臺灣博碩士論文加值系統

全人工膝關節置換術的病例逐年增加，復健的議題越來越受到重視，而隨著虛擬實境以及動作捕捉技術的發展與普及，讓物理治療師在改善病人復健效果上有了新的選擇。然而，過去的研究中很少有針對膝關節復健的解決方案，並且有許多設備上的限制。因此，本論文旨在探討將虛擬實境結合動作捕捉技術，讓全人工膝關節置換術後病患在虛擬環境下進行遊戲，如何影響其復健的動機，並了解系統的使用性以及動機的變化對於復健的成效會產生哪些影響。本實驗擬使用Unity 3D遊戲引擎搭配Microsoft Kinect感應器開發一個自行車競速遊戲 (PRS)，將之佈署在全人工膝關節置換術後患者的復健流程中，進行持續一週的復健療程。試圖透過遊戲的趣味性以及擬真環境來提高復健動機，並使用Kinect的影像捕捉技術，克服以往的復健部位受限於感應裝置的困難。本研究採用準實驗設計，將受測病患分為實驗組與控制組，比較有無使用PRS在復健成效是否有所差異，並針對實驗組的受測者發放問卷，評估系統操作以及動機的變化對於復健效果的影響。研究結果顯示使用PRS系統可以強化病患的復健動機並提高成效，未來可作為相關研究在設計系統以及物理治療師指導病患的參考。

Total knee replacement (TKR) cases increase year by year, the rehabilitation issues are more concern. With the development and popularization of virtual reality and motion capture technology, physical therapists have a new option to improve patients’ rehabilitation effect. However, there are few studies in the past for knee rehabilitation solutions, and there are many restrictions on the devices. Therefore, this paper aims to explore how rehabilitants change their motivation, and to understand how users’ motivation and perceptive of system usability affect the rehabilitation performances in a game-based rehabilitation condition. This study intends to develop a bike-racing game as Physical Rehabilitation System (PRS) with Unity 3D game engine and Microsoft Kinect sensor, deploy it in a one-week TKR rehabilitation process, and try to strengthen the rehabilitants’ motivation through the game interesting and immersive environment. The using of Kinect sensor overcomes the difficulties of body sensing restriction. This study used a quasi-experimental design, participants were divided into experimental group which rehabilitated with PRS and control groups, and the experimental group rehabilitants had to fill out the questionnaire which was used to evaluate whether the system operations and motivation changes will affect rehabilitation achievement. The results indicate that PRS can effectively strengthen patients’ motivation and improve the rehabilitation performances, which can be a reference for related research and helping rehabilitation in the future.

摘要 i
ABSTRACT ii
Content iii
List of Tables iv
List of Figures v
1. Introduction 1
2. Literature Review 4
2.1 Game-Based Rehabilitation 4
2.2 Attention, Relevance, Confidence, Satisfaction (ARCS model) 5
2.3 System Usability Scale (SUS) 6
2.4 Self-Determination Theory (SDT) 7
3. Methodology 9
3.1 Research Concept 9
3.2 Participants and Questionnaire Design 12
3.2.1 Participants 12
3.2.2 Questionnaire Design 13
3.3 System Development 15
3.4 Experiment Procedure 16
3.4.1 PRS Setting 17
3.4.2 Intervention Phase 17
4. Data Analysis and Results 20
4.1 Data Analysis of Questionnaire 20
4.2 Results of Hypothesis Test 21
4.3 Findings 29
5. Conclusion 33
Reference 34

