- 期刊
- OpenAccess
兩側動作及工作平面高低對中風患者患側上肢之動作控制分析
Effect of Bilateral Movements with Different Levels of Task-plane on Arm Control of Patients with Stroke
摘要
According to previous researches, bilateral movements are suggested to facilitate symmetric and better movement control of the hemiparetic arm in stroke. This study investigated the quality of hemiparetic arm movements control under a facilitation of bilateral reaching with different levels of task-plane. There were fourteen unilateral stroke patients recruited in this study. We used the three-dimensional kinematics motion analysis tool (WsualeyezTM Hardware, Canada) to collect the movement trajectoiy data of stroke involved arm. There were four movement tasks used in our design:(1)contralateral limb reaching to the target at horizontal desk-level;(2)bilateral limbs simultaneously reaching to the target at horizontal shoulder-level;(3)contralateral limb reaching to the target at shoulder level;(4)bilateral limbs simultaneously reaching to the target at horizontal shoulderlevel. There were fourteen unilateral stroke patients recruited in this study. We used the three-dimensional kinematics motion analysis tool (WsualeyezTM Hardware, Canada) to collect the movement trajectoiy data of stroke involved arm. There were four movement tasks used in our design:(1)contralateral limb reaching to the target at horizontal desk-level;(2)bilateral limbs simultaneously reaching to the target at horizontal shoulder-level; (3) contralateral limb reaching to the target at shoulder level;(4)bilateral limbs simultaneously reaching to the target at horizontal shoulderlevel. The primary dependent variables were maximal velocity, percentage of reach where maximal velocity occurs, maximal acceleration, maximal acceleration, percentage of reach where maximal acceleration occurs, movement time, movement distance, normalized jerk score of movements, number of movement units, elbow flexion-extension range, shoulder abduction-adduction range, shoulder flexion-extension range, trunk curve line value, and trunk linear line value. All of the data were tested by using repeated-measures analysis of variance (ANOVA). Results showed that kinematic dependent variables in the four task conditions were significantly different (p＜ .05). In horizontal desk-level, subjects performed greater shoulder joint range of motion (ROM) in bilateral reaching than that in unilateral task (p＜ .05). In horizontal shoulder-level, subjects in both bilateral and unilateral reaching performed greater shoulder joint ROM than that in horizontal desk-level (p＜ 05). However, subjects performed greater upper extremity ROM, in bilateral movement tasks, were also found with inducing more trunk adaptation (p＜ .05). Although we did not find that subjects had smoother affected arm movements during bilateral reaching at task with different levels, we suggested that bilateral movements may facilitate greater active ROM, with the effects of visual guiding and interlimb coupling, than unilateral movements. In occupational therapy, activity incorporate with bilateral movements, trunk restriction and appropriate task demand may be beneficial to facilitate arm active movement and motor recovery for stroke patients.
並列摘要
According to previous researches, bilateral movements are suggested to facilitate symmetric and better movement control of the hemiparetic arm in stroke. This study investigated the quality of hemiparetic arm movements control under a facilitation of bilateral reaching with different levels of task-plane. There were fourteen unilateral stroke patients recruited in this study. We used the three-dimensional kinematics motion analysis tool (WsualeyezTM Hardware, Canada) to collect the movement trajectoiy data of stroke involved arm. There were four movement tasks used in our design:(1)contralateral limb reaching to the target at horizontal desk-level;(2)bilateral limbs simultaneously reaching to the target at horizontal shoulder-level;(3)contralateral limb reaching to the target at shoulder level;(4)bilateral limbs simultaneously reaching to the target at horizontal shoulderlevel. There were fourteen unilateral stroke patients recruited in this study. We used the three-dimensional kinematics motion analysis tool (WsualeyezTM Hardware, Canada) to collect the movement trajectoiy data of stroke involved arm. There were four movement tasks used in our design:(1)contralateral limb reaching to the target at horizontal desk-level;(2)bilateral limbs simultaneously reaching to the target at horizontal shoulder-level; (3) contralateral limb reaching to the target at shoulder level;(4)bilateral limbs simultaneously reaching to the target at horizontal shoulderlevel. The primary dependent variables were maximal velocity, percentage of reach where maximal velocity occurs, maximal acceleration, maximal acceleration, percentage of reach where maximal acceleration occurs, movement time, movement distance, normalized jerk score of movements, number of movement units, elbow flexion-extension range, shoulder abduction-adduction range, shoulder flexion-extension range, trunk curve line value, and trunk linear line value. All of the data were tested by using repeated-measures analysis of variance (ANOVA). Results showed that kinematic dependent variables in the four task conditions were significantly different (p＜ .05). In horizontal desk-level, subjects performed greater shoulder joint range of motion (ROM) in bilateral reaching than that in unilateral task (p＜ .05). In horizontal shoulder-level, subjects in both bilateral and unilateral reaching performed greater shoulder joint ROM than that in horizontal desk-level (p＜ 05). However, subjects performed greater upper extremity ROM, in bilateral movement tasks, were also found with inducing more trunk adaptation (p＜ .05). Although we did not find that subjects had smoother affected arm movements during bilateral reaching at task with different levels, we suggested that bilateral movements may facilitate greater active ROM, with the effects of visual guiding and interlimb coupling, than unilateral movements. In occupational therapy, activity incorporate with bilateral movements, trunk restriction and appropriate task demand may be beneficial to facilitate arm active movement and motor recovery for stroke patients.
延伸閱讀
- 林育璿（2006）。正常人與中風病人上肢動作兩側性缺失之探討〔碩士論文，高雄醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0011-1907200623474600
- 吳宗憲、戴翊、謝清麟、陳嘉炘、李素、林昭宏（2010）。比較中風病人上肢動作量表及運動學分析之再測信度。物理治療，35(4)，292-299。https://www.airitilibrary.com/Article/Detail?DocID=15632555-201012-201102120026-201102120026-292-299
- Chao, C. P. (2009). 合併制動療法對中風後上肢功能表現之運動學分析 [master's thesis, National Taiwan University]. Airiti Library. https://doi.org/10.6342/NTU.2009.01228
- Cheng, H. J., Lin, T. A., Lee, M. T., Huang, Y. F., Hsieh, Y. W., Wu, C. Y., & Lin, K. C. (2014). 中風患者於雙側機器輔助療法之上肢動作功能療效：文獻回顧. 臺灣職能治療研究與實務雜誌, 10(2), 115-127. https://doi.org/10.6534/jtotrp.2014.10(2).115
- Bezděková, D., Hluštík, P., & Opavský, J. (2007). Multimodal Evaluation of the Effects of Physiotherapy on Stroke Patients with Upperlimb Involvement. Acta Universitatis Palackianae Olomucensis.Gymnica, 37(4), 11-16. https://www.airitilibrary.com/Article/Detail?DocID=12121185-200712-201107070061-201107070061-11-16