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研究生:盛昱叡
研究生(外文):Yu-JuiSheng
論文名稱:探討即時互動遊戲對半側忽略病人之復健效果
論文名稱(外文):The Effect of Real-Time Interactive Game for Patients with Visual Spatial Neglect
指導教授:鄭國順鄭國順引用關係白明奇白明奇引用關係
指導教授(外文):Kuo-Sheng ChengMing-Chyi Pai
學位類別:碩士
校院名稱:國立成功大學
系所名稱:生物醫學工程學系
學門:生命科學學門
學類:生物化學學類
論文種類:學術論文
論文出版年:2016
畢業學年度:104
語文別:英文
論文頁數:49
中文關鍵詞:半側忽略症病覺缺失復健自身影像視覺回饋遊戲軟體
外文關鍵詞:NeglectAnosognosiaRehabilitationSelf-imageVisual feedbackGame
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半側忽略症是腦神經系統發生問題,而出現難以察覺、探索腦傷對側的空間的一種疾病。因腦傷的範圍廣泛不定,它常常與其他症狀一起發生,如半側癱瘓、病覺缺失等問題,所以是一種複合型的症候群。因此傳統的單一療法其實是不夠的,應該結合多種療法才能對應到不同的症狀。本篇研究之主要目的是發展一套電腦化、具有自身影像之視覺回饋的即時互動復建軟體,幫助半邊忽略症患者的復健。受試者為二位患有左側視覺忽略症的中風患者與一位正常人,兩位病患在8周內使用本軟體做了18次實驗,正常人則做了10次實驗,兩者再互相做比較。本軟體利用影像處理演算法,將患者的上半身身體影像與背景環境分離,僅投射個人影像到電腦螢幕中,使患者能夠看到自身影像,如此一來不但增加視覺回饋使整體感覺一致性提高,也能減輕病覺缺失和重建空間表徵。透過手勢判別技術辨別患者所做的手勢,患者能與螢幕上利用軟體所顯示的刺激進行互動,達到復健效果。此軟體將近幾年來所發展的多種忽略症療法概念結合,患者可同時接受多種不同的刺激,有助於腦神經連結重塑。結果顯示兩位病患在專注力、星星刪除測驗、線二分段測驗與簡易心智量表都有進步,但線刪除測驗則沒有太大的差別。與近幾年來的研究比較,本軟體改善了病人的忽略症情形,依照本研究的結果來看,是幫助改善忽略症的一種新穎的療法。
Visual spatial neglect is a neurological syndrome characterized by a lack of awareness and explorative behaviors toward the patients’ contralesional hemispace. It is a multicomponent disorder that is often combined with hemiplegia and anosognosia. Therefore, this multicomponent disorder should be treated with multiple therapies. The purpose of this study was to develop a real-time interactive training system to rehabilitate patients with visual spatial neglect. Two cases of left visual spatial neglect and one normal case were included. The patients were trained 18 times over 8 weeks, and the results were compared to those of the normal subject who received 10 training sessions. The interactive software uses an image processing algorithm to separate the body image of the patient from a background image, thus revealing only the patient’s image on the screen. The patient sees their image, which increases visual feedback and enhances the integrity of their sensory inputs. Therefore, this therapy decreases the severity of anosognosia, allowing the patient to reconstruct their spatial representation. The hand gesture recognition technique allows the patient to interact with the application. This software combines concepts from different therapies to reconstruct brain neurons. The results showed that patients improved attention ability, Star Cancellation, Line Bisection, and Mini Mental State Examination test scores, but no improvements on the Line Cancellation Test was observed. This software helped the patients free themselves from the symptoms of visual neglect and may be a beneficial therapeutic technique.
摘要 I
Abstract III
Acknowledgement V
List of Tables IX
List of Figures X
Chapter 1 Introduction 1
1.1 Neglect syndrome 1
1.2 The classification of Neglect syndrome 2
1.2.1 Personal space 3
1.2.2 Peripersonal space 3
1.2.3 Extrapersonal space 3
1.3 The complication of Neglect syndrome 4
1.3.1 Anosognosia 4
1.4 The rehabilitation of neglect 5
1.4.1 Visual scanning training 5
1.4.2 Limb activation 5
1.4.3 Feedback training 5
1.4.4 Sustained attention training 6
1.4.5 Computerized therapy 7
1.5 Motivation and the aims of this study 9
Chapter 2 Materials and Methods 11
2.1 Experimental design 11
2.2 Participants 12
2.3 Assessment 12
2.3.1 Experiment 12
2.3.2 Tests 13
Chapter 3 System design 14
3.1 System architecture 14
3.2 Camera module 15
3.2.1 Background subtraction 15
3.2.2 Otsu thresholding 16
3.3 Detection Module 17
3.3.1 Finding the skin 18
3.3.2 Palm contour determination 18
3.3.3 Determining simple hand gesture (open or close palm) 19
3.4 Application 20
3.4.1 The finite state machine (standard operating procedure) 21
Chapter 4 Results 24
4.1 Test 24
4.2 Experiment 25
4.3 Case results 28
4.3.1 Patient 1: WSW 28
4.3.2 Patient 2: WCSL 32
4.3.3 Control: LCH 35
Chapter 5 Discussion 37
5.1 Test results 37
5.2 Experimental results 38
5.2.1 Hand reaction time 38
5.2.2 Distraction rate 39
5.3 Game design 40
5.4 Patients 41
5.5 Limitations of the experiment 41
Chapter 6 Conclusion and Prospects 43
References 44
Human study approval 48

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