請用此 Handle URI 來引用此文件:
http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/44156
完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 胡名霞(Ming-Hsia Hu) | |
dc.contributor.author | I-Hsuan Lin | en |
dc.contributor.author | 林宜萱 | zh_TW |
dc.date.accessioned | 2021-06-15T02:42:28Z | - |
dc.date.available | 2011-09-15 | |
dc.date.copyright | 2009-09-15 | |
dc.date.issued | 2009 | |
dc.date.submitted | 2009-08-10 | |
dc.identifier.citation | 1.行政院衛生署。網址:http://www.doh.gov.tw/CHT2006/index_populace.aspx
2.胡名霞。動作控制與動作學習。第二版。台北:金名圖書有限公司;2003。 3.Allison SC, Abraham LD. Correlation of quantitative measures with the modified Ashworth scale in the assessment of plantar flexor spasticity in patients with traumatic brain injury. J Neurol 1995;242:699-706. 4.Andersson AG, Kamwendo K, Seiger A, Appelros P. How to identify potential fallers in a stroke unit: validity indexes of four test methods. Journal of Rehabilitation Medicine 2006;38:186-91. 5.Bayouk JF, Boucher JP, Leroux A. Balance training following stroke: effects of task-oriented exercises with and without altered sensory input. Int J Rehabil Res 2006;29:51-9. 6.Berg K, Wood-Dauphinee S, Williams JI. The Balance Scale: reliability assessment with elderly residents and patients with an acute stroke. Scand J Rehabil Med 1995;27:27-36. 7.Berg K, Wood-Dauphinee S, Williams JI, Gayton D. Measuring balance in the elderly: preliminary development of an instrument. Physiotherapy Canada 1989;41:304-11. 8.Berg KO, Wood-Dauphinee SL, Williams JI, Maki B. Measuring balance in the elderly: validation of an instrument. Can J Public Health 1992;83 Suppl 2:S7-11. 9.Blum L, Korner-Bitensky N. Usefulness of the Berg Balance Scale in stroke rehabilitation: a systematic review. Phys Ther 2008;88:559-66. 10.Bohannon RW, Leary KM. Standing balance and function over the course of acute rehabilitation. Archives of Physical Medicine & Rehabilitation 1995;76:994-6. 11.Bonan IV, Colle FM, Guichard JP, Vicaut E, Eisenfisz M, Tran Ba Huy P, Yelnik AP. Reliance on visual information after stroke. Part I: Balance on dynamic posturography. Arch Phys Med Rehabil 2004a;85:268-73. 12.Bonan IV, Yelnik AP, Colle FM, Michaud C, Normand E, Panigot B, Roth P, Guichard JP, Vicaut E. Reliance on visual information after stroke. Part II: Effectiveness of a balance rehabilitation program with visual cue deprivation after stroke: a randomized controlled trial. Arch Phys Med Rehabil 2004b;85:274-8. 13.Carr J, Shepherd R, Gordon J, editors. Movement science: foundations for physical therapy in rehabilitation. Rockville, Md. : Aspen Publishers; 1987. 14.Chiu YP, Fritz SL, Light KE, Velozo CA. Use of item response analysis to investigate measurement properties and clinical validity of data for the dynamic gait index. Phys Ther 2006;86:778-87. 15.Chou CY, Chien CW, Hsueh IP, Sheu CF, Wang CH, Hsieh CL. Developing a short form of the Berg Balance Scale for people with stroke. Phys Ther 2006;86:195-204. 16.de Haart M, Geurts AC, Dault MC, Nienhuis B, Duysens J. Restoration of weight-shifting capacity in patients with postacute stroke: a rehabilitation cohort study. Archives of Physical Medicine & Rehabilitation 2005;86:755-62. 