請用此 Handle URI 來引用此文件：
http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/5873完整後設資料紀錄
| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 林克忠(Keh-chung Lin) | |
| dc.contributor.author | Yu-Yin Lu | en |
| dc.contributor.author | 盧昱吟 | zh_TW |
| dc.date.accessioned | 2021-05-16T16:17:57Z | - |
| dc.date.available | 2018-09-24 | |
| dc.date.available | 2021-05-16T16:17:57Z | - |
| dc.date.copyright | 2013-09-24 | |
| dc.date.issued | 2013 | |
| dc.date.submitted | 2013-08-16 | |
| dc.identifier.citation | Ashworth, B. (1964). Preliminary Trial of Carisoprodol in Multiple Sclerosis. Practitioner, 192, 540-542.
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Upper Saddle River, NJ: Prentice Hall Health; 2009:422-3. 行政院衛生署（2012）。101年國人主要死因統計 (以ICD-10編碼)。擷取自http://www.doh.gov.tw/。 呂旭峰、呂汶紋、陳媛孃、施勇綸、劉嘉又、劉啟明、蔡惠貞（2009）。C-反應蛋白之量測差異性與台灣族群參考值分佈。 J Biomed Lab Sc，20，33-39。 胡漢華（2008）。台灣腦中風防治指引2008。台灣腦中風學會。 邱弘毅（2008）。腦中風之現況與流行病學特徵。台灣腦中風學會會訊，第15卷第3期。 徐嘉吟、方信智（2006）。心血管疾病的新指標-高敏感性C-反應蛋白 (hs-CRP)。基層醫學，21(3)，63-67。 楊婕淩、林克忠、陳香瑜、陳慧瑜、趙培均、林伯儔、吳菁宜（2009）。中風病患機器輔助治療療效之文獻回顧。臺灣職能治療研究與實務雜誌， 5(2)，128-144。 廖建彰、李菜娟、林瑞雄、宋鴻樟（2006）。2000年台灣腦中風發生率與盛行率的城鄉差異。臺灣公共衛生學會雜誌， 25，223-230。 廖婉彣、林光華、謝妤葳、莊麗玲、吳菁宜、林克忠（2010）。機器輔助療法於中風復健之成效-隨機控制試驗之系統回顧。臺灣職能治療研究與實務雜誌，35(2)，126-138。 | |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/5873 | - |
| dc.description.abstract | 前言
中風是導致成人長期失能的主因。機器輔助治療被認為是相當具潛力之臨床復健療法，其中具雙側鏡像動作特性的Bi-Manu-Track對上肢動作損傷成效尤為顯著，但其介入的適用時機、使用劑量與結合其他療法的應用仍待探究。生物標記與復健療效的關係更是值得探討的跨領域研究趨勢。 目的 本前導型研究試圖以臨床試驗，驗證機器輔助治療搭配任務導向練習於亞急性中風患者之上肢動作、日常生活功能與生活品質的相關之復健成效，並參照生物標記之變化，有助於中風復健的實證醫學與臨床應用之參考。 方法 採前後測之臨床試驗，針對亞急性中風個案進行每天1.5小時、每週5天、持續4週的治療。主要成效評估包含Fugl-Meyer Assessment (FMA)、Medical Research Council Scale (MRC)、Functional Independence Measures (FIM)、Wolf Motor Function Test (WMFT)，次要成效評估包含Motor Status Scale (MSS)、Modified Ashworth scale (MAS)、accelerometer、Action Research Arm Test (ARAT)、Box and Block Test (BBT)、Motor Activities Log (MAL)、ABILHAND Questionnaire、Modified Rankin Handicap Scale (mRS)、Functional Ambulation Categories (FAC)和Postural Assessment Scale for Stroke Patients (PASS)、Stroke Impact Scale (SIS)、EuroQol Quality of Life Scale (EQ-5D)等評估工具，囊括ICF各層面之分析。生物標記包含glycated haemoglobin (HbA1c)、C-reactive protein (CRP)。資料分析運用Wilcoxon signed-ranks test進行前後測比較與Spearman's Rank-Order Correlation Coefficient進行臨床指標與生物標記的相關分析。 結果 主要成效FMA近遠端、MRC近遠端、FIM與WMFT等項目都達高度效應值與顯著差異，生活品質層面成效呈現中到高度效應值，但未達顯著差異。生物標記部分，HbA1c與CRP在治療後均呈現下降趨勢。而部分臨床評估工具與生物標記呈相關趨勢。 結論 研究結果支持機器輔助治療於亞急性、中重度損傷中風個案的動作損傷與日常生活功能的改善。未來應進行更大樣本的隨機對照研究，並持續關注生物標記與臨床功能變化的關係。 | zh_TW |
| dc.description.abstract | Introduction
Stroke is the leading cause of long-term disability. Robot-assisted therapy (RT) is a promising and effective intervention in rehabilitation. The Bi-Manu-Track, which is operating in mirror mode, is particularly with remarkable efficacy in upper extremity impairment. However, the applications of RT, such as proper dosage, intervention timing, combined therapy, needed further investigation. The relationship between effects in rehabilitation and change in biomarkers was merely known and of great worth to explore. Objective