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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 陸哲駒 | |
dc.contributor.author | Hsiu-Yun Chang | en |
dc.contributor.author | 張綉芸 | zh_TW |
dc.date.accessioned | 2021-06-17T03:47:08Z | - |
dc.date.available | 2020-02-22 | |
dc.date.copyright | 2018-02-22 | |
dc.date.issued | 2017 | |
dc.date.submitted | 2018-01-26 | |
dc.identifier.citation | 1. Hirtz D, Thurman DJ, Gwinn-Hardy K, Mohamed M, Chaudhuri AR, Zalutsky R. How common are the 'common' neurologic disorders? Neurology 2007;68:326-37.
2. Pringsheim T, Jette N, Frolkis A, Steeves TD. The prevalence of Parkinson's disease: a systematic review and meta-analysis. Mov Disord 2014;29:1583-90. 3. Bella SD, Benoit CE, Farrugia N, Schwartze M, Kotz SA. Effects of musically cued gait training in Parkinson's disease: beyond a motor benefit. Ann N Y Acad Sci 2015;1337:77-85. 4. Freeman JS, Cody FW, Schady W. The influence of external timing cues upon the rhythm of voluntary movements in Parkinson's disease. J Neurol, Neurosurg and Psychiatry 1993;56:1078-84. 5. Hausdorff JM, Schaafsma JD, Balash Y, Bartels AL, Gurevich T, Giladi N. Impaired regulation of stride variability in Parkinson's disease subjects with freezing of gait. Exp Brain Res 2003;149:187-94. 6. Nieuwboer A, Kwakkel G, Rochester L, Jones D, van Wegen E, Willems AM, et al. Cueing training in the home improves gait-related mobility in Parkinson's disease: the RESCUE trial. J Neurol, Neurosurg and Psychiatry 2007;78:134-40. 7. Spaulding SJ, Barber B, Colby M, Cormack B, Mick T, Jenkins ME. Cueing and gait improvement among people with Parkinson's disease: a meta-analysis. Arch Phys Med Rehabil 2013;94:562-70. 8. Thaut MH, McIntosh GC, Rice RR, Miller RA, Rathbun J, Brault JM. Rhythmic auditory stimulation in gait training for Parkinson's disease patients. Mov Disord 1996;11:193-200. 9. Willems AM, Nieuwboer A, Chavret F, Desloovere K, Dom R, Rochester L, et al. The use of rhythmic auditory cues to influence gait in patients with Parkinson's disease, the differential effect for freezers and non-freezers, an explorative study. Disabil Rehabil 2006;28:721-8. 10. Baker K, Rochester L, Nieuwboer A. The effect of cues on gait variability--reducing the attentional cost of walking in people with Parkinson's disease. Parkinsonism Relat Disord 2008;14:314-20. 11. Benoit CE, Dalla Bella S, Farrugia N, Obrig H, Mainka S, Kotz SA. Musically cued gait-training improves both perceptual and motor timing in Parkinson's disease. Front Hum Neurosci 2014;8:494. 12. Vercruysse S, Spildooren J, Heremans E, Vandenbossche J, Wenderoth N, Swinnen SP, et al. Abnormalities and cue dependence of rhythmical upper-limb movements in Parkinson patients with freezing of gait. Neurorehabil Neural Repair 2012;26:636-45. 13. Jones D, Rochester L, Birleson A, Hetherington V, Nieuwboer A, Willems AM, et al. Everyday walking with Parkinson's disease: understanding personal challenges and strategies. Disabil Rehabil 2008;30:1213-21. 14. Garcia RK, Nelson AJ, Ling W, Van Olden C. Comparing stepping-in-place and gait ability in adults with and without hemiplegia. Arch Phys Med Rehabil 2001;82:36-42. 