單側腦傷患者健側肢體之感覺動作缺損：實證回顧

Sensorimotor Deficits in the Ipsilateral Extremity of Patients with Unilateral Brain Damage: An evidence-based Review

黃威超(Wei-Chao Huang) ； 蔣伊真(Yi-Chen Chiang) ； 柯致中(Jhih-Jhong Ke) ； 林克忠(Keh-Chung Lin)

《職能治療學會雜誌》 23卷 (2005/10) Pp. 62-73

https://doi.org/10.6594/JTOTA.2005.23.06

摘要

腦傷所造成的功能缺損往往是復健所關注的要點。在過去單側腦傷患者被注重的是腦傷對側邊的感覺運動功能缺損，因此定義腦傷的對側邊為患側；而相對地，腦傷的同側邊則定義為健側。最近有越來越多研究文獻指出，單側腦傷的患者健側肢體的動作協調、精細動作、握力、感覺等感覺動作功能會因腦傷而受到影響。健側肢體的感覺動作缺損將使得單側腦傷的患者在日常生活功能上遭遇到極大的困難。
首先，本文回顧過去探討健側邊感覺動作功能缺失的研究文獻，並就單側腦傷健側邊受影響的感覺動作功能表現進行整理。另一方面，造成健側邊感覺動作功能缺損的原因如腦傷影響同側皮層脊髓束功能、認知功能等，至今仍是眾說紛紜，並無定論。所以此篇文章的另一個重點是對於各種造成健側感覺動作功能缺損原因做相關歸納與探討。總結而言，單側腦傷病患主要使用健側邊來代償日常生活功能，但健側邊感覺動作功能缺損卻是復健層面上一個影響復健成效卻容易被忽略的部分。本文探討單側腦傷後健側邊的感覺動作缺損，並希望能使健側邊的感覺動作缺損之問題獲得更多重視。

關鍵字

單側腦傷 ； 健側肢體 ； 感覺動作缺損

並列摘要

Deficits caused by brain damage on the affected limbs have been the focus of neurological rehabilitation. While most people suffering from unilateral brain injury manifest sesorimotor deficits on the side contralateral to the brain lesion, there is an accumulation of studies showing ipsilateral deficits in coordination, dexterity, grip strength, and sensory functions. The patients may thus encounter difficulty in certain activities of daily life (ADL) that require fine sensorimotor control of the less affected limbs.
Despite the growing emphasis of the ipsilateral deficits in recent literature, the nature of the deficits is not entirely clear and may be multifaceted involving ipsilateral projection, cognitive functions, and laterality of brain lesion. This review surveyed studies that looked at ipsilateral deficits following unilateral brain damage in order to update knowledge about this issue important for neurological rehabilitation.
The review showed evidence for ipsilateral extremity deficits following unilateral brain damage in a variety of outcome domains. Since ipsilateral deficits may have a negative impact on functional performance and may play a significant role in rehabilitation success after brain injury, further research that investigates prognostic significance of ipsilateral deficits for specific aspects of functional outcomes is needed. Rehabilitation assessment and treatment should be planned in consideration of the deficits.

並列關鍵字

unilateral brain damage ； ipsilateral extremity ； sensorimotor deficits