臺灣博碩士論文加值系統

中文摘要
研究背景
隨機共振刺激的應用已被證實可以改善下肢執行本體覺任務時的
動作表現。然而，我們不知道隨機共振刺激對於上肢的應用，應用的
電刺激強度也沒有一致的結果。本文將以健康人為受試者， 探討隨機
共振電刺激是否能提升本體感覺及神經肌肉控制。 本研究同時探討隨
機共振電刺激的最佳強度（０％感覺強度電刺激、７０％感覺強度電
刺激、９０％感覺強度電刺激以及１００％感覺強度電刺激），以及電
刺激當下或是一個三十分鐘電刺激療程後的動作能力表現， 做為未來
臨床介入的參考。
研究目的
本篇研究主要目的是探討不同隨機共振電刺激強度（０％、７０
％、９０％以及１００％） 對健康成年人腕部的關節及力量本體感覺，
以及對神經肌肉控制的立即和電刺激三十分鐘後的延遲效應。
神經肌肉控制會以握力維持的動作任務表現， 以及以腦波-肌電圖
同調性做為測試方法。
研究方法
本研究招募 14 位健康人，研究分成兩天進行。 第一天進行本體覺
測試以及決定隨機共振電刺激的最佳強度，決定最佳強度後進行隨機ix
共振電刺激前以及電刺激當下，以中強度力量(30%最大自主收縮)執行
握力計維持 30 秒，同時紀錄腦波訊號及表面肌電訊號。第二天受試者
會接受單一次 30 分鐘的隨機共振電刺激，在電刺激介入前及介入後以
中強度力量(30%最大自主收縮)執行握力計維持 30 秒，同時紀錄腦波
訊號及表面肌電訊號並以共調性方式呈現。
結果
力量本體感覺在 70% 感覺程度電刺激時有最小的力量誤差值；關
節角度本體感覺在 100% 感覺程度電刺激有最小的力量誤差值；共調
性方面， 在未電刺激、電刺激當下與電刺激三十分鐘後皮質肌肉共調
性不論是在 β 或是 γ 頻帶的尖峰值與面積值皆沒有顯著的上升或下
降。
討論與結論
本研究證實了隨機共振電刺激確實能改善本體覺測試。動作表現的
進步，在排除學習效應、周邊肌肉組織改變等原因後，可能是因為隨
機共振電刺激提升了大腦皮質興奮性，進而導致動作控制較電刺激前
為佳。

英文摘要
Background: The application of mechanical and electrical noise
stimulation has been shown to improve the proprioception task in lower
limbs. However, little did we know the application of stimulation to the
upper limbs. Besides, there is no consistent result in the stimulation
intensity. Method: We applied four different levels of stochastic resonance
(no-stimulation, 70%, 90%, and 100% of their sensory threshold ST) on
median nerve. The proprioception tests consist of a force task and a join
position task. In the force task, subjects maintained steady grip force at
30% maximal voluntary contraction (MVC) for 1s and repeat 5 time
without visual feedback. In the join angle task, subjects reproduce 30
degree of wrist extension with eye closed, and repeat 5 time for each trial.
The stimulation intensity of the best performance in proprioception test was
the optimal stimulation (OS). Next, Subjects perform a steady hold
30%MVC task for 30 seconds and simultaneously collect EEG and EMG
tested before, during, and after 30-min stochastic resonance stimulation.
Results: 70% ST has the best force task performance; 100%ST has the best
join position task performance. CMC show no significant result in both
beta and gamma band. The power spectrum of EEG decreases 17% in
channel FC1 at the gamma band during the stimulation but show little
change in beta band. After 30minutes stimulation it increase 25% in
channel C3 at the gamma band but show little change in beta band.
Our preliminary results indicate that stochastic resonance stimulation
improves sensorimotor function and it induces brain plasticity, which can
be detected using EEG and EMG.