15. Nantel J, de Solages C, Bronte-Stewart H. Repetitive stepping in place identifies and measures freezing episodes in subjects with Parkinson's disease. Gait Posture 2011;34:329-33. 16. del Olmo MF, Arias P, Furio MC, Pozo MA, Cudeiro J. Evaluation of the effect of training using auditory stimulation on rhythmic movement in Parkinsonian patients--a combined motor and [18F]-FDG PET study. Parkinsonism Relat Disord 2006;12:155-64. 17. Alexander GE, Crutcher MD, DeLong MR. Basal ganglia-thalamocortical circuits: parallel substrates for motor, oculomotor, 'prefrontal' and 'limbic' functions. Prog Brain Res 1990;85:119-46. 18. Marsden CD. The mysterious motor function of the basal ganglia: the Robert Wartenberg Lecture. Neurology 1982;32:514-39. 19. Patel N, Jankovic J, Hallett M. Sensory aspects of movement disorders. Lancet Neurol 2014;13:100-12. 20. Arsalidou M, Duerden EG, Taylor MJ. The centre of the brain: topographical model of motor, cognitive, affective, and somatosensory functions of the basal ganglia. HumBrain Mapp 2013;34:3031-54. 21. Hisahara S, Shimohama S. Dopamine receptors and Parkinson's disease. Int J Med Chem 2011;2011:403039. 22. Benninger DH, Hallett M. Non-invasive brain stimulation for Parkinson's disease: Current concepts and outlook 2015. NeuroRehabilitation 2015;37:11-24. 23. Braak H, Del Tredici K, Rub U, de Vos RA, Jansen Steur EN, Braak E. Staging of brain pathology related to sporadic Parkinson's disease. Neurobiol Aging 2003;24:197-211. 24. Nussbaum RL, Ellis CE. Alzheimer's disease and Parkinson's disease. N Engl J Med 2003;348:1356-64. 25. Hirsch L, Jette N, Frolkis A, Steeves T, Pringsheim T. The Incidence of Parkinson's Disease: A Systematic Review and Meta-Analysis. Neuroepidemiology 2016;46:292-300. 26. de Lau LM, Breteler MM. Epidemiology of Parkinson's disease. Lancet Neurol 2006;5:525-35. 27. Chen CC, Chen TF, Hwang YC, Wen YR, Chiu YH, Wu CY, et al. Different prevalence rates of Parkinson's disease in urban and rural areas: a population-based study in Taiwan. Neuroepidemiology 2009;33:350-7. 28. Jankovic J. Parkinson's disease: clinical features and diagnosis. J Neurol, Neurosurg and Psychiatry 2008;79:368-76. 29. Grimbergen YA, Munneke M, Bloem BR. Falls in Parkinson's disease. Curr Opin Neurol 2004;17:405-15. 30. Ashburn A, Stack E, Pickering RM, Ward CD. A community-dwelling sample of people with Parkinson's disease: characteristics of fallers and non-fallers. Age Ageing 2001;30:47-52. 31. Martinez-Martin P, Rodriguez-Blazquez C, Kurtis MM, Chaudhuri KR. The impact of non-motor symptoms on health-related quality of life of patients with Parkinson's disease. Mov Disord 2011;26:399-406. 32. Morris ME, Iansek R, Galna B. Gait festination and freezing in Parkinson's disease: pathogenesis and rehabilitation. Mov Disord 2008;23 Suppl 2:S451-60. 33. Bloem BR, Hausdorff JM, Visser JE, Giladi N. Falls and freezing of gait in Parkinson's disease: a review of two interconnected, episodic phenomena. Mov Disord 2004;19:871-84. 34. Nutt JG, Bloem BR, Giladi N, Hallett M, Horak FB, Nieuwboer A. Freezing of gait: moving forward on a mysterious clinical phenomenon. Lancet Neurol 2011;10:734-44. 35. Macht M, Kaussner Y, Moller JC, Stiasny-Kolster K, Eggert KM, Kruger HP, et al. Predictors of freezing in Parkinson's disease: a survey of 6,620 patients. Mov Disord 2007;22:953-6. 