17.de Haart M, Geurts AC, Huidekoper SC, Fasotti L, van Limbeek J. Recovery of standing balance in postacute stroke patients: a rehabilitation cohort study. Archives of Physical Medicine & Rehabilitation 2004;85:886-95. 18.Di Fabio RP, Badke MB. Relationship of sensory organization to balance function in patients with hemiplegia. Phys Ther 1990;70:542-8. 19.Di Fabio RP, Badke MB. Stance duration under sensory conflict conditions in patients with hemiplegia. Arch Phys Med Rehabil 1991;72:292-5. 20.Ford-Smith CD, Wyman JF, Elswick RK, Jr., Fernandez T, Newton RA. Test-retest reliability of the sensory organization test in noninstitutionalized older adults. Arch Phys Med Rehabil 1995;76:77-81 21.Forster A, Young J. Incidence and consequences of falls due to stroke: a systematic inquiry. BMJ 1995;311:83-6. 22.Garland SJ, Ivanova TD, Mochizuki G, Garland SJ, Ivanova TD, Mochizuki G. Recovery of standing balance and health-related quality of life after mild or moderately severe stroke. Archives of Physical Medicine & Rehabilitation 2007;88:218-27. 23.Geurts AC, de Haart M, van Nes IJ, Duysens J. A review of standing balance recovery from stroke. Gait Posture 2005;22:267-81. 24.Hu MH, Woollacott MH. Multisensory training of standing balance in older adults: I. Postural stability and one-leg stance balance. J Gerontol 1994;49:M52-61. 25.Hu MH, Woollacott MH. Multisensory training of standing balance in older adults: II. Kinematic and electromyographic postural responses. J Gerontol 1994;49:M62-71. 26.Hyndman D, Ashburn A, Stack E. Fall events among people with stroke living in the community: circumstances of falls and characteristics of fallers. Arch Phys Med Rehabil 2002;83:165-70. 27.Jonsdottir J, Cattaneo D. Reliability and validity of the dynamic gait index in persons with chronic stroke. Arch Phys Med Rehabil 2007;88:1410-5. 28.Kirker SG, Jenner JR, Simpson DS, Wing AM. Changing patterns of postural hip muscle activity during recovery from stroke. Clin Rehabil 2000;14:618-26. 29.Laufer Y, Sivan D, Schwarzmann R, Sprecher E. Standing balance and functional recovery of patients with right and left hemiparesis in the early stages of rehabilitation. Neurorehabil Neural Repair 2003;17:207-13. 30.Leroux A. Exercise training to improve motor performance in chronic stroke: effects of a community-based exercise program. Int J Rehabil Res 2005;28:17-23. 31.Leroux A, Pinet H, Nadeau S. Task-oriented intervention in chronic stroke: changes in clinical and laboratory measures of balance and mobility. Am J Phys Med Rehabil 2006;85:820-30. 32.Liaw LJ, Hsieh CL, Lo SK, Chen HM, Lee S, Lin JH. The relative and absolute reliability of two balance performance measures in chronic stroke patients. Disabil Rehabil 2007:1-6. 33.Lin JH, Hsieh CL, Hsiao SF, Huang MH. Predicting long-term care institution utilization among post-rehabilitation stroke patients in Taiwan: a medical centre-based study. Disabil Rehabil 2001;23:722-30. 34.Liston RA, Brouwer BJ. Reliability and validity of measures obtained from stroke patients using the Balance Master. Arch Phys Med Rehabil 1996;77:425-30. 