中文摘要........................................................................................................i
英文摘要......................................................................................................iii
圖目錄........................................................................................................viii
表目錄...........................................................................................................x
中、英文重要字彙對照表..........................................................................xi
第一章 緒論.................................................................................................1
第一節 研究背景與動機......................................................................1
第二節 研究目的..................................................................................4
第三節 研究假設..................................................................................4
第四節 重要性......................................................................................4
第二章 文獻回顧.........................................................................................6
第一節 神經肌肉電刺激對中樞的影響..............................................6
第二節 隨機共振電刺激......................................................................9
2.2.1 定義........................................................................................9
2.2.2 已知成效................................................................................9
第三節 感覺動作系統與大腦皮質共調性........................................ 11
2.3.1 感覺動作系統...................................................................... 11
2.3.1.1 本體感覺........................................................................... 11
2.3.1.2 肌肉感覺受器................................................................... 11
2.3.1.3 關節感覺受器...................................................................12
2.3.1.4 皮膚感覺受器...................................................................12
2.3.2 大腦皮質肌肉共調性..........................................................13
第三章 研究方法.......................................................................................15
第一節 研究設計................................................................................15
第二節 研究對象................................................................................15
第三節 實驗流程................................................................................16
第四節 測試方法與資料收集............................................................17
3.4.1 抓握力量覺..........................................................................18
3.4.2 腕關節位置覺......................................................................20
3.4.3 共調性..................................................................................21
第五節 資料處理................................................................................23
3.5.1 位置覺與力量覺資料分析..................................................23
3.5.2 維持三十秒鐘力量穩定度與準確度計算..........................23
3.5.3 共調性計算..........................................................................24
第六節 統計分析................................................................................26
第四章 結果...............................................................................................27
4.1 受試者基本資料............................................................................27
4.2 不同強度下動作能力表現............................................................28
4.2.1 抓握力量覺表現..................................................................28
4.2.2 關節角度覺表現..................................................................28
4.3 以最佳強度分析............................................................................29
4.3.1 抓握力量與關節角度覺表現..............................................29
4.3.2 維持三十秒抓握力量覺表現..............................................29
4.3.3 維持三十秒抓握穩定度表現..............................................31
4.3.4 共調性分析..........................................................................32
4.3.5 腦波頻譜分析......................................................................33
第五章 討論.............................................................................................36
5.1 受試者............................................................................................36
5.2 不同強度電刺激的影響................................................................36
5.3 最佳強度電刺激下........................................................................37
5.3.1 電療當下的動作表現..........................................................37
5.3.2 維持三十秒的抓握力量表現..............................................37
5.3.3 共調性與頻譜分析..............................................................38
5.3.4 研究限制與未來研究之建議..............................................39
第六章 結論...............................................................................................41
參考文獻.....................................................................................................42
附錄.............................................................................................................47
1 受試者同意書...................................................................................47
圖目錄
圖 1-1 周邊電刺激誘發中樞神經系統可塑性示意圖 ................2
圖 1-2 隨機共振電刺激與傳統電刺激波型比較 .....................4
圖 3-1 實驗流程圖.......................................................................15
圖 3-2 實驗示意圖.....................................................................157
圖 3-3 抓握力量測試圖...............................................................19
圖 3-4 握力計...............................................................................20
圖 3-5 關節角度實驗圖...............................................................21
圖 3-6 關節角度計黏貼位置.......................................................21
圖 3-7 力量維持三十秒...............................................................23
圖 4-1 不同隨機共振電刺激強度下肌肉力量本體感覺之表現
................................................................................................28
圖 4-2 不同隨機共振電刺激強度下腕關節本體感覺之表現 ..29
圖 4-3 電療當下受試者動作表現...............................................30
圖 4-4 電療三十分鐘後受試者動作表現...................................31
圖 4-5 電療當下受試者動作穩定度表現...................................32
圖 4-6 電療三十分鐘後受試者動作表現...................................32
圖 4-7 無電療與電療當下 Beta 頻帶各頻道狀態.....................34
圖 4-8 無電療與電療當下 Gamma 頻帶各頻道狀態................34
圖 4-9 無電療與電療三十分鐘後 Beta 頻帶各頻道狀態.........35
圖 4-10 無電療與電療三十分鐘後 Gamma 頻帶各頻道狀態..35
表目錄
表 1 受試者基本資料..................................................................27
表 2 抓握力量與關節角度覺表現..............................................29
表 3 電療前與電療當下的皮質肌肉共調性..............................33
表 4 電療前與電療三十分鐘後皮質肌肉共調性......................33

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