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研究生:陳玫樺
研究生(外文):Mei-Hua Chen
論文名稱:評估遊戲平台WiiFit®與改良式活動對治療有平衡缺失的慢性中風患者之效果
論文名稱(外文):The Effect of Wii Fit® Gaming Console on Balance Deficit for Patients with Chronic Stroke
指導教授:鄭誠功鄭誠功引用關係
指導教授(外文):Cheng-Kung Cheng
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:醫學工程研究所
學門:工程學門
學類:生醫工程學類
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:108
中文關鍵詞:Wii Fit®慢性中風平衡
外文關鍵詞:Wii F it®chronic strokebalance
相關次數:
  • 被引用被引用:19
  • 點閱點閱:553
  • 評分評分:
  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:4
研究背景:中風會造成不同系統的損傷導致功能受限,平衡缺失是其中一個常見的障礙,而平衡是維持日常生活功能的一個重要因子,所以,平衡訓練對於中風患者十分重要。但慢性中風患者功能復原能力已進入平原期,再加上復健治療缺乏變化,容易造成患者不想持續復健,而平衡功能更加退化的惡性循環。有研究指出新的治療方法,以任務為導向的治療模式被證實可以促進慢性中風患者的功能恢復。研究目的:利用遊戲平台-Wii Fit®搭配改良式活動做為新的治療方法,應用在慢性中風患者的平衡訓練,與傳統物理治療的治療效果比較。研究方法:招募16位慢性中風患者,以便利取樣的方式平均分配成實驗組及控制組各八位。兩組都接受規律的復健治療,實驗組額外接受每週兩次,一次40分鐘的Wii Fit®搭配改良式活動的治療,持續六週。療效評估包含:臨床量表有柏格氏平衡量表和計時起走測試;利用Wii Fit® 平衡板和自行開發的LabVIEW®程式收取壓力中心參數作評估。研究結果:壓力中心評估方面,穩定性測試只有控制組在閉眼站時,前後向最大晃動範圍在第一次追蹤評估有比基線評估減少(p=.041)。穩定限度方面,實驗組在治療中的健側穩定限度比基線評估增加(p=.017);實驗組在第三次追蹤評估的患側穩定限度比控制組大(p=.029),實驗組前方穩定限度的第一次追蹤評估比控制組大(p=.029);實驗組第一次追蹤評估的前方穩定限度比基線評估增加(p=.046),也比控制組多(p=.029);實驗組在治療後與第三次追蹤評估的後方穩定限度在統計上有顯著比控制組大(p=.013, .043)。柏格氏平衡量表方面,實驗組在每個評估時間點都比基線評估有統計上顯著的增加(p=.018, .027, .018, .027, .026),控制組在治療中、治療後和第一次追蹤評估有比基線評估有統計上顯著的增加。計時起走測試在實驗組治療後評估和第二、三次追蹤評估都有比基線評估有統計上顯著的增加(p=.046, .043, .042),在控制組則沒有統計上的差異。結論:整體來說,利用遊戲平台Wii Fit®與改良式活動在六週內訓練有平衡缺失的慢性中風患者,相較於只接受傳統物理治療的患者,在臨床平衡量表方面確實有顯著進步,所以Wii Fit®與改良式活動可用來做為訓練慢性中風患者平衡的工具之一。
Background: Stroke would cause impariment, and lead to functional disability. Balance deficit is a common problem among chronic stroke patient. Balance is one of the important factors that will have influences on patient’s activities of daily living. There is a recovery plateau for patients who suffered from stroke over 6 months, and it will decrease the motivation to receive rehabilitation programs. Previous studies have shown that patients with chronic stroke exhibited substantial improvement on motor function with the interventions of novel rehabilitation protocols, e.g. with visual and audio feedback, and task-oriented exercise. Purpose: The purpose of this study was to evaluate the application of the WiiFit® gaming console with modified activites for chronic stroke patients with balance deficits. Material and method: Sixteen chronic patients were recruited in this study, and were assigned to the control and experimental group. Both groups received regular traditional rehabilitation programs. The subjects in the experimental group received additional 40 minutes Wii Fit® trainig program 2 sessions per week for six weeks. The outcome measurment were consisted of Berg balance scale, Timed up and go, and parameters of center of pressure gathered by Wii Fit® balance board and self-developed LabVIEW® program. Results: Most parameters of center of pressure in steadiness test did not show improvement throughtout the study. With regard to the limits of stability tests, the ranges of limits of stability for sound side in the experimental group improved when compared to those at the baseline assessement. The results also showed improvement in the ranges of anterior limits of stability at the firtst follow-up assessment in the experimental group. For the experimental group,the scores of Berg balance scale were statsitically increased at mid-, post-intervention, and follow-up assessment compared to those at baseline assessment.In addition, the scores of Timed up and go were statistically increased for subjects in the experimental group at post-intervention assessment and maintained at 6 weeks follow-up assessment. Conclusion: Using the Wii Fit® gaming console with modified activities as a treatment showed improvement on the Berg balance scale and Timed up and go test for chronic stroke patients in 6-weeks intervention. The Wii Fit® gaming console with modified activities can be utilized as one of the training tools in the future for this particular population.
摘要 i
Abstract iii
目次 v
表次 viii
圖次 x
第一章 緒論 1
第一節 研究背景 1
第二節 文獻探討 3
一、平衡系統 3
二、中風患者的平衡評估 7
三、中風患者的平衡訓練 10
第三節 研究動機與目的 15
第二章 研究材料與方法 16
第一節 研究對象 16
第二節 實驗流程 16
第三節 實驗設備與軟體 18
一、任天堂Wii Fit®套件 18
二、Wii Fit® 平衡板特性 20
三、保護裝置 27
四、平衡評估程式 29
第四節 平衡訓練 35
一、穩定類 35
二、動態平衡類 36
第五節 平衡評估 40
一、壓力中心參數 40
二、臨床評估量表 46
三、問卷 47
第六節 統計分析 48
第三章 結果 49
第一節 受測者基本資料 49
第二節 治療項目 51
第三節 壓力中心參數 53
一、穩定性 53
二、穩定限度 71
第四節 臨床評估量表 78
一、柏格氏平衡量表 78
二、計時起走測試 81
第五節 問卷 84
第四章 討論 85
第一節 Wii Fit®平衡板特性 85
第二節 壓力中心參數 86
一、穩定性 86
二、穩定限度 87
第三節 臨床評估量表 88
第四節 問卷 90
第五節 Wii Fit®與改良式活動的治療項目 91
第六節 研究限制 93
第五章 結論 95
參考文獻 96
附錄一 台北市立聯合醫院人體試驗委員會同意書 101
附錄二 受測者試驗同意書 102
附錄三 柏格氏平衡量表評分標準 105
附錄四 問卷 107
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