擴增性回饋對動作學習的影響－中樞神經損傷患者是否遵循如健康者之動作學習原則？

Effects of Augmented Feedback on Motor Learning-Do Neurologically Impaired Patients Follow the Same Principles as Healthy Subjects?

許書旋(Shu-Shyuan Hsu) ； 湯佩芳(Pei-Fang Tang) ； 胡名霞(Ming-Hsia Hu)

《物理治療》 31卷4期 (2006/08) Pp. 252-260

摘要

背景與目的：文獻顯示擴增性回饋可促進健康成人的動作學習，且較低回饋頻率優於較高回饋頻率。本文目的在探討中樞神經系統損傷患者使用擴增性回饋對動作學習的影響。方法：以系統性文獻回顧搜尋PubMed及Medline二個電子資料庫中有關回饋對神經疾患學習效果之原始論著，並由查詢引用文獻擴大搜尋範圍再以PEDro量表評分。結果：共納入9篇論文，結果顯示腦中風及腦外傷患者在學習動作技巧時，提供擴增性回饋可以促進動作學習，但依照動作任務的不同，回饋方式可能對學習效應有不同程度的影響。而巴金森氏症患者則過度倚賴回饋，在學習較複雜的動作技巧時，一旦回饋被剝奪則會影響學習。另外，腦中風及腦外傷患者給予較少的回饋頻率能促進學習效果，而巴金森氏症患者則需要較高的回饋頻率。結論：由於目前文獻不多，而且研究設計差異頗大，未來尚需更多的研究探討，以促進治療師對於擴增性回饋施予方式以及施予頻率用於臨床治療上的有效方式之了解。

關鍵字

擴增性回饋 ； 動作學習 ； 回饋頻率 ； 中樞神經損傷

並列摘要

Background and Purpose: Motor learning is a set of processes associated with practice or experience leading to relatively permanent changes in the capability for movement. Extrinsic, augmented feedback has been shown to enhance motor learning in healthy subjects and subjects had better learning effect under low feedback frequency. Since learning involves central mechanisms, it is unclear as to whether patients suffered from neurological impairment would benefit from augmented feedback as healthy subjects do. The purpose of this article was to systematically review evidence regarding the effects of augmented feedback and the frequency of augmented feedback on motor skill learning in neurologically impaired patients. Method: The PubMed and Medline electronic database between 1966 and Jan 2006 were searched. Original articles including both patient and control groups and meeting the topics of interest were selected. A total of eight articles were included in this review. Results: The results have revealed that neurologically impaired patients demonstrate some ability to learn a motor skill as healthy subjects, but their learning abilities depend on the types of task and feedback. Patients with stroke and those with traumatic brain injury demonstrate better learning effect when giving augmented feedback. However, the motor learning ability of Parkinsonian patients suffered from withheld of augmented feedback when learning complex motor skills. In addition, Patients with stroke and those with traumatic brain injury had better learning effects under decreased feedback frequency condition, but the Parkinsonian patients are not. Conclusion and Discussion: Due to the differences in research design among the studies reviewed, and the limited number of studies included in this review, conclusive remarks on the effects of augmented feedback and its frequency on motor learning in patients with different neurological disorders are difficulty to reach. Nevertheless, this review suggests that many patients with neurological disorders preserve motor learning ability to some extent and that the use of augmented feedback may be particularly beneficial to some of them.

並列關鍵字

Augmented feedback ； Motor learning ； Frequency of feedback ； Neurologically impaired patients