36. Schaafsma JD, Balash Y, Gurevich T, Bartels AL, Hausdorff JM, Giladi N. Characterization of freezing of gait subtypes and the response of each to levodopa in Parkinson's disease. Eur J Neurol 2003;10:391-8. 37. Stolze H, Klebe S, Zechlin C, Baecker C, Friege L, Deuschl G. Falls in frequent neurological diseases--prevalence, risk factors and aetiology. J Neurol 2004;251:79-84. 38. Avanzino L, Pelosin E, Vicario CM, Lagravinese G, Abbruzzese G, Martino D. Time Processing and Motor Control in Movement Disorders. Front Hum Neurosci 2016;10:631. 39. Hausdorff JM, Cudkowicz ME, Firtion R, Wei JY, Goldberger AL. Gait variability and basal ganglia disorders: stride-to-stride variations of gait cycle timing in Parkinson's disease and Huntington's disease. Mov Disord 1998;13:428-37. 40. Schaafsma JD, Giladi N, Balash Y, Bartels AL, Gurevich T, Hausdorff JM. Gait dynamics in Parkinson's disease: relationship to Parkinsonian features, falls and response to levodopa. J Neurol Sci 2003;212:47-53. 41. Rocha PA, Porfirio GM, Ferraz HB, Trevisani VF. Effects of external cues on gait parameters of Parkinson's disease patients: a systematic review. Clin Neurol Neurosurg 2014;124:127-34. 42. Lim I, van Wegen E, de Goede C, Deutekom M, Nieuwboer A, Willems A, et al. Effects of external rhythmical cueing on gait in patients with Parkinson's disease: a systematic review. Clin Rehabil 2005;19:695-713. 43. Arias P, Cudeiro J. Effects of rhythmic sensory stimulation (auditory, visual) on gait in Parkinson's disease patients. Exp Brain Res 2008;186:589-601. 44. Hausdorff JM, Lowenthal J, Herman T, Gruendlinger L, Peretz C, Giladi N. Rhythmic auditory stimulation modulates gait variability in Parkinson's disease. Eur J Neurosci 2007;26:2369-75. 45. del Olmo MF, Cudeiro J. Temporal variability of gait in Parkinson disease: effects of a rehabilitation programme based on rhythmic sound cues. Parkinsonism Relat Disord 2005;11:25-33. 46. Bryant MS, Rintala DH, Lai EC, Protas EJ. An evaluation of self-administration of auditory cueing to improve gait in people with Parkinson's disease. Clin Rehabil 2009;23:1078-85. 47. Ford MP, Malone LA, Nyikos I, Yelisetty R, Bickel CS. Gait training with progressive external auditory cueing in persons with Parkinson's disease. Arch Phys Med Rehabil 2010;91:1255-61. 48. Nombela C, Hughes LE, Owen AM, Grahn JA. Into the groove: can rhythm influence Parkinson's disease? Neurosci Biobehav Rev 2013;37:2564-70. 49. Cunnington R, Windischberger C, Deecke L, Moser E. The preparation and execution of self-initiated and externally-triggered movement: a study of event-related fMRI. Neuroimage 2002;15:373-85. 50. Cunnington R, Iansek R, Bradshaw JL, Phillips JG. Movement-related potentials in Parkinson's disease. Presence and predictability of temporal and spatial cues. Brain 1995;118 ( Pt 4):935-50. 51. Wu T, Wang L, Hallett M, Chen Y, Li K, Chan P. Effective connectivity of brain networks during self-initiated movement in Parkinson's disease. Neuroimage 2011;55:204-15. 52. Samuel M, Ceballos-Baumann AO, Blin J, Uema T, Boecker H, Passingham RE, et al. Evidence for lateral premotor and parietal overactivity in Parkinson's disease during sequential and bimanual movements. A PET study. Brain 1997;120 ( Pt 6):963-76. 