使用智慧型手機輔助帕金森氏症病人居家言語復健

Smartphone-Based Home Speech Rehabilitation for Parkinson’s Disease Patients

郭欣怡(Shin-Yi GUO)

指導教授 ： 邱泓文

臺北醫學大學/醫學科技學院/醫學資訊研究所/碩士(2016年)

摘要

帕金森氏症不是致命性的疾病，但目前醫療並不能完全治癒帕金森氏症，所以病患會面對機能退化帶來的困擾，一直到死亡。造成死亡的主要原因是吸入性肺炎、營養不良等併發症，而帕金森氏症的吞嚥障礙是造成吸入性肺炎與營養不良的主要原因。90%帕金森氏症的病人在病症初期會有運動不及型吶語症的問題，機能持續退化後還會產生吞嚥障礙，進而導致死亡。言語復建除了可以改善帕金森氏症的溝通與社交生活品質，還可以有效緩解吞嚥障礙。言語能力無法只靠藥物或手術治療得到改善，一定還要進行言語復健。病患除了到醫院做言語治療外，最重要的是居家的持續練習。

本研究所發展的帕金森症居家輔助言語復健系統包含兩個部份：手機端與網路端。手機端的應用程式開發採用Android studio，並搭配智慧型手機資料庫SQLite。網頁瀏覽系統使用ASP.NET來進行撰寫。手機端的應用程式主要是遵循目前語言治療師提供給病患的居家練習課程。網路端的應用程式則是輔助語言治療師及醫生透過網頁來瞭解病患的居家練習情況，並及時的給予回饋。

研究實際到醫院進行系統的介面評估及詢問對系統之建議。總收案人數為69人，其中20位有使用智慧型手機；2位正在學習中。以有使用智慧型手機的人進行系統介面的評估；使用量表為System Usability Scale (SUS)共有十題五題正向的和五題反向的，所得到的平均分數為70.5分，大部分的人都認為能很快學會如何使用此系統並對系統感到友善，樂意繼續使用。對於課程的內容，希望可以縮減復健的時間，增加其他項目的復健內容，讓復健練習可以

帕金森氏症的言語障礙不只影響到生活，也會影響到病患的心理與生理的狀態，目前市面上現有的語言復健應用程式皆缺乏學習回饋與記錄練習歷程。而本研究所發展的系統則著重於記錄居家練習的過程，並提供病患及時回饋，以加強病患的學習動力。

關鍵字

帕金森氏症 ； 運動不及型吶語症 ； 言語治療 ； 吞嚥障礙

並列摘要

Current treatments for Parkinson’s disease (PD) merely ease the degeneration of activity abilities rather than completely cure the disease. As PD is a nonfatal disease, patients must suffer with the disordered brought by dysfunction until their deaths. The main reasons of death include aspiration pneumonia and malnutrition, which are caused by the dysphagia induced by PD. Approximately 90 % of PD patients suffer from hypokinetic dysarthria early on, and functions continue to degenerate until dysphagia appears, which then ultimately leads to death. Speech rehabilitation could improve the quality of communication and social life for PD patients and effectively relieve dysphagia. However, verbal abilities cannot be improved by medication or surgery alone, such that speech rehabilitation is crucial. More important than the speech therapy received at hospitals is continual practice at home. However, it has long been difficult to ensure the effectiveness of rehabilitation at home.

This study combined mobile devices with networking technologies to develop a home speech rehabilitation assistant system for PD patients so as to promote continuing and effective practicing. The system of the speech rehabilitation assistant contains two portions: the mobile phone and the internet part. Android Studio was used to develop the mobile phone application, and the smartphone database SQLite was also deployed. The internet part include the database and the Web server, the Web application was developed by ASP.NET, and Windows 7 serves as the operating system of the server, in conjunction with Internet Information Services (IIS) 7. The function of the database server is to record patient practices. PD patient can use the application to do the speech rehabilitation at home and can save the practices data. Therapists and physicians can realize the rehabilitation conditions of their patients via the Web browser. The operation procedures of the proposed system are according with the content of home practice exercises assigned by the speech therapists. On the Web browser, speech therapists and physicians can review the patient’s practice procedures, give feedback, or compile statistics regarding practice conditions.

We collected personal recommendations from 69 PD patients among 20 patients had uesd the smart phone and 2 patients are leaning for it. We ues System Usability Scale to evaluate the system interface. The average score is 70.5 point. Most patients think that they can learn to use this system very quickly and will continue using it. They wish the content speech rehabilitation course reduce to 3 to 5 mins for once and increase the other rehabilitation items to make system more interesting.

Dysphasia affects the lives of PD patients as well as their mental and physiological statuses. Although other speech rehabilitation applications are also available, these applications lack feedback and recording mechanisms. The purpose of the proposed system is to enable the provision of feedback as patients practiced at home, increase patient motivation.

並列關鍵字

Hypokinetic Dysarthria ； Dysphigia ； Speech Rehabilitation

參考文獻

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