35.Mackintosh SF, Hill K, Dodd KJ, Goldie P, Culham E. Falls and injury prevention should be part of every stroke rehabilitation plan. Clin Rehabil 2005;19:441-51. 36.Mao HF, Hsueh IP, Tang PF, Sheu CF, Hsieh CL. Analysis and comparison of the psychometric properties of three balance measures for stroke patients. Stroke 2002;33:1022-7. 37.McClellan R, Ada L. A six-week, resource-efficient mobility program after discharge from rehabilitation improves standing in people affected by stroke: placebo-controlled, randomised trial. Aust J Physiother 2004;50:163-7. 38.Nichols DS. Balance retraining after stroke using force platform biofeedback. Phys Ther 1997;77:553-8. 39.Nyberg L, Gustafson Y. Fall prediction index for patients in stroke rehabilitation. Stroke 1997;28:716-21. 40.O’Sullivan SB. Stroke. In O’Sullivan SB, Schmitz TJ (eds). Physical rehabilitation : assessment and treatment procedures. 4th ed. Philadelphia: F.A. Davis, 2001. 41.Podsiadlo D, Richardson S. The timed 'Up & Go': a test of basic functional mobility for frail elderly persons.[see comment]. Journal of the American Geriatrics Society 1991;39:142-8. 42.Sackley CM. Falls, sway, and symmetry of weight-bearing after stroke. Int Disabil Stud 1991;13:1-4. 43.Salbach NM, Mayo NE, Wood-Dauphinee S, Hanley JA, Richards CL, Cote R. A task-orientated intervention enhances walking distance and speed in the first year post stroke: A randomized controlled trial. Clin Rehabil 2004;18:509-19. 44.Salbach NM, Mayo NE, Robichaud-Ekstrand S, Hanley JA, Richards CL, Wood-Dauphinee S. The effect of a task-oriented walking intervention on improving balance self-efficacy poststroke: a randomized, controlled trial. J Am Geriatr Soc 2005;53:576-82. 45.Schoppen T, Boonstra A, Groothoff JW, de Vries J, Goeken LN, Eisma WH. The Timed 'up and go' test: reliability and validity in persons with unilateral lower limb amputation. Arch Phys Med Rehabil 1999;80:825-8. 46.Shumway-Cook A, Gruber W, Baldwin M, Liao S. The effect of multidimensional exercises on balance, mobility, and fall risk in community-dwelling older adults. Phys Ther 1997;77:46-57. 47.Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther 2000;80:896-903. 48.Shumway-Cook A, Woollacott M. Motor control: Theory and practical applications. 2nd ed. Philadelphia: Lippincott, Williams & Wilkins; 2001. 49.Shumway-Cook A, Woollacott M. Motor control. Translating research into clinical practice. 3rd ed. Baltimore: Lippincott Williams & Wilkins; 2007. 50.Smith PS, Hembree JA, Thompson ME. Berg Balance Scale and Functional Reach: determining the best clinical tool for individuals post acute stroke. Clin Rehabil 2004;18:811-8. 51.Stevenson TJ. Detecting change in patients with stroke using the Berg Balance Scale. Aust J Physiother 2001;47:29-38. 52.Vearrier LA, Langan J, Shumway-Cook A, Woollacott M. An intensive massed practice approach to retraining balance post-stroke. Gait Posture 2005;22:154-63. 