Alankus, G., Proffitt, R., Kelleher, C., &; Engsberg, J. (2010). Stroke therapy through motion-based games: A case study. ASSETS’10, Proceedings of the 12th international ACM SIGACCESS conference on computers and accessibility (pp. 219–226).
Betker, A. L., Desai, A., Nett, C., Kapadia, N., Szturm, T. (2007). Game-based exercises for dynamic short-sitting balance rehabilitation of people with chronic spinal cord and traumatic brain injuries. Physical Therapy, 87(10), 1389-1398.
Brooke, J. (1996): SUS: A “Quick and Dirty” Usability Scale. In Jordan, P.W., Thomas, B., Weerdmeester, B.A., McClelland (Eds.), Usability Evaluation in Industry (pp. 189–194). Taylor &; Francis, London.
Chan, D. K. C., Hagger, M. S., &; Spray, C. M. (2011). Treatment motivation for rehabilitation after a sport injury: Application of the trans-contextual model. Psychology of Sport and Exercise, 12, 83-92.
Chang, Y. J., Chen, S. F., Chuang, A. F. (2011). A gesture recognition system to transition autonomously through vocational tasks for individuals with cognitive impairments. Research in Developmental Disabilities, 32, 2064-2068.
Chen, Y. P., Kang, L. J., Chuang, T. Y., Doong, J. L., Lee, S. J., Tsai, M. W., Jeng, S. F., Sung, W. H. (2007). Use of virtual reality to improve upperextremity control in children with cerebral palsy: A single-subject design. Physical Therapy, 87, 1441–1457.
Deci, E. L., &; Ryan, R. M. (1985). Intrinsic motivation and self-determination in human behavior. New York: Plenum.
Deutsch, J. E., Borbely, M., Filler, J., Huhn, K., &; Guarrera-Bowlby, P. (2008). Use of a low-cost, commercially available gaming console (Wii) for rehabilitation of an adolescent with cerebral palsy. Physical Therapy, 88, 1–12.
Jack, D., Boian, R., Merians, S., Tremaine, M., Burdea, G. C., Adamovich, S. V., Recce, M., Poizner, H. (2001). Virtual reality - enhanced stroke rehabilitation. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 9, 308–318
Keller, J. M. (1983). Motivational design of instruction. In C. M. Reigeluth (Eds.), Instructional-design theories and models: An overview of their current status (pp. 386-434). Hillsdale, NJ: Lawrence Erlbaum Associates
Kubeck, J. E., Delp, N. D., Haslett, T. K., McDaniel, M. A. (1996). Does job-related training performance decline with age? Psychology and Aging, 11(1), 92-107.
Levac, D., Pierrynowski, M. R.,Canestraro, M., Gurr, L., Leonard, L., Neely, C. (2010). Exploring children’s movement characteristics during virtual reality video game play. Human Movement Science 29, 1023–1038.
Lotan, M., Yalon-Chamovitz, S., Weiss, P. L. (2010). Virtual reality as means to improve physical fitness of individuals at a severe level of intellectual and developmental disability. Research in Developmental Disabilities, 31, 869-874.
O’Connor, T. J., Cooper, R. A., Fitzgerald, S. G., Dvorznak, M. J., Boninger, M. L., Vansickle, D. P., &; Glass, L. (2000). Evaluation of a manual wheelchair interface to computer games. Neurorehabil Neural Repair, 14(1), 21-31.
Reinen, I. J., &; Plomp, T. (1997). Information technology and gender equality: a contradiction in terminis? Computers &; Education, 28(2), 65–78.
Rizzo, A. A., Buckwalter, J. G., &; Neumann, U. (1997). Virtual reality and cognitive rehabilitation: A brief review of the future. Journal of Head Trauma and Rehabilitation, 12, 1–15.
Rizzo, A. A.,&;Kim, G. J. (2005). A SWOTanalysis of the field of VR rehabilitation and therapy. Presence: Teleoperators and Virtual Environments, 14, 119–146.
Rose, F. D., Brooks, B. M., Attree, E. A., Parslow, D. M., Leadbetter, A. G., McNeil, J. E., et al. (1999). A preliminary investigation into the use of virtual environments in memory retraining after vascular brain injury: Indication for future strategy? Disability and Rehabilitation, 21, 548–554.
Sayenko, D. G., Masani, K., Robinson, M. F., Vette, A. H., McConville, K. M. V., Popovic, M. R. (2011). Video game-based neuromuscular electrical stimulation system for calf muscle training: A case study. Medical Engineering &; Physics, 33, 249-255.
Schultheis, M. T., &; Rizzo, A. A. (2001). The application of virtual reality technology in rehabilitation. Rehabilitation Psychology, 46, 296–311.
Shaughnessy, M., Resnick, B., &; Macko, R. (2006). Testing a model of post-stroke exercise behavior. Rehabilitation Nursing, 31, 15–21.
Tondeur, J., Valcke, M., &; van Braak, J. (2008). A multidimensional approach to determinants of computer use in primary education: teacher and school characteristics. Journal of Computer Assisted Learning, 24(6), 494–506.
Weiss, P. L., Rand, D., Katz, N., &; Kizony, R. (2004). Video capture virtual reality as a flexible and effective rehabilitation tool. Journal of Neuroengineering and Rehabilitation, 1, 12.
Wood, S. R., Murillo, N., Bach-y-Rita, P., Leder, R. S., Marks, J. T., &; Page, S. J. (2003). Motivating, Game-Based Stroke Rehabilitation: A Brief Report. Topics in Stroke Rehabilitation, 10(2), 134-140.