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研究生:潘亮全
研究生(外文):Liang-Chaun Pan
論文名稱:長型對掌副木應用於中風偏癱患者的成效
論文名稱(外文):The effects of long opponens splint on stroke patients
指導教授:陳敏生陳敏生引用關係
指導教授(外文):Min-Sheng Chen
學位類別:碩士
校院名稱:國立雲林科技大學
系所名稱:工業工程與管理研究所碩士班
學門:工程學門
學類:工業工程學類
論文種類:學術論文
論文出版年:2010
畢業學年度:98
語文別:中文
論文頁數:96
中文關鍵詞:手功能日常生活副木中風
外文關鍵詞:hand functionactivity of daily lifestrokesplint
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研究背景:中風會影響患者日常生活功能,造成生活的不便,改善患者的日常生活功能並提升其生活品質,為職能治療的首要目標。手功能對於日常生活而言,是很重要的一個環節,許多的活動皆需要手來執行。副木在臨床手部治療上運用頻繁,但目前中風病患上的副木使用範圍卻很局限,甚少用於增進手功能,相關應用的探討也相當稀少。研究目的:本研究希望以長型對掌副木作為介入工具,探討此副木在中風病患上,是否能有助於提升患者的上肢、手部功能與日常生活功能的能力。研究方法:選取26名40歲至80歲符合資格的中風患者,分為穿戴副木的實驗組13名,無穿戴副木的控制組13名。兩組皆接受相同的手功能運動訓練,每次30分鐘,每週2次,為期8週,並於訓練前、訓練4週後、訓練8週後以五個測驗工具評估其上肢、手功能與日常生活功能。研究結果:經過8週的副木介入,實驗組前中後測的測驗成績比較,進步幅度優於對照組,且實驗組大部分的進步幅度達顯著差異。結論:長型對掌副木介入能有效提升中風患者的上肢、手功能與日常生活功能。此副木有做為中風手功能復健工具的潛力,未來可將副木應用於治療項目中,幫助中風患者手部功能與日常生活功能之提升,並擴展副木在中風患者的應用範圍。
Background: The primary goal of occupational therapy is to improve the stroke patients’ function of activity of daily life (ADL), because stroke affects people and makes their inconvenient life. Hand function is an important link to ADL, many activities depends on hands. Splint is a common tool in hand therapy, but there is limited use on stroke patients to enhance hand function, and few literatures on it. Purpose: This study utilized long opponens splint as a intervention tool to investigate whether this splint improve the function of upper extremity, hand and ADL on stroke patients. Methods: Twenty-six subjects between 40 to 80 years old with stroke were selected and divided into the splint group (experiment group: 13 subjects) and non-splint group (control group: 13 subjects). Both groups received the same hand function training activities at the frequency of 30 minutes per session and 2 sessions per week in the period of 8 weeks. Subjects were evaluated their function of the upper extremity, hand and ADL by five assessment tools before and after 4 weeks training and after 8 weeks training. Results: The improvement is better in experiment group compared with control group after 8 weeks intervention of splint. In experiment group, the function of upper extremity, hand and ADL were significantly improved after training. Conclusion: The long opponens splint could improve the function of upper extremity, hand and ADL effectively, It has a great potential to be utilized as a hand function rehabilitation tool on stroke patients. It could expend the application range of splint on stroke patients, and help stroke patients regaining normal life as soon as possible.