53.Wee JY, Bagg SD, Palepu A. The Berg balance scale as a predictor of length of stay and discharge destination in an acute stroke rehabilitation setting. Arch Phys Med Rehabil 1999;80:448-52. 54.Wee JY, Wong H, Palepu A. Validation of the Berg Balance Scale as a predictor of length of stay and discharge destination in stroke rehabilitation. Arch Phys Med Rehabil 2003;84:731-5. 55.Weiss A, Suzuki T, Bean J, Fielding RA. High intensity strength training improves strength and functional performance after stroke. Am J Phys Med Rehabil 2000;79:369-76; quiz 91-4. 56.Yang Y-R, Wang R-Y, Lin K-H, Chu M-Y, Chan R-C. Task-oriented progressive resistance strength training improves muscle strength and functional performance in individuals with stroke. Clinical Rehabilitation 2006;20:860-70. 57.Yavuzer G, Eser F, Karakus D, Karaoglan B, Stam HJ. The effects of balance training on gait late after stroke: a randomized controlled trial. Clin Rehabil 2006;20:960-9. 58.Yelnik AP, Le Breton F, Colle FM, Bonan IV, Hugeron C, Egal V, Lebomin E, Regnaux JP, Perennou D, Vicaut E. Rehabilitation of balance after stroke with multisensorial training: A single-blind randomized controlled study. Neurorehabil Neural Repair 2008;22:468-76. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/44156 | - |
dc.description.abstract | 腦中風患者常出現平衡能力不佳的情形,影響日常生活功能。近年來臨床物理治療進行平衡訓練的策略以任務導向手法為主流,研究指出經過任務導向模式訓練之後,中風患者的平衡功能、姿勢控制、平衡信心以及行走速度、耐力等都有明顯的進步。研究指出無法選擇正確的感覺訊息(包括視覺、前庭覺與體感覺)是中風患者無法維持平衡的原因之一,依據國際功能、失能與健康分類系統模式以及系統為基礎的任務導向模式概念,若以任務導向運動訓練加上感覺操弄,由於其產生的交互作用,對於不同感覺情境下的姿勢控制與平衡功能,應能產生正面療效。研究發現中風患者以16小時任務導向訓練加上感覺操弄後,結果顯示受試者的姿勢控制有顯著改善,但平衡功能是否改善則未知。其他學者的研究顯示,低至僅6小時之任務導向肌力訓練即可使平衡功能有顯著改善。為促進臨床效益,本研究欲探討6小時的感覺操弄之任務導向平衡訓練,是否能改善中風病患之姿勢控制與平衡功能等兩個層級的平衡能力。
本研究為施測者單盲隨機分組控制研究設計,在台大醫院復健部、神經部或其他醫院、社區及支持團體收案39名腦中風病患。所有個案完成前測評估後隨機分配到任務導向合併感覺操弄平衡之訓練組與雙側上肢訓練對照組,均接受每次60分鐘、每週2次共三週的訓練。在治療前、後與治療後一個月評估柏格氏平衡量表、計時起走測試、動態步態指標,以及電腦動態姿勢平衡儀之感覺整合測驗與八方向持續重心轉移測驗。本研究使用二維重複變異數分析及事後分析檢定兩組的差異;若前測值有差異,則將前測值作為共變數,進行二維重複共變數分析,並以皮爾森相關係數分析變項間與改變量間相關性。統計上顯著差異水平定為0.05。 本研究結果顯示前測時,兩組受試者除了感覺整合測驗的視覺同步與底板同步情境之平衡分數控制組高於實驗組外,其餘各參數在兩組間均無顯著差異。所有參數在訓練後均無顯著組間差異,但在柏格氏平衡量表、計時起走測試、動態步態指標、感覺整合測驗的平衡總分、底板同步、閉眼及底板同步、視覺同步及底板同步的平衡分數有顯著組內差異,且實驗組較控制組有進步較多的趨勢。 本研究無法證實感覺操弄任務導向平衡訓練對於中風患者在平衡功能與姿勢控制相較控制組的差異性,可能是受到受試者變異性、樣本數、評估工具的適當性和治療劑量與內容的影響。然而由結果可發現實驗組進步的趨勢較控制組明顯,表示感覺操弄平衡訓練對中風患者的平衡功能與姿勢控制改善有良好效益。 | zh_TW |
dc.description.abstract | Imbalance is a major disability following stroke which contributes to the activity of daily living in these patients. In recent years, task-oriented approach has become a main stream for balance training in physical therapy for the stroke patients. Literature revealed that task-oriented approach may lead to significant improvements in balance function, postural control, balance confidence, walking speed and walking endurance. Impairment of sensory integration for balance is a major contributing factor for imbalance after stroke. Based on the concept of system-based task-oriented approach, a task-oriented approach balance function training combines sensory manipulation may lead to improvement in both balance impairment and balance function more efficiently, hence requiring less training time to result in significant improvement.
