動態手部矯具之改良設計及運用於改善腦中風患者手功能之可用性研究

目的：本研究之目的為將一動態手部矯具改良設計為堅固、耐用且可調式的動態手部矯具，並進行安全性檢測及檢視此動態手部矯具運用於改善腦中風患者手功能之可用性。方法：使用低溫副木材料、3D列印和五金材料，改良此動態手部矯具之設計。透過疲勞強度測試及落下測試檢驗其安全性，並使用動作分析系統、抓／放木塊測試和滿意度調查表，檢視此動態手部矯具運用於改善腦中風患者手功能之可用性。結果：動態手部矯具之指套、彈性懸吊機構及阻力調整系統已設計改良及規格化，且此改良之動態手部矯具通過安全測試。7位男性腦中風患者參加可用性實驗，動作分析結果顯示受測者在穿戴矯具時，做指腹抓握／張開動作，掌指關節的關節活動度顯著增加（所有p ＜ .05）且動作效率提升（所有p ＜ .001），且如預期近端指間關節及遠端指間關節的關節活動度減少。抓／放木塊測試顯示受測者拿取及放置木塊速度顯著增加（p = .038），未穿戴矯具時2分鐘平均完成8.14次，穿戴矯具時平均完成13.29次。受測者對使用動態手部矯具感到滿意，問卷10題（10 - 50）的平均總分為37.43分，每題的平均分數為3.74分。結論：此動態手部矯具是一個堅固、耐用、可調整阻力且安全之矯具，包含有效性、效率和滿意度之可用性測試顯示此動態手部矯具可運用於腦中風患者增進手功能。

關鍵字

手部矯具；動態副木；腦中風；可用性

並列摘要

Objectives: The purposes of this study were to improve the design of a firm, durable and adjustable dynamic hand orthosis and to examine the safety and usability of the dynamic hand orthosis for improving hand function in persons with stroke. Methods: Low temperature splinting materials, 3D prints and hardware materials were used to improve the design of the dynamic hand orthosis. Fatigue and drop test were conducted to evaluate safety of the orthosis. The motion analysis system, pick/release a block and satisfaction questionnaire were used to examine the usability of the dynamic hand orthosis for improving hand function in persons with stroke. Results: The design of three components (finger gutter, elastic outrigger mechanism and resistance adjustment system) of the dynamic hand orthosis has been improved and normalized, and the orthosis has passed the safety tests. Seven men with stroke participated in the usability test. The results of motion analysis showed that the range of motion (ROM) of metacarpophalangeal (MP) joint from hand open to pulp grip increased significantly (all p ＜ .05) while the ROM of proximal and distal interpharangeal (PIP, DIP) joints decreased as expected when wearing the orthosis. The efficiency of joint movements of MP, PIP and DIP was also significantly improved (all p ＜ .001). When wearing the orthosis the speed of pick-up and release significantly improved (p = .038). The mean repetition of picking up and releasing the block was 8.14 without the orthosis and 13.29 with the orthosis within 2 minutes. The participants indicated that they were satisfied with the dynamic hand orthosis. The mean total score of the ten items (10-50) was 37.43. Mean score of each item was 3.74. Conclusion: This dynamic hand orthosis is a firm, durable, resistance adjustable and safety orthosis. The results of usability test comprising effectiveness, efficiency, and satisfaction demonstrated that the dynamic hand orthosis can apply for persons with stroke to improve hand function.

並列關鍵字

hand orthosis ； dynamic splint ； stroke ； usability

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