以Wii Fit電子遊戲為身體壓力中心的視覺回饋練習對於正常發展兒童之前置性姿勢調整的影響

背景與目的：前置性姿勢調整（anticipatory postural adjustment）是指主動執行動作時，伴隨動作啟動瞬間所事先出現姿勢動作控制調整的情形，可以反應出主動動作與姿勢控制間協調情形。目前很流行的電子遊戲Wii Fit電子遊戲中提供遊戲者一個外在的電子影像來瞭解自身的壓力中心（center of pressure, COP）移動情況作為外在視覺COP移動回饋系統訓練。目前無研究對Wii Fit^TM或提供額外COP移動的視覺回饋練習對於正常發展兒童前置性姿勢調整之影響探討。因此本研究的目的是利用Wii Fit^TM電子遊戲作為提供額外COP移動的視覺回饋練習來探討正常發展兒童的前置性姿勢調整的改變。方法：本研究採前後實驗設計，以方便取樣的方式，有4名正常發展兒童參與在家訓練兩個星期共十天修正過的（modified）Wii Fit^TM電子遊戲練習。個案在練習介入前和後各接受一次評估。兒童伸手向前取球時，前置性姿勢調整評估以AMTI力板（forceplate）（Advanced Mechanical Technology Inc., Watertown, MA）來記錄力學訊號，以MA-100系統（Motion Lab Systems, Inc., Baton Rouge, LA）來記錄肌電圖訊號。此外，還記錄兒童的靜態站立下COP移動以及臨床功能活動評估，包括功能性伸手測試（functional reach test, FRT）、計時站立行走測試（timed ”up and go” test, TUG）及單腳站立測試（one leg standing test）。以描述性統計及無母數魏克森符號排序檢定作為統計分析。結果：在訓練前，正常發展兒童在伸手向前取球時己經出現COP向後移動及脛前肌（tibialis anterior）先啟動等前置性姿勢調整，但仍有部分個案姿勢調整的啟動時間落在與手部動作啟動相對最佳時間範圍之外。訓練後，所有個案的姿勢調整啟動時間落在與手部動作啟動相對最佳時間範圍之內，且有一名個案單腳站時間增加，但前置性姿勢調整的改變差異和功能評估之改變未達統計上顯著差異。結論：本研究礙於人數較少且缺乏控制組，因此在結果的解釋上，仍需小心。但是4名個案在姿勢調整出現在最佳化的情形有較為一致，因此未來值得繼續探討。

關鍵字

壓力中心位移；視覺回饋練習；前置性姿勢調整；正常發展兒童

並列摘要

Backgrounds and Purpose: The anticipatory postural adjustments (APAs) are postural adjustments accompanied by voluntary movements. The APAs can represent the coordination between voluntary movements and postural adjustments. Wii Fit is an innovative game that provides an external visual feedback that assists users in understanding the excursion of their own center of pressure (COP). To date, no study had been conducted to determine the change of the APAs after Wii Fit training or other training instruments which also provide visual COP feedback in the children with typical development (TD). Thus, the purposes of this study were to describe the effects on the improvements of the APAs by Wii Fit training method that provided visual COP feedback for children with TD. Methods: A pre-post test design was used. Four children with TD participated in a modified Wii Fit training at home for 10 days in two weeks. Participants received evaluations before and after the intervention. The forward reaching a moving ball was used to examine the APAs. The APAs were determined with kinetic data recorded by an AMTI forceplate (Advanced Mechanical Technology Inc., Watertown, MA) and electromyography (EMG) recorded by MA-100 (Motion Lab Systems, Inc., Baton Rouge, LA). In addition, displacement of COP in standing and clinical functional ability test, i.e., functional reach test, timed ”up and go” test and one leg standing test were also evaluated. Descriptive analyses and Wilcoxon signed rank test were used for data analysis. Results: AII children showed the APAs before the training, such as posterior shift of COP and activation of tibialis anterior, but a part of parameters were out the optimal APAs time frame. After the training, all of the children showed APAs within the optimal time frame. One child improved his one leg standing ability. However, the pre-post changes of the APAs and functional tests for group comparisons did not reach statistical significant differences. Conclusions: Limitations of this study include its relatively small sample size and lack of a placebo control group. The result s should be interpreted with caution. There were several positive trends in several measurements. In the future, it is worth to research the relative studies.

並列關鍵字

Displacement of center of pressure ； Visual feedback training ； Anticipatory posture adjustments ； Children with typical development

國際替代計量

以Wii Fit電子遊戲為身體壓力中心的視覺回饋練習對於正常發展兒童之前置性姿勢調整的影響

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