中文摘要 i
英文摘要 ii
誌謝 iii
目錄 iv
表目錄 viii
圖目錄 ix
第一章 緒論 1
1.1 研究動機與背景 1
1.2 研究目的 3
1.3 研究假設 4
1.4 研究範圍與限制 4
第二章 文獻探討 5
2.1 腦中風 5
2.1.1 腦中風的三大類型 5
2.1.2 腦中風症狀 6
2.1.3腦中風的動作問題 7
2.1.4 Brunnstrom Stage 8
2.2 職能治療 12
2.2.1 職能治療的定義 12
2.2.2 職能治療專業倫理 12
2.2.3 動作學習理論 13
2.3 手功能 14
2.4 副木(Splint) 19
2.4.1 副木的定義 19
2.4.2 副木的材質 23
2.5 相關輔具研究 25
2.6 本章整理 30
第三章 研究方法 32
3.1 研究架構 32
3.2 研究對象 33
3.2.1 研究對象之篩選 33
3.2.2 研究對象之描述 33
3.3 實驗方法 34
3.4 實驗設計 34
3.5 研究器材 35
3.5.1 上肢功能測驗 35
3.5.1.1傅格-梅爾評估量表(Fugl-Meyer Assessment, FMA) 35
3.5.1.2 沃夫動作功能測驗(Graded Wolf Motor Function Test, GWMF) 38
3.5.2 手部精細功能測驗 41
3.5.2.1 明尼蘇達手部操作測驗(Minnesota Rate of Manipulation Test, MRMT) 41
3.5.2.2 積木與盒子測驗(Box and Block Test of Manual Dexterity, BBT) 42
3.5.3 日常生活功能評估 43
3.5.3.1 功能獨立性評定(Functional independence measure, FIM) 43
3.5.4 副木 45
3.5.5 碼錶 51
3.6 研究過程與程序 52
3.6.1 篩選與決定研究對象 52
3.6.2 擬定訓練計劃 52
3.6.3實驗流程 56
第四章 數據蒐集、分析 58
4.1 第一節基本資料分析 58
4.1.1 性別 58
4.1.2 年齡 59
4.2 第二節實驗結果分析 60
4.2.1 測驗類別: 61
4.2.2 評估工具類別: 62
4.2.2.1 傅格-梅爾評估量表(Fugl-Meyer Assessment, FMA): 62
4.2.2.2 沃夫動作功能測驗(Graded Wolf Motor Function Test, GWMF): 64
4.2.2.3 明尼蘇達操作測驗(Minnesota Rate of Manipulation Test, MRMT): 66
4.2.2.4 積木與盒子測驗(Box and Block Test of Manual Dexterity, BBT): 68
4.2.2.5 功能獨立性評定(Functional independence measure, FIM): 70
4.2.2.6 功能獨立性評定(Functional independence measure, FIM)運動分項目: 72
第五章 討論 75
5.1 上肢功能結果 75
5.2 手功能結果 75
5.3 日常生活功能結果 76
5.4 總結 77
第六章 結論與建議 79
6.1 結論 79
6.2 建議 79
參考資料 80
1.Ashford, S., Slade, M., Malaprade, F., & Turner-Stokes, L. (2008). Evaluation of functional outcome measures for the hemiparetic upper limb: a systematic review. J Rehabil Med, 40(10), 787-795.
2.Cole, B., Finch, E., Gowland, C., & Nayo, N. (1994). Physical Rehabilitation Outcome Measures: The Canadian Physiotherapy Association.
3.Croser, R. (2008). Effectiveness of electronic aids to daily living: Increased independence and decreased frustration. Australian Occupational Therapy Journal, 48(1), 35-44.
4.Desrosiers, J., Bravo, G., Hebert, R., Dutil, E., & Mercier, L. (1994). Validation of the Box and Block Test as a measure of dexterity of elderly people: reliability, validity, and norms studies. Arch Phys Med Rehabil, 75(7), 751-755.
5.Eggers, O. (1994). Occupational therapy in the treatment of adult hemiplegia Oxford: Butterworth-Heinemann Ltd.
6.Elaine Ewing Fess, C. A. P. (1987). Hand splinting: principles and methods: Mosby.
7.Gracies, J. M., Marosszeky, J. E., Renton, R., Sandanam, J., Gandevia, S. C., & Burke, D. (2000). Short-term effects of dynamic lycra splints on upper limb in hemiplegic patients. Arch Phys Med Rehabil, 81(12), 1547-1555.
8.Instrument, L. (2009). Minnesota Manual Dexterity Test. Retrieved 3/5, 2010, from http://www.lafayetteevaluation.com/product_detail.asp?ItemID=164
9.Kim, D. G., Cho, Y. W., Hong, J. H., Song, J. C., Chung, H. A., Bai, D. S., et al. (2008). Effect of constraint-induced movement therapy with modified opposition restriction orthosis in chronic hemiparetic patients with stroke. NeuroRehabilitation, 23(3), 239-244.
10.Lannin, N. A., Cusick, A., McCluskey, A., & Herbert, R. D. (2007). Effects of splinting on wrist contracture after stroke: a randomized controlled trial. Stroke, 38(1), 111-116.
11.Lannin, N. A., & Herbert, R. D. (2003). Is hand splinting effective for adults following stroke? A systematic review and methodologic critique of published research. Clin Rehabil, 17(8), 807-816.