Previous study showed that after a 16-hour task-oriented balance training with sensory manipulation, stroke patients improved their postural control. The effect on balance function was not investigated in this previous study. The aim of our study was to investigate the immediate and long term treatment effect of a 6-hour task-oriented balance training with sensory manipulation on postural control and balance function in stroke patients. The design of this study was a single-blind randomized controlled trial. The sample size was 39. Patients with stroke were recruited from the Department of Physical Medicine and Rehabilitation, Department of Neurology in National Taiwan University Hospital, other hospitals, community and family support groups. After consent, subjects were randomized to either the balance training group or a control training group. Both groups received 60 minutes/day, 2 days/week for a total of 3 weeks of exercise training. Outcome tests included the Berg Balance Scale, the Timed Up and Go Test, the Dynamic Gait Index and the dynamic posturography (Sensory Organization Test, Limits of Stability of the NeuroCom Smart Balance Master system). These tests were conducted during baseline, immediately after training and at 4 weeks after training. Two-way ANOVA with repeated measure followed by post hoc tests was used for analyzing the differences between two groups. A two-way ANCOVA was used to analyze the Equilibrium Score in the eyes open, sway referenced surround and support condition. The relationships between outcomes and changes were analyzed by Pearson’s correlation coefficient. The results were accepted as statistically significant at p<0.05. There were no significant group differences in baseline data except the equilibrium score in eye open, sway reference surround and support condition derived from the Sensory Organization Test. After the 6-hour balance training, no significant differences were found between experimental and control groups in all variables. Significant within-group improvement was noted in the Berg Balance Scale, the Timed Up and Go Test, the Dynamic Gait Index, the Composite Equilibrium Score, the Equilibrium Score in the eyes open, sway referenced support condition, the eyes closed, sway referenced support condition and the eyes open, sway referenced surround and support condition. Further analysis suggested small differences in favor of the experimental group. No evidence was found for the superiority of the task-oriented balance training with sensory manipulation in stroke patients. This was possibly due to the wide between-group variation, small sample size, appropriateness of outcome measures and the content of balance training program. However, balance function and postural control improved more in the balance training group than in the control group from pre-test to post-test. Therefore, this study showed that a 6-hour task-oriented balance training improved balance function and postural control in stroke patients. Further studies are recommended. | en |
dc.description.provenance | Made available in DSpace on 2021-06-15T02:42:28Z (GMT). No. of bitstreams: 1 ntu-98-R96428007-1.pdf: 2090914 bytes, checksum: fa98ae4de827da2e18abed2153156193 (MD5) Previous issue date: 2009 | en |
dc.description.tableofcontents | 口試委員審定書 I
誌謝 II 中文摘要 III 英文摘要 V 第一章 前言 1 第一節、 研究背景 1 第二節、 研究的重要性 3 第三節、 研究目的 4 第四節、 研究問題與假說 4 第五節、 名詞定義 5 第二章 文獻回顧 8 第一節、 中風病患之站立平衡能力與恢復 8 第二節、 任務導向模式之特質與對中風病患姿勢控制的療效 11 第三節、 感覺操弄訓練的特質對中風病患姿勢控制的效果 13 第四節、 結果評量之心理計量特性 15 第三章 研究方法 20 第一節、 研究設計 20 第二節、 受試者 20 第三節、 評估項目與測量工具 21 第四節、 訓練方式與內容 24 第五節、 資料處理與統計分析 25 第六節、 中止實驗原則 25 第四章 結果 26 第一節、 受試者資料 26 第二節、 後測與追蹤的參數改變 28 第三節、 參數之間的相關性 30 第五章 討論 31 第一節、 感覺操弄平衡訓練對平衡功能的效果 31 第二節、 感覺操弄平衡訓練對姿勢控制的效果 34 第三節、 各變量相關性之探討 37 第四節、 研究限制 37 第五節、 臨床應用 38 第六章 結論 39 參考文獻 40 附錄 71 | |
dc.language.iso | zh-TW | |
dc.title | 任務導向平衡訓練合併感覺操弄對腦中風患者平衡功能與姿勢控制之療效研究 | zh_TW |
dc.title | Effects of Task-Oriented Balance Training with Sensory Manipulation on Balance Function and Postural Control in Stroke Patients | en |
dc.type | Thesis | |
dc.date.schoolyear | 97-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 王顏和(Yen-Ho Wang),鄭建興(Jiann-Shing Jeng),湯佩芳(Pei-Fang Tang) | |
dc.subject.keyword | 腦中風,平衡,任務導向,感覺操弄, | zh_TW |
dc.subject.keyword | stroke,balance,task-oriented,sensory manipulation, | en |
dc.relation.page | 86 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2009-08-11 | |
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 |
文件中的檔案:
檔案 | 大小 | 格式 | |
---|---|---|---|
ntu-98-1.pdf 目前未授權公開取用 | 2.04 MB | Adobe PDF |
系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。