53. McIntosh GC, Brown SH, Rice RR, Thaut MH. Rhythmic auditory-motor facilitation of gait patterns in patients with Parkinson's disease. J Neurol, Neurosurg and Psychiatry 1997;62:22-6. 54. Picelli A, Camin M, Tinazzi M, Vangelista A, Cosentino A, Fiaschi A, et al. Three-dimensional motion analysis of the effects of auditory cueing on gait pattern in patients with Parkinson's disease: a preliminary investigation. Neurol Sci 2010;31:423-30. 55. Nieuwboer A, Dom R, De Weerdt W, Desloovere K, Fieuws S, Broens-Kaucsik E. Abnormalities of the spatiotemporal characteristics of gait at the onset of freezing in Parkinson's disease. Mov Disord 2001;16:1066-75. 56. Chee R, Murphy A, Danoudis M, Georgiou-Karistianis N, Iansek R. Gait freezing in Parkinson's disease and the stride length sequence effect interaction. Brain 2009;132:2151-60. 57. Plotnik M, Giladi N, Hausdorff JM. Bilateral coordination of walking and freezing of gait in Parkinson's disease. Eur J Neurosci 2008;27:1999-2006. 58. Nieuwboer A, Vercruysse S, Feys P, Levin O, Spildooren J, Swinnen S. Upper limb movement interruptions are correlated to freezing of gait in Parkinson's disease. Eur J Neurosci 2009;29:1422-30. 59. Tolleson CM, Dobolyi DG, Roman OC, Kanoff K, Barton S, Wylie SA, et al. Dysrhythmia of timed movements in Parkinson's disease and freezing of gait. Brain Res 2015;1624:222-31. 60. Peterson DS, Pickett KA, Duncan R, Perlmutter J, Earhart GM. Gait-related brain activity in people with Parkinson disease with freezing of gait. PloS One 2014;9:e90634. 61. Fling BW, Cohen RG, Mancini M, Nutt JG, Fair DA, Horak FB. Asymmetric pedunculopontine network connectivity in parkinsonian patients with freezing of gait. Brain 2013;136:2405-18. 62. Wright RL, Masood A, MacCormac ES, Pratt D, Sackley CM, Wing AM. Metronome-Cued Stepping in Place after Hemiparetic Stroke: Comparison of a One- and Two-Tone Beat. ISRN Rehabil 2013;2013:1-5. 63. Barker AT, Jalinous R, Freeston IL. Non-invasive magnetic stimulation of human motor cortex. Lancet 1985;1:1106-7. 64. Liew SL, Santarnecchi E, Buch ER, Cohen LG. Non-invasive brain stimulation in neurorehabilitation: local and distant effects for motor recovery. Front Hum Neurosci 2014;8:378. 65. Hallett M. Transcranial magnetic stimulation: a primer. Neuron 2007;55:187-99. 66. Kobayashi M, Pascual-Leone A. Transcranial magnetic stimulation in neurology. Lancet Neurol 2003;2:145-56. 67. Cantello R, Tarletti R, Civardi C. Transcranial magnetic stimulation and Parkinson's disease. Brain Research: Brain Res Rev 2002;38:309-27. 68. Bares M, Kanovsky P, Klajblova H, Rektor I. Intracortical inhibition and facilitation are impaired in patients with early Parkinson's disease: a paired TMS study. Eur J Neurol 2003;10:385-9. 69. MacKinnon CD, Gilley EA, Weis-McNulty A, Simuni T. Pathways mediating abnormal intracortical inhibition in Parkinson's disease. Ann Neurol 2005;58:516-24. 70. Tremblay F, Tremblay LE. Cortico-motor excitability of the lower limb motor representation: a comparative study in Parkinson's disease and healthy controls. Clin Neurophysiol 2002;113:2006-12. 