12.Lannin, N. A., Horsley, S. A., Herbert, R., McCluskey, A., & Cusick, A. (2003). Splinting the hand in the functional position after brain impairment: a randomized, controlled trial. Arch Phys Med Rehabil, 84(2), 297-302.
13.Mary Vining Radomski, C. A. T. L. (2007). Occupational therapy for physical dysfunction (6th ed.): Lippincott Williams & Wilkins.
14.McPherson, J. J., Kreimeyer, D., Aalderks, M., & Gallagher, T. (1982). A comparison of dorsal and volar resting hand splints in the reduction of hypertonus. Am J Occup Ther, 36(10), 664-670.
15.Morris, D. M., Uswatte, G., Crago, J. E., Cook, E. W., 3rd, & Taub, E. (2001). The reliability of the wolf motor function test for assessing upper extremity function after stroke. Arch Phys Med Rehabil, 82(6), 750-755.
16.Neuhaus, B. E., Ascher, E. R., Coullon, B. A., Donohue, M. V., Einbond, A., Glover, J. M., et al. (1981). A survey of rationales for and against hand splinting in hemiplegia. Am J Occup Ther, 35(2), 83-90.
17.Pedretti, L. W. (1996). Occupational Therapy: Practice Skills for Physical Dysfunction (4 ed.): C.V. Mosby.
18.Sanford, J., Moreland, J., Swanson, L. R., Stratford, P. W., & Gowland, C. (1993). Reliability of the Fugl-Meyer assessment for testing motor performance in patients following stroke. Phys Ther, 73(7), 447-454.
19.Sports, T. (1997). Minnesota Rate Test. Retrieved 3/20, 2010, from http://www.topendsports.com/testing/tests/minnesota-rate-of-manipulation.htm
20.Takahashi, C. D., Der-Yeghiaian, L., Le, V., Motiwala, R. R., & Cramer, S. C. (2008). Robot-based hand motor therapy after stroke. Brain, 131(Pt 2), 425-437.
21.Trombly, C. A. (1995). Occupational therapy for physical dysfunction (4th ed.): Williams & Wilkins.
22.Urton, M. L., Kohia, M., Davis, J., & Neill, M. R. (2007). Systematic literature review of treatment interventions for upper extremity hemiparesis following stroke. Occup Ther Int, 14(1), 11-27.
23.Wajon, A., & Ada, L. (2005). No difference between two splint and exercise regimens for people with osteoarthritis of the thumb: a randomised controlled trial. Aust J Physiother, 51(4), 245-249.
24.Willard, H. S., Spackman, C. S., Neistadt, M. E., & Crepeau, E. B. (1988). Willard and Spackman''s occupational therapy (9th ed.): Lippincott.
25.Wolf, S. L., Catlin, P. A., Ellis, M., Archer, A. L., Morgan, B., & Piacentino, A. (2001). Assessing Wolf motor function test as outcome measure for research in patients after stroke. Stroke, 32(7), 1635-1639.
26.Woodson, A. M. (1988). Proposal for Splinting the Adult Hemiplegic Hand to Promote Function. Occupational Therapy in Health Care, 4(3-4), 85-96.
27.中華民國職能治療學會. (1992). 關於職能治療專業. from http://www.ot-roc.org.tw/head1.htm
28.行政院衛生署. (2010). 98年度死因統計完整統計表. Retrieved 7/8, 2010, from http://www.doh.gov.tw/CHT2006/DM/DM2_2_p02.aspx?class_no=440&now_fod_list_no=11122&level_no=3&doc_no=76512
29.張玄松, 陳貞夙, 龍希文, 楊樑怡, 鄧復旦, & 倪壽民. (2007). 踝足裝具對於中風患者站立平衡能力與行走表現的影響:比較前置型與後置型踝足裝具的效益. 台灣職能治療研究與實務, 3(2), 94-109.
30.張珍華. (2003). 短型對掌拇指副木對腦性麻痺兒童手部功能的影響. 中山醫學大學, 台中市.
31.陳惠媚. (2009). 中風病人兩種手功能測驗的不同測試次數之再測信度. 職能治療學會雜誌, 27(1), 1-9.
32.郭綜合醫院復健科. (2001). 副木之目的及適用症. Retrieved 4/12, 2010, from http://www.kgh.com.tw/health/12-03.html
33.豐原醫院. (2002). 什麼是副木. Retrieved 4/12, 2010, from http://web1.fyh.doh.gov.tw/depweb/Rehabilitation/unblock/teach/splint/splint.htm
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