響………………………………… 13
第二節 中風病患姿勢穩定度的缺失………………………………… 15
壹 雙側下肢承重不對稱………………………………………… 15
貳 壓力中心搖晃增加…………………………………………… 16
參 可感知的穩定極限範圍縮小………………………………… 16
第三節 雙重任務下的姿勢控制……………………………………… 17
壹 不同認知任務對健常人姿勢穩定度的影響………………… 17
貳 不同姿勢任務對健常人姿勢穩定度的影響………………… 18
參 雙重任務在神經疾患者之影響……………………………… 19
第四節 雙重任務之注意力理論……………………………………… 21
壹 瓶頸理論模式………………………………………………… 22
貳 過濾理論……………………………………………………… 22
參 減弱理論……………………………………………………… 23
肆 後選擇模式…………………………………………………… 23
伍 資源容量模式………………………………………………… 23
陸 行動選擇理論………………………………………………… 24
第五節 研究提問與研究假設………………………………………… 24
壹 子實驗一的研究提問與研究假設…………………………… 24
貳 子實驗二的研究提問與研究假設…………………………… 25
參 子實驗三的研究提問與研究假設…………………………… 26
第三章 研究方法…………………………………………………………… 27
第一節 研究設計……………………………………………………… 27
壹 研究設計與架構……………………………………………… 27
貳 研究對象……………………………………………………… 27
參 研究工具……………………………………………………… 29
肆 資料收集參數………………………………………………… 33
第二節 研究步驟…………………………………………………….. 34
第三節 資料分析…………………………………………………….. 37
壹 資料處理……………………………………………………… 37
貳 統計分析……………………………………………………… 38
第四章 子實驗一之研究結果與討論……………………………………... 41
第一節 子實驗一之研究結果………………………………………… 41
壹 受測者資本資料……………………………………………… 41
貳 壓力中心參數結果…………………………………………… 42
參 基礎視覺空間任務參數……………………………………… 49
第二節 子實驗一之討論……………………………………………… 51
壹 壓力中心之參數表現………………………………………… 51
貳 基礎視覺空間參數的表現…………………………………… 54
第五章 子實驗二之研究結果與討論……………………………………... 56
第一節 子實驗二之討論……………………………………………… 56
壹 受測者資本資料……………………………………………… 56
貳 壓力中心參數結果…………………………………………… 56
參 高階視覺空間任務參數……………………………………… 65
第二節 子實驗二之討論……………………………………………… 70
壹 壓力中心參數表現…………………………………………… 70
貳 兩種認知任務參數的表現…………………………………… 72
第六章 子實驗三之研究結果與討論……………………………………... 75
第一節 子實驗三之研究結果………………………………………… 75
壹 受測者資本資料……………………………………………… 75
貳 壓力中心參數結果…………………………………………… 76
參 視覺空間任務參數…………………………………………… 85
第二節 子實驗三之討論……………………………………………... 89
第七章 結論………………………………………………………………... 93
第八章 研究限制與未來方向……………………………………………... 94
參考文獻……………………………………………………………………… 96
附錄…………………………………………………………………………… 101
中文參考文獻:
戴玉慈、黃炳強、黃貴薰、羅美芳(1999)。住院年老病患的認知功能、台灣醫學,3,279-286。
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