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研究生:葉寧心
研究生(外文):Ip, Ling-Sum
論文名稱:手指精細運動設備與音樂對老人之效果
論文名稱(外文):The Effect of Finger Fine Motor Training Device with Music on Older Adult
指導教授:蘇芳慶蘇芳慶引用關係郭立杰郭立杰引用關係
指導教授(外文):Su, Fong-ChinKuo. Li-Chieh
口試委員:安介南林倩如揭小鳳
口試委員(外文):An, Kai-Nan
口試日期:2022-01-13
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:2022
畢業學年度:110
語文別:英文
論文頁數:61
中文關鍵詞:手功能手指精細動作訓練音樂介入居家復健設備
外文關鍵詞:hand functionfinger fine motor trainingmusic interventionin-house rehabilitation equipment
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全球人口近幾年快速老化,而根據失智症協會的一項流行病學調查發現,失智症之病發率與年齡呈正比,並有每五歲病發率倍增之趨勢。目前在台灣有超過27萬失智人口,平均每一年會增長1萬人口,預計未來隨著台灣邁入超高齡社會,長照和醫療服務的需求也會相對急速增加。然而目前針對失智症在藥物治療上,並沒有辦法恢復已受損的腦細胞。「預防勝於治療」,因此失智症預防是目前一個被受關注的議題。過去有多個研究發現透過手指的精細運動,大腦皮質層會根據不同的活動及刺激,有不同程度的活化,以期延緩腦部的退化及失智的發生。
故本研究的目的擬依研究室先前之研究基礎重新設計一個手部精細動作訓練設備,並導入音樂為一個正向鼓勵的元素,旨在讓長者多做手指精細運動間接刺激腦部的活化,最終讓此訓練設備將以產品的形態開發,目的於可實際導入一般居家市場,讓更多長者能受惠在宅訓練。本研究中將透過研究設計及臨床實驗用以提供相關實證依據,觀察探究長者在使用此手指精細運動裝置後對其手及大腦功能之訓練效果與影響。
本研究目的是希望把音樂以一個介入的元素,提高長者對手指運動的動力及樂趣。本研究在前導實驗中先以近紅外光譜儀((Near-infrared spectroscopy, NIRS) 觀察長者在使用此設備時,音樂的選擇對大腦的活化程度,而主要重點研究在於探討在使用一段時間後其手功能和認知功能的改變。22位健康高齡長者分別參與實驗訓練組和對比組,各組11位,所有受測者均有固定的運動習慣。實驗訓練組在主要研究中,會使用一個重新設計手部精細動作訓練設備,進行共15次的手指精細動作訓練,每次30-40分鐘,一周2-3次。對比組則只參與前測和4-6周後的後測。前後測包括普渡手功能測驗 (Purdue Pegboard Test) 、蒙特利爾認知評估 (MoCA)、路徑描繪測驗 (Trail making test) 、數字廣度測驗 (digit span test) 以及空間定向記憶測驗 (Spatial memory test)。
在前導實驗中發現,新的音樂較懷舊音樂更能活化大腦。因此在訓練期間,供受測者選擇受訓使用之音樂主要為新歌或非長者熟識的音樂。本研究發現,經過15次的訓練後,高齡長者在手的靈活性上有進步,而認知功能方面,其執行能力也有顥注進步。但短期及空間記憶力並沒有在本研究中得到顥注發現。未來在此設備開發上,建議可往遊戲體驗和音樂連結度上、遊戲難易度及多樣性方面多作研究,讓老年人能通過此手部精細動作訓練設備得到多方面的刺激,以此活化大腦、延緩或預防失能失智。
The ageing population is rapidly increasing globally in the recent years. According to an epidemiological survey conducted by the Dementia Association, the prevalence of dementia is highly related to age, whereas the incidence rate doubled approximately every 5 years. Currently there are over 270 thousand of people living with dementia in Taiwan, and there is a prediction of an increment of 10 thousand dementia population on average every year. It is expected in the near future, Taiwan will become a super-aged society, and thus relatively, the burden on long-term care and medical services will also increase rapidly. However, there is no way to restore the damaged brain cells to treat dementia, therefore "Prevention is better than cure", prevention is pivotal to reduce the occurrence of dementia worldwide.
