目標物距離與軀幹侷限於中風後伸手及物動作之情境效應

Task context and reaching performance after stroke: Effects of target distance and trunk restarint

魏慈慧(Tzu-Hui Wei)

指導教授 ： 林克忠

國立臺灣大學/醫學院/職能治療研究所/碩士(2005年)

https://doi.org/10.6342/NTU.2005.02951

摘要

目標物距離於中風後伸手及物動作之情境效應
摘要
目標：探討中風病人伸手及物動作的距離效應，以及軀幹、手臂的協調情形。
方法：25位中風病人使用健側手分別在手長範圍內、手長及手長範圍外執行按鈴任務，使用運動學分析來探討動作表現。
結果：距離影響軀幹、手臂以及兩者之間的協調；距離增加，軀幹及手臂的速度、位移量及角度變化量都增加。軀幹及手臂的協調有固定模式，在時間上，軀幹比手臂先開始動作；在空間上，不論目標物的距離遠近，動作後段的位移主要由軀幹貢獻。
結論：目標物距離對健側手和軀幹動作的影響很大，特別在時間及空間的協調上；軀幹不只做為姿勢穩定之用，負責在動作後半部將手帶到目標物上。研究結果顯示左腦傷者在手臂及軀幹動作控制的障礙包括動作軌跡及時間協調兩部分。

目標物距離與軀幹侷限於中風後伸手及物動作之情境效應
摘要
目標：研究目標物距離與軀幹侷限對中風病人伸手及物動作的影響。
方法：25位中風病人使用健側手在四種實驗情境下執行伸手及物動作，實驗情境由目標物距離（遠、近）以及軀幹侷限與否共同決定：近距離及軀幹侷限、遠距離及軀幹侷限、近距離及不侷限軀幹、遠距離及不侷限軀幹。
結果：目標物距離及軀幹侷限對增加手臂關節角度變化量有顯著且高度的效應，在軀幹侷限而且目標物在近距離的情況下，可以改善動作流暢度。
結論：本研究結果顯示內在侷限及外在侷限都會影響動作表現。左腦傷及失用症患者在手臂動作流暢度的控制出現明顯的障礙，臨床評估及治療時應該納入考量，另外軀幹控制能力對伸手及物動作有很大的影響，尤其是反應時間及動作時間。

關鍵字

伸手及物動作 ； 運動學分析 ； 距離 ； 軀幹及手臂協調 ； 軀幹侷限 ； 距離效應 ； 健側手

並列摘要

Task context and reaching performance after stroke: Effects of target distance
Abstract
Purposes: To examine the effect of target distance on reaching performance in persons after stroke and the influence of voluntary trunk movement on the arm endpoint trajectory during reaching.
Methods: Twenty-five persons after stroke using ipsilesional arm performed reaching task. Kinematics of reaching movements to targets placed within arm length, arm length and beyond arm length were analyzed.
Results: As reaching distance increased, the velocity, displacement and active joint ranges of trunk and arm increased. Whenever the trunk was involved, there was a stereotyped sequential recruitment of the arm and trunk in that the trunk began moving before the hand. The trunk played an important role in positioning the hand close to the target during the terminal stage of the reaching movement.
Conclusions: Reaching distance affected the spatio-temporal aspects of coordination between the trunk and arm. The trunk not only acts as a postural stabilizer during reaching, but also becomes an integral component in positioning the hand close to the target. Persons with left brain damage showed deficits in trunk and arm movement trajectory control and in temporal coordination of trunk and arm.

Task context and reaching performance after stroke:
Effects of target distance and trunk restraint
Abstract
Purpose: To examine the effects of context on reaching performance in persons with stroke.
Methods: Twenty-five persons with stroke used ipsilesional arm to perform an upper-extremity reaching task under four experimental conditions, formed by the crossing of target distance and trunk restraint.
Results: Significant and large effects of target distance and trunk restraint were found on increasing elbow and shoulder joint ranges. Movement smoothness was improved under condition of trunk restraint and target placed in near distance.
Conclusions: The results of this study showed that the influence of internal and external constraints on reaching performance. Participants with left brain damage and apraxia showed deficits in movement trajectory control. The ability of trunk control affected reaching performance in the variables of movement time and reaction time.

並列關鍵字

reaching ； kinematics ； distance ； trunk-arm ； coordination ； trunk restraint ； Destance effect ； ipsilesional arm

參考文獻

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