表現與結果回饋及認知訓練介入對中風後動作能力重建之影響

Performance and the Results of Feedback and Cognitive Training Intervention after the Action on the Stroke of the Impact of the Reconstruction Ability

王俊傑(Jiun-Jien Wang)

《大專體育學術專刊》 98年度 (2009/05) Pp. 697-703

https://doi.org/10.6695/AUES.200905_98.0095

摘要

現代人的忙碌，造成很多文明人的疾病，其中以心血管與腦血管病症最為頻繁。中風即為其中一例，中風是大腦缺血後幾秒鐘至數分鐘之內，出現的一系列功能紊亂的總稱。本研究是利用林佳皇醫師的佐證資料進行後設分析研究，研究目的在於以運動學角度分析在兩種不同回饋型式（KP & KR）的重覆性動作訓練，研究方法以兩組實驗組（KP & KR）和控制組用「隨機雙盲對照試驗」的方式進行中風病患上肢學習能力的影響以及評量認知缺損對動作能力學習的影響。研究結果顯示：中風病人發病6個月後，高達30－66%仍持續的有上肢動作功能缺損。然而適當的動作訓練介入，可讓慢性中風偏癱個案的動作能力有所改善。動作能力的改善取決於訓練中所給的回饋型式。所得到的結論相較於控制組，KP組則在動作表現（關節活動）有明顯改善，而KR組在動作結果（準確度）有明顯改善，且所有改善在介入後一個月仍亦持續著。理論上，在Shumway-Cook and Woollacott（2006）在其回顧型文獻彙整300個隨機控制實驗中，發現改善臨床上動作表現的兩項關鍵因素：訓練強度及訓練活動的特異性。但是在神經生理研究顯示上，重覆的動作活動可奠定重新獲得動作能力的基礎。除了「練習」是關鍵，另一項關鍵是提供個案的回饋形式。

關鍵字

動作訓練 ； 上肢動作 ； 特異性 ； 練習

並列摘要

Recorded in the busy modern people, civilized people, many of the diseases caused by, among them, cardiovascular and cerebral vascular disease is most frequent. Stroke is one of a case. After ischemic stroke is the brain a few seconds to minutes. A series of general term for disorders. In this study, Dr. Chia-Wong Ling is the use of Lin's information after the evidence-based analysis. Purpose of the study is to analyze the kinematic point of view two different types of feedback (KP & KR) training in repetitive movements. To study ways to group the experimental group (KP & KR) and the control group as ”randomized double-blind controlled trial” means the ability to learn the upper limbs of stroke patients, as well as to assess the impact of cognitive impairment on the ability to study the impact of action. The results showed that: Incidence of stroke patients six months after, as high as 30~66% continued to have the defect of upper limb motor function. However, appropriate training intervention action. Allows cases of chronic stroke hemiplegia improved motor ability. Action to improve the capacity of training depends on the feedback given by the type. Concluded in comparison to the control group. KP group in motor performance (joint activities) a significant improvement. The KR group action results (accuracy) there have been noticeable improvements. And all the improvements in one month after the intervention is still continuing. In theory, in Shumway-Cook and Woollacott (2006) recalled that in its literature collection type 300 randomized controlled experiment. Action was found to improve the clinical performance of two key factors: Training intensity and specificity of training activities. But, neurophysiological studies have shown. Activities can repeat the action moves to regain the ability to lay the basis. In addition to ”practice” is the key, the key is to provide a feedback form of the case.

並列關鍵字

action training ； upper limb motion ； specificity ； pratice