Therefore, the main purpose of this research is to develop a finger fine motor training device based on the previous research from our laboratory, and induce music a positive encouragement element, aiming to make finger fine motor training more appealing to elderly, and benefit from brain activation. The prototype used in the present study is aimed to develop into a mature product to be launched in the elderly market, which enable more elderly people can benefit from training at home. In this study, research design and clinical experiments will be used to provide relevant empirical evidence, and study is focused on the observation and exploration the training effect and influence in elderly on their hand and brain function after using this finger fine training device.
This research aims to use music intervention to enhance the motivation and engagement toward finger training with delight. In the pilot study, Near-infrared spectroscopy (NIRS) was used observe the brain activation towards different music when using the training device. And the main study was focused on the effect of this device on the elderly hand and brain function after training for a period of time. 22 health elderly were recruited, which separated into the training group and control group according to their own wills and available time, with 11 participants in each group respectively, all participants had regular exercise habits. In the main study, participants were trained with the new design finger fine motor training device for 15 times, with 2-3 times per week and 30-40 minutes for each training. All participants needed to take the pre-test and post-test after 4-6 weeks, the control group only participated in the pre- and post-test. The assessment tests included the Purdue Pegboard Test, Montreal Cognitive Assessment (MoCA), Trail Making Test, Digit Span Test and Spatial Memory Test.
In the pilot study, it was found that unfamiliar new music activated the brain more than old familiar music. Therefore, there were a range of new music available in the music library for the training. In the main study, improvement on hand dexterity was found in the training group after 15 times of training. Regarding to the cognitive function, elderly showed a great tendency of improvement in the executive function, however no significant effect on the ability of short term and spatial memory was found after the finger fine motor training in this study. It is suggested in the future development of this device, more consideration need to make regarding to the linkage between gamification experiment and music, the diversity and difficulty of the games, in order to create a diverse stimuli gaming device for elderly to play, activate their brain and hence prevent or delay the prevalence of dementia.
中文摘要 I
Abstract III
誌 謝 V
Contents VI
List of Tables VIII
List of Figures IX
Chapter 1 Introduction 1
1.1 Background 1
1.2 Finger Fine Motor Training 2
1.3 Music and Music-Based Intervention 3
1.4 Device for Home-base Usage 3
1.5 Motivation and Objective 4
Chapter 2 Experimental Material and Methods 6
2.1 Participants 6
2.2 Study Design and Experimental Procedure 7
2.2.1 Brain Region of interest (ROI) 7
2.2.2 Pilot Study Design 9
2.2.3 Main Study Design 13
2.2.4 Main Study Assessments 14
2.2.4.1 Purdue Pegboard Test 15
2.2.4.2 MoCA 15
2.2.4.3 FDS and BDS 16
2.2.3.4 TMT-A and TMT-B 16
2.2.4.5 Spatial Memory Test (SMT) 16
2.3 Instrumentation 17
2.3.1 Finger Training Device 17
2.3.1.1 Hardware Design 18
2.3.1.2 Customized Music 20
2.3.1.3 Gamification of the Training Program 21
2.3.2 NIRS 24
2.3.3 Purdue Pegboard 24
2.4 Data Processing 24
2.4.1 Data Analysis for the Pilot Study 24
2.4.2 Data Analysis for the Main Study 25
Chapter 3 Results 26
3.1 Participants Characteristics 26
3.2 Pilot Study Outcome 27
3.2.1 Brain Activation between Training and Listening Task 27
3.2.2 Brain Activation in Different Brain Regions 30
3.3 Main Study Outcome 34
3.2.1 Hand Function 34
3.2.1.1 Purdue Pegboard Right Test 34
3.2.1.1 Purdue Pegboard Assembly Test 36
3.2.2 Cognitive Function 38
3.2.2.1 MoCA 38
3.2.2.2 TMT-A 39
3.2.2.3 TMT-B 41
3.2.3 Short Term Memory 42
3.2.3.1 Forward Digit Span (FDS) 42
3.2.3.2 Backward Digit Span (BDS) 44
3.2.3.3 Spatial Memory Test (SMT) 46
Chapter 4 Discussion 49
4.1 Brain activation 49
4.2 Hand Function after Training 51
4.3 Brain Function after Training 52
4.3.1 Cognitive Function 52
4.3.2 Short Term Memory 53
4.4 Limitation 54
Chapter 5 Conclusion 56
References 58
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