觸控式電腦化螢幕上肢訓練系統之建構效度初探

背景及目的：我們最近設計了一個以任務導向概念結合電腦化觸控螢幕訓練系統提供中風患者上肢復健。此電腦化觸控螢幕復健系統 (CTRS) 的活動設計和分類是根據研發者的專業知識和經驗。因此，需要進一步的信度和效度數據。本篇研究目的是驗證CTRS 的單向度建構效度。方法：60 名中風受試者被招募並以患側上肢隨機進行系統中類別一（共11 個螢幕活動）和類別二（共5 個螢幕活動）的活動。每個螢幕活動的表現時間設定在一分鐘。CTRS 會自動記錄正確動作的重複次數。因素分析和羅序分析被用來驗證這兩類螢幕活動的建構效度和向度。結果：在類別一的上肢動作和肩關節穩定度訓練中，只抽取出一個主要因子，可解釋變異值為66.72%。在類別二的上肢伸手訓練中，只抽取出一個主要因子，可解釋變異值為87.04%。羅序分析的結果也支持類別一和類別二的活動分別只具有單一向度的建構。結論：本研究支持CTRS 中類別一和類別二的螢幕活動分類具有良好的單向度建構效度。本研究結果不但可促進CTRS 做為臨床輔助治療設備之應用，同時可幫助治療師在CTRS中選擇適當的螢幕活動以符合個案的治療目標。

關鍵字

腦中風；虛擬實境；上肢復健；羅序分析

並列摘要

Objective：We recently design a task-oriented concept combined with computerized touch-screen training system with the purpose of upper limb rehabilitation for patients with stroke. The activities design and classification of computerized touch-screen rehabilitation system (CTRS) are based on the developer's expertise and experience. Thus, further empirical reliability and validity data are needed. The purpose of this study is to verify the unidimensionality construct validity of the CTRS. Method：Sixty stroke subjects were recruited and randomly assigned to execute the category I (11 screen activities) and category II (5 screen activities) in the system with affected upper limb. The performance time for each screen activity was set in one minute. The CTRS would record the correct numbers of motor repetitions automatically. Factor analysis and Rasch analysis were utilized to verify the construct validity and dimensionality of these two category screen activities. Results：In the category I for upper limb movement and shoulder stability training, only one major factor were extracted with 66.72% variance explanation. In the category II for arm reaching training, one major factor was extracted with 87.04% variance of explanation. The results of Rasch analysis also supported the category I and category II activities only with one-dimensional construct individually. Conclusions：The study supports the classification of screen activities (category I and category II) in the CTRS with good unidimensionality construct validity. The implications of the results from this study will both enhance the application of CTRS as an adjunctive therapeutic modality in clinics, as well as help the therapist to choose appropriate screen activity in CTRS to meet the client’s treatment goal.

並列關鍵字

Stroke ； Virtual reality ； Upper limb rehabilitation ； Rasch analysis

國際替代計量

觸控式電腦化螢幕上肢訓練系統之建構效度初探

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