71. Vacherot F, Attarian S, Eusebio A, Azulay JP. Excitability of the lower-limb area of the motor cortex in Parkinson's disease. Neurophysiol Clin 2010;40:201-8. 72. Nieuwboer A, Rochester L, Herman T, Vandenberghe W, Emil GE, Thomaes T, et al. Reliability of the new freezing of gait questionnaire: agreement between patients with Parkinson's disease and their carers. Gait Posture 2009;30:459-63. 73. Rossi S, Hallett M, Rossini PM, Pascual-Leone A. Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol 2009;120:2008-39. 74. Fisher BE, Wu AD, Salem GJ, Song J, Lin CH, Yip J, et al. The effect of exercise training in improving motor performance and corticomotor excitability in people with early Parkinson's disease. Arch Phys Med Rehabil 2008;89:1221-9. 75. Priori A, Berardelli A, Inghilleri M, Accornero N, Manfredi M. Motor cortical inhibition and the dopaminergic system. Pharmacological changes in the silent period after transcranial brain stimulation in normal subjects, patients with Parkinson's disease and drug-induced parkinsonism. Brain 1994;117 ( Pt 2):317-23. 76. Siebner HR, Mentschel C, Auer C, Lehner C, Conrad B. Repetitive transcranial magnetic stimulation causes a short-term increase in the duration of the cortical silent period in patients with Parkinson's disease. Neurosci Lett 2000;284:147-50. 77. Thomas SL, Gorassini MA. Increases in corticospinal tract function by treadmill training after incomplete spinal cord injury. J Neurophysiol 2005;94:2844-55. 78. Lefaucheur JP. Motor cortex dysfunction revealed by cortical excitability studies in Parkinson's disease: influence of antiparkinsonian treatment and cortical stimulation. Clin Neurophysiol 2005;116:244-53. 79. Perez MA, Lungholt BK, Nyborg K, Nielsen JB. Motor skill training induces changes in the excitability of the leg cortical area in healthy humans. Exp Brain Res 2004;159:197-205. 80. Yang Y, Tseng C, Chiou S, Liao K, Cheng S, Lai K, et al. Combination of rTMS and treadmill training modulates corticomotor inhibition and improves walking in Parkinson disease: a randomized trial. Neurorehabil Neural Repair 2013;27:79-86. 81. Cunic D, Roshan L, Khan FI, Lozano AM, Lang AE, Chen R. Effects of subthalamic nucleus stimulation on motor cortex excitability in Parkinson's disease. Neurology 2002;58:1665-72. 82. Ginis P, Nackaerts E, Nieuwboer A, Heremans E. Cueing for people with Parkinson's disease with freezing of gait: A narrative review of the state-of-the-art and novel perspectives. Ann Phys Rehabil Med 2017. 83. P. G, Heremans E, Ferrari A, Canning CG, Nieuwboer A. Continuous versus intelligent cueing and feedback for gait in people with Parkinson’s disease: One size does not fit all. 2017 ISPGR World Congress 2017 June 25-29; Fort Lauderdale, Florida, USA | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/70166 | - |
dc.description.abstract | 前言:
巴金森氏症是常見的神經退化性及動作障礙疾病,因為基底核的退化性病變,導致巴金森患者的內生節律功能受損,因此在執行節律性動作時(如行走)也會出現困難。針對節律性動作困難的問題,臨床上常使用聽覺提示介入來改善行走步伐節奏不一、凍結步態等問題。目前對於巴金森氏症患者的下肢節律性運動的研究多採用行走為主要的動作模式,而原地踏步動作(stepping in space, SIP)對於一些空間受限或是平衡功能不佳的患者是行走訓練的取代方式。然而以原地踏步做為巴金森氏症患者下肢節律性運動的研究甚少,也少有研究探討聽覺提示介入原地踏步動作時對於大腦神經生理的影響。 目的: 本研究希望能夠透過原地踏步動作來評估巴金森患者下肢節律性動作問題,比較在聽覺提示介入期間以及介入前後原地踏步動作以及行走的動作表現;並使用經顱刺激 (Transcranial magnetic stimulation, TMS)評估介入前後的大腦皮質興奮度的變化,藉以討論聽覺提示介入對於大腦的影響。 方法: 此為隨機交叉實驗,共收取21位巴金森氏症患者(平均年齡63.4 ± 6.2 歲),依據症狀會被分成兩組: 有凍結症狀組(FOG+,10位)以及無凍結症狀組(FOG-,11位)。每組皆會以隨機順序接受兩種情形下的實驗介入,兩次實驗中間會相隔至少一個星期,兩次實驗分別為(1)聽覺提示介入原地踏步動作(AC condition): 聆聽等時性節律(110%步頻),並同時按照節律的頻率作出對應同步化之原地踏步動作 50下,重覆10組;(2)無聽覺提示介入原地踏步動作(NC condition): 以自然的步頻進行原地踏步動作 50下,重覆10組。而實驗前後皆會以原地踏步測試、行走及經顱磁刺激器作為評估。 統計分析: 本研究之受試者基本資料採用獨立t檢定進行分析,實驗結果先以Shapiro-Wilk 檢定檢驗是否符合常態分布,因數據不符合常態分佈,因此組內比較採用Wilcoxon符號檢定,組間比較採用Mann-Whitney U檢定。 結果: 從動作表現來看,無論有無聽覺提示,受試者接受原地踏步訓練之後的踏步變異度有下降(AC: p=0.033, NC: p=0.009),並且行走步頻有增快的情形(AC: p=0.019, NC: p=0.0023)。有凍結症狀組在兩種情形下的行走步伐變異度都有下降;無凍結症狀組僅在無聽覺提示訓練的踏步變異度有下降的情形。在經顱磁刺激檢查中,僅有聽覺提示訓練下的大腦興奮度受到調節,皮質寧靜期(cortical silent period, CSP)顯著延長(p=0.005),刺激間距兩毫秒的皮質內抑制(short intracortical inhibition, SICI)的興奮性提高(p=0.001)。而有凍結症狀組別在休息動作閾值(resting motor threshold, RMT)以及皮質寧靜期有抑制增強的現象,此現象在無凍結症狀組別並無特別差異;兩組的皮質內抑制以及皮質內促進也受到聽覺提示調節。 結論: 節律性聽覺提示配合原地踏步動作訓練能夠改善巴金森氏症患者下肢動作變異程度以及調節大腦興奮程度,而有凍結症狀的巴金森氏症患者對於聽覺提示介入的效果更加顯著。 | zh_TW |
dc.description.abstract | Background:
Parkinson’s disease (PD) is a common neurodegenerative disease and movement disorder. Due to the degeneration of basal ganglia, patients suffered from PD demonstrate internal rhythm dysfunction, thus lead to difficulty in rhythmic movements such as ambulation. For improving the performance of the rhythmic movements, auditory cueing is often used in clinical setting and shows benefits in ambulation. Finger tapping test and ambulation were commonly used to assess the rhythmic movement problems. On the other side, stepping in place (SIP) is an alternative exercise program for the patients who don’t have sufficient space or lack of enough balance ability to perform ambulation training. However, only few study used SIP to evaluate or train rhythmic movements in the lower extremity of patients with PD. Besides, no study investigates the effects of auditory cueing on brain neurophysiology in SIP task either. Objective: In this study, we used stepping-in-place movements to assess the rhythmic dysfunction of the patients with PD. Motor performances such as stepping in place and walking before and after auditory cueing training were used to explore the effects of auditory cueing on rhythmic movements. Cortical excitability was assessed by transcranial magnetic stimulation (TMS) to investigate the effects of auditory cueing on brain neurophysiology. Methods: This is a cross-over study. 21 participants were classified into FOG+ or FOG- group according to the FOG questionnaire. Each participant received two experiments in random order. There was one-week wash-out period between two experiments. Two experiments were the following: (1) Stepping in place with concurrent auditory cues (AC condition): participants should step according to the rhythmic auditory cues (110% step frequency) we gave, 50 steps per session, totally 10 sessions. (2) Stepping in place without any auditory cue (NC condition): participants should step at a comfortable speed, 50 steps per session, totally 10 sessions. Assessments consisted of stepping in place test, walking test and TMS, and were done before and after experiments. Statistically analysis: The demographic data were analyzed by independent t-test. The