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研究生:鐘婉(王亭)
研究生(外文):Wan-TingChung
論文名稱:中風患者身體活動量與日常功能之關係
論文名稱(外文):Physical Activity Assessment and the Relationship to Daily Functioning in Patients with Stroke
指導教授:汪翠瀅汪翠瀅引用關係
指導教授(外文):Tsui-Ying Wang
學位類別:碩士
校院名稱:國立成功大學
系所名稱:職能治療學系碩博士班
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:2012
畢業學年度:100
語文別:中文
論文頁數:78
中文關鍵詞:身體活動加速規中風社區生活功能活動參與
外文關鍵詞:physical activityaccelerometerstrokecommunity functionactivity and participation
相關次數:
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  • 下載下載:35
  • 收藏至我的研究室書目清單書目收藏:0
前言:中風後的動作缺失會影響到個案的日常活動執行及參與功能。而針對中風患者的身體活動量多以自評方式進行評估,此種方式可能會受到主觀的記憶或是情緒的影響而有所誤差。加速規呈現個案的真實日常活動量,可做為一客觀且具信效度的身體活動量測工具,本研究使用加速規來測量身體活動量,並採用世界衛生組織提出之國際健康功能與身心障礙分類系統(International Classification of Functioning, Disability and Health),將日常功能分成活動、參與兩種層次,探討中風患者身體活動量與日常功能之關係。
方法:本研究招募各25位中風患者與一般退休居民,以加速規做為身體活動量的測量工具,請受試者於兩手腕、腰部配戴加速規為期連續三天,以記錄雙側上肢活動量、下肢活動量。在活動層次日常功能使用芙蘭切活動量表(Frenchay Activities Index),參與層次日常功能則選擇台灣簡明版世界衛生組織生活品質問卷(World Health Organization Questionnaire on Quality of Life: BREF-Taiwan Version)做為指標。對兩組受試者的各項測量資料進行以描述性統計與比較,探討人口學變項(憂鬱、性別)、活動量與日常功能的相關性,並檢驗活動量與日常功能之顯著預測因子。
結果:(1) 雙側上肢活動量之顯著相關及預測因子為中風與否、性別、憂鬱情形(R2 = .394, p 〈 .001),下肢活動量之顯著相關及預測因子為中風與否(R2 = .275, p 〈 .001)。(2) 在活動層次的日常功能,雙側上肢活動量與下肢活動量可共同顯著預測芙蘭切活動量表總分(R2 = .492, p 〈 .001),在參與層次日常功能的生活品質問卷,下肢活動量為生理範疇之預測因子(R2 = .089, p = .020),雙側上肢活動量則為心理、社會、環境三大範疇之預測因子(R2 = .091, .205, .139,p’s = .019, .001, .004)。
結論:加速規測得之雙側上肢與下肢活動量為客觀之肢體動作表現指標。雙側上肢活動量與下肢活動量可分別預測不同領域之日常功能表現。此研究證實個人的身體活動量與日常活動參與及品質具顯著關係。

Introduction: Motor impairments in patients with stroke affect their activity performances and participations for daily lives. Physical activity (PA) in post-stroke patients was often measured by self-report instruments that may be biased by subjective memory and emotional status. Accelerometer owns the merit as an objective, valid, and reliable measure of body movements that represents the true quantity of one's daily activities. We employed the accelerometers to measure the physical ability and adopted the activity and daily participation concepts of International Classification of Functioning, Disability and Health (ICF) framework to explore the relationships between PA and the activity performance, as well as PA and the participation function.
Method: The community-dwelling sample included 25 stroke patients (patient group) and 25 age and education comparable older adults (control group). Participants wore the accelerometers on both wrists and the waist for three consecutive days for their PAs recording of the upper and lower limbs movement measures (ULM and LLM) with their daily routines maintained as usual. The activity and participation performances were assessed by Frenchay Activities Index (FAI) and World Health Organization Questionnaire on Quality of Life: BREF-Taiwan Version (WHOQOL-BREF-T). The relationships between PA and daily functioning as well as other demographic variables such as genders and depression scores were explored by using correlation and regression analysis.
Results: Some significant results were found in this study: (1) Stroke, gender, and depression scores were significantly correlated with upper limb PA, and predicted 39.4% of the total variance of the PA of the ULM (p 〈 .001). Stroke factor exclusively correlated with the PA of the LLM with significance, explaining 27.5% of the total variance (p 〈 .001). (2) For the activity performance, the PAs of both ULM and LLM were significantly correlated with the total scores of FAI. The PAs of the ULM and LLM together predicted 49.2% of the total variance of the FAI scores (p 〈 .001). At the participation level of functioning, the PA of LLM was significantly correlated with the physical domains of WHOQOL-BREF-T with 8.9% of the variance explained for the model (p = .020). The PA of ULM accounted for 9.1 %, 20.5 %, and 13.9% of the total variance of the mental health, social relationships, and the environment domain of WHOQOL-BREF-T with significances (p's = .019, .001, and .004, respectively).
Conclusion: The PA measured for ULM and LLM by the accelerometer was an objective indicator of body movements. The PAs of ULM and LLM were significant predictors for daily functions in different domains. The findings of this study provide supporting evidence for the relationship between the quantities of motor movements to the activity function and participation.

中文摘要 i
Abstract iii
誌謝 vi
表目錄 xi
圖目錄 xii
名詞定義 xiii
第一章、 前言 1
第一節、 動機與重要性 1
第二節、 研究目的與假設 2
第二章、 文獻回顧 3
第一節、 中風患者的肢體動作表現與測量 3
壹、 患側肢體動作缺失與復原時程 3
貳、 患側上肢的習得廢用現象與健側上肢的代償行為 5
參、 復健領域對於肢體動作功能的測量 6
肆、 加速規於身體活動量測量之應用 7
第二節、 中風患者日常功能之定義與測量:ICF架構 9
第三節、 中風患者肢體動作表現與日常功能之關係 11
壹、 肢體動作表現與活動層面日常功能之關係 11
貳、 肢體動作表現與參與層面日常功能之關係 12
第四節、 研究變項之界定 14
第三章、 研究方法 16
第一節、 研究對象 16
第二節、 研究工具 18
壹、 加速規 18
貳、 巴氏量表 20
參、 芙蘭切活動量表 21
肆、 台灣簡明版世界衛生組織生活品質問卷 21
伍、 流行病學研究中心憂鬱量表 22
第三節、 研究流程 23
第四節、 資料分析 25
第四章、 研究結果 26
第一節、 人口學資料、身體活動量與日常功能 27
壹、 兩組人口學資料之描述與比較 27
貳、 兩組身體活動量、日常功能之描述與比較 30
第二節、 人口學資料與身體活動量之關係:相關與迴歸 34
壹、 人口學變項與身體活動量之相關性 34
貳、 逐步迴歸分析:人口學變項對於身體活動量之預測性 35
第三節、 身體活動量與日常功能之關係:相關與迴歸 38
壹、 身體活動量與活動層次日常功能 38
貳、 身體活動量與參與層次日常功能 39
第五章、 討論 44
第一節、 兩組人口學資料、身體活動量與日常功能之表現 45
第二節、 人口學變項與身體活動量之關係探討 50
第三節、 身體活動量與日常功能之關係探討 52
壹、 身體活動量對於活動層次日常功能之預測力 53
貳、 身體活動量對於參與層次日常功能之預測力 57
第四節、 臨床應用與研究限制 62
第六章、 結論 64
參考文獻 65

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