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研究生:賴虹璉
研究生(外文):Hung-Lien Lai
論文名稱:唐氏症兒童動態平衡能力之探討
論文名稱(外文):Dynamic Balance Assessment in Children with Down Syndrome
指導教授:傅麗蘭傅麗蘭引用關係
指導教授(外文):Li-Lan Fu
學位類別:碩士
校院名稱:國立體育大學
系所名稱:運動保健科學研究所
學門:民生學門
學類:運動休閒及休閒管理學類
論文種類:學術論文
論文出版年:2009
畢業學年度:97
語文別:中文
論文頁數:111
中文關鍵詞:唐氏症動態平衡姿勢控制
外文關鍵詞:Down SyndromeDynamic BalancePostural Control
相關次數:
  • 被引用被引用:8
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  • 收藏至我的研究室書目清單書目收藏:1
研究目的:本實驗的研究目的分別為一、了解唐氏症兒童與正
常兒童在兩種不同動態平衡測試中重心移動速率表現與差異;
二、了解唐氏症兒童與正常兒童在兩種不同動態平衡測試中方
向控制能力:三、了解唐氏症兒童在兩種動態平衡能力中,不
同方向之重心移動速率、方向控制能力差異。研究方法:受試者為唐氏症兒童(平均年齡:9.98 ± 1.84 歲)與正常兒童(平均年齡:9.1 4 ± 0.80 歲)各15名。兩組受試者均進行腳跟接腳尖走15 步、雙腳跳格子兩種動態平衡能力測試及利用電腦平衡測定儀(Basic Balance Master Systems , Neurocom , U.S.A.)進行規律重心轉移、多方向重心轉移測試。紀錄不同速度規律重心轉移測試中(慢速、中速、快速),兩個方向之重心移動速率(度/秒)、方向控制(%limits of stability, %LOS);多方向重心轉移測試中(前、後、左、右)之參數,包括重心移動速率(度/秒)、終點位移偏移量(%LOS)、最大偏移位移量(%LOS)及方向控制(%LOS)。結果:在臨床動態平衡能力評估中,唐氏症兒童在腳跟接腳尖走一直線15步、雙腳跳格子完成時間顯著較正常兒童差(p < .05);在重心移動速率部分,唐氏症兒童僅在規律重心轉移測試的快速測試結果顯著差於正常兒童(p < .05);在方向控制能力參數部分,不論在規律重心轉移測驗中之方向控制、多方向重心轉移測試中之方向控制、終點偏移位移量、最大偏移位移量唐氏症兒童均顯著較正常兒童差。就唐氏症兒童而言,在規律重心轉移測試中,左/右方向重心移動速率可跟上三種不同速度,三種速度達顯著差異(p < .05),且在三種速度測試中,左/右的重心移動速率皆較前/後方向佳(p < .05)。由此顯示唐氏症兒童在規律重心轉移測試中的左/右方向重心移動速率較前/後方向佳;在多方向重心轉移測試中,唐氏症兒童向後的重心移動速率最差(p < .05),也顯著差於向左方向(p < .05)。關於方向控制能力參數,唐氏症兒童在最大位移量及方向控制向後表現較其他三方向差(向前、向右、向左) (p < .05)。結論:唐氏症兒童在快速訊息輸入下,重心移動速率無法與正常兒童有相同的表現。在方向控制能力部分,不論何種速度測試均較正常兒童差,且唐氏症兒童本身而言,不論訊息輸入快慢,左右方向的重心移動速率及方向控制均較前後佳。由此顯示唐氏症兒童雖然可在自主移動、較慢訊息輸入時,有與正常兒童相同的表現。但是,在穩定限度中要有良好的動態平衡能力除重心移動速率外,還需準確的方向控制能力。唐氏症兒童可能和正常兒童相同,對向後方向訊息掌控不足,以及本身對雙重任務的動作控制不協調、控制準確與速度控制能力不足,導致其不僅在向後的方向控制、最大位移最差、重心移動速率最慢,且在所有方向能力參數表現也顯著較正常兒童差。
Purpose: The purpose of this study was to investigate the movement velocity, directional control of center of pressure (COP) during dynamic balance assessment in children with Down Syndrome. Methods: Subjects were 15 children with Down syndrome (DS, mean age 9.98 ± 1.84 yrs) and 15 healthy normal children (N, mean age 9.14 ± 0.80 yrs).Both groups were assessed with clinical assessments including heel-toe walking for 15 steps and jumping squares with both feet on the floor. Subjects were then assessed by the Basic Balance Master system(Neurocom, U.S.A) including Rhythmic Weight Shifting (RWS) assessment (right/left, R/L; forward/backward, F/B), parameters of RWS were movement velocity (MVL, °/sec) in three distinct speeds(slow, medium, fast) and directional control (DCL), expressed in percent of limits of stability (%LOS). And parameters of Limits of Stability test (LOSt)(F, B, R, L) were movement velocity (MVL, °/sec), endpoint excursion (EPE, %LOS), maximal endpoint excursion (MXE, %LOS) and directional control (DCL, %LOS). Results: Significant difference were found between children with DS and normal groups for the numbers of the finish time in heel-toe walking for 15steps and jumping in squares test (all p < .05). In MVL, significance difference was found between two groups for fast speed test in RWS (all p < .05). Besides, not only MXE, but also EPE and DCL, significance were found between two groups (all p < .05). In children with Down Syndrome, significant difference was found between R/L and F/B in MVL and DCL in RWS (all p < .05). Children with Down Syndrome had higher movement velocity and directional ability in R/L than F/B. In LOSt, significant difference was found between backward and another three directions (F, R, L)(p < .05). Conclusion: In general, children with Down syndrome had poorer dynamic balance than normal group in the limits of stability. They moved their COP to the correct direction at a slower pace and less accurate than the normal group probably because of their poor motor coordination and control abilities in dual-task postural control, control precision and rate control.
第一章 緒論-------1
第一節 研究背景----1
第二節 研究動機-----3
第三節 研究目的-----4
第四節 研究假設-----4
第五節 研究範圍與限制--5
第六節 名詞解釋與操作性定義----6
第二章 文獻探討----------------7
第一節 唐氏症患者成因與特徵----7
第二節 正常兒童與唐氏症兒童動作發展之探討-------11
第三節 唐氏症患者姿勢控制與平衡之探討----------19
第四節 平衡能力測量方法之探討------------------24
第五節 文獻總結------------------------------33

第三章 研究方法--------------------------------35
第一節 研究對象------------------------------35
第二節 實驗時間與地點-------------------------35
第三節 實驗器材與設備-------------------------36
第四節 實驗方法與步驟-------------------------39
第五節 資料處理與統計分析---------------------48

第四章 結果----------------------------------50
第一節 受試者基本資料------------------------50
第二節 規律重心轉移測試結果分析比較------------52
第三節 多方向重心轉移測試結果分析比較----------57

第五章 討論----------------------------------63
第一節 受試者基本資料與臨床評估結果之探討-------63
第二節 唐氏症與正常兒童在不同動態平衡測試中重心移動速率之探討--66
第三節 唐氏症與正常兒童組間不同動態平衡測試中方向控制能力之探討69
第四節 唐氏症兒童於不同動態平衡測試中參數之探討-------------74

第六章 結論與建議---------------------------------- 80
第一節 結論-------------------------------------- 80
第二節 建議----------------------------------- 81

參考文獻--------------------------------------- 82
附錄------------------------------------------ 91
附錄一 正常兒童組在兩種測試中各參數組內比較------ 91
附錄二 受試者同意書------------------------- 95
附錄三 個人資料表-------------------------- 98
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