results were first examined by Shapiro-Wilk test to ensure normal distribution. Because the data didn’t fit in a normal distribution, Wilcoxon signed-rank test was applied for within group comparison, and Mann-Whitney U test was used for between-group comparison. Results: In the movement assessments, the stepping variability decreased significantly (AC: p=0.033, NC: p=0.009) and the walking cadence increased (AC: p=0.019, NC: p=0.0023) no matter there was auditory cues or not. The freezers showed dropped walking variability in both conditions and the non-freezers only improved in stepping variability in NC condition. In TMS assessments, cortical excitability was modulated only in AC condition. Lengthened CSP duration (p=0.005) and decreased SICI (p=0.001) were noted. The freezers demonstrated enhanced inhibition in RMT and CSP duration. This phenomenon was not found in the non-freezers. SICI and ICF were modulated in both groups under AC condition. Conclusion: Auditory-cued SIP training could improve the lower-limb movement variability and modulate the cortical excitability for patients with PD. The freezers may benefit more from this training. | en |
dc.description.provenance | Made available in DSpace on 2021-06-17T03:47:08Z (GMT). No. of bitstreams: 1 ntu-106-R04428002-1.pdf: 2054327 bytes, checksum: cad3211f7ddbe1fc6f149cd8eb75002b (MD5) Previous issue date: 2017 | en |
dc.description.tableofcontents | 口試委員會審定書 i
致謝 ii 中文摘要 iv 英文摘要 vii List of Figures x List of Tables xi Chapter 1 Introduction 1 1.1 Background 1 1.2 Purpose and Significance 2 1.3 Hypothesis 3 Chapter 2 Literature Review 5 2.1 Introduction of Parkinson’s disease 5 2.2 External cue as rehabilitative strategy 9 2.3 Freezers and non-freezers 14 2.4 Stepping-in-place 17 2.5 Transcranial magnetic stimulation 20 2.6 Purpose 24 Chapter 3 Methodology 26 3.1 Study design 26 3.2 Subjects 26 3.3 Stepping-in-place training 27 3.4 Assessments 28 3.5 Procedures 31 3.6 Data analysis 32 Chapter 4 Results 33 4.1 Participants 33 4.2 Movement assessments 34 4.3 Transcranial magnetic stimulation 35 4.4 Freezers and non-freezers 36 Chapter 5 Discussion 38 5.1 Effects of auditory cues on lower extremity rhythmic movements 38 5.2 Effects of auditory cues on cortical excitability 39 5.3 Comparison between freezers and non-freezers 42 5.4 Clinical implication 45 5.5 Study limitation and future study 46 Chapter 6 Conclusion 48 References 49 Figures 56 Tables 60 | |
dc.language.iso | en | |
dc.title | 節律性聽覺提示對於巴金森氏症病人原地踏步動作的效果 | zh_TW |
dc.title | Effects of Rhythmic Auditory Cueing on Stepping in Place in Patients with Parkinson’s Disease | en |
dc.type | Thesis | |
dc.date.schoolyear | 106-1 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 吳瑞美,李亞芸,楊雅如 | |
dc.subject.keyword | 巴金森氏症,聽覺提示,原地踏步,經顱磁刺激,皮質興奮度, | zh_TW |
dc.subject.keyword | Parkinson’s disease,auditory cueing,step in place,transcranial magnetic stimulation,cortical excitability, | en |
dc.relation.page | 66 | |
dc.identifier.doi | 10.6342/NTU201800206 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2018-01-29 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 物理治療學研究所 | zh_TW |
顯示於系所單位: | 物理治療學系所 |
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