This pilot study aimed to testify the effects of RT combined task-oriented practice in subacute stroke patients. Outcome measures included upper limb impairment, function of daily life, the quality of life, and the change of biomarkers. The results would contribute to evident-based medicine and could be helpful in clinics. Methods A pretest-posttest, control group design was used in this pilot study. The participants received treatment for 90 to 105 minutes per session, 5 sessions on weekdays, for 4 weeks. Primary outcome measures included Fugl-Meyer Assessment (FMA), Medical Research Council Scale (MRC), Functional Independence Measures (FIM), Wolf Motor Function Test (WMFT). Secondary outcome measures included Motor Status Scale (MSS), Modified Ashworth scale (MAS), accelerometer, Action Research Arm Test (ARAT), Box and Block Test (BBT), Motor Activities Log (MAL), ABILHAND questionnaire, modified Rankin Handicap Scale (mRS), Functional Ambulation Categories (FAC), Postural Assessment Scale for Stroke Patients (PASS), Stroke Impact Scale (SIS), EuroQol Quality of Life Scale (EQ-5D). Biomarkers included glycated haemoglobin (HbA1c), C-reactive protein (CRP). Data analysis used Wilcoxon signed-ranks test and Spearman's Rank-Order Correlation Coefficient. Results Large and significant effects were found in the FMA, MRC at both proximal and distal part of upper-limb motor impairment, and most aspects of daily function measured by FIM and WMFT. The results in quality of life demonstrated nonsignificant, medium to large effects. HbA1c and CRP exhibited decline after treatment. Partial clinical outcome measures were related to the change in biomarkers. Conclusions The results supported using RT could improve motor impairment, daily function in subacute stroke patients. We need larger sample size, randomized controlled trials in the future, and continuously paying close attention to the relationship between biomarkers and clinical outcomes. | en |
| dc.description.provenance | Made available in DSpace on 2021-05-16T16:17:57Z (GMT). No. of bitstreams: 1 ntu-102-R00429008-1.pdf: 717627 bytes, checksum: 68d27a138b7aa4b4790ebf5acfb5dcdd (MD5) Previous issue date: 2013 | en |
| dc.description.tableofcontents | 口試委員會審定書 i
誌謝 ii 中文摘要 iii 英文摘要 v 目 錄 vii 圖 目 錄 ix 表 目 錄 x 第一章 前言 1 1 中風 1 1.1 中風簡介 1 1.2 中風的影響 1 2 機器輔助治療 Robot-assisted Therapy 3 2.1 機器輔助治療簡介 3 2.2 機器輔助治療之特質 4 2.3 機器輔助治療文獻回顧 6 2.4 Bi-Manu-Track介紹 8 2.5 療效的神經機制 9 2.6 先前研究之不足 10 3 生物標記 Biomarkers 13 3.1 血糖 (blood glucose/blood sugar) 13 3.2 糖化血色素 (glycated haemoglobin/hemoglobin, HbA1c) 15 3.3 C-反應蛋白 (C-reactive protein, CRP) 15 第二章 研究目的與假設 17 第三章 研究方法 18 1 受試者 18 2 實驗設計 18 3 介入 19 3.1 機器輔助治療組 (Robot-assisted therapy, RT) 19 3.2 傳統治療組 (Conventional therapy, CT) 20 4 成效評估 21 4.1 人口學與臨床特性 21 4.2 臨床評估－依ICF model分類 21 4.3 生物標記量測 28 5 資料分析 29 第四章 結果 30 1 受試者 30 2 臨床評估 31 2.1 身體功能與構造層級結果 31 2.2 活動層級結果 33 2.3 參與層級結果 35 2.4 生物標記結果 35 2.5 生物標記結果與臨床成效評量的相關性 36 第五章 討論 37 1 個案特質 37 2 FMA進步幅度 37 3 雙側力量的改善 39 4 手部活動量的變化 40 5 日常生活功能進步 41 6 日常生活操作性功能進步 41 7 日常生活移行功能進步 43 8 生活品質成效 44 9 生物標記的變化與臨床評估工具的相關性 45 10 副作用 46 11 治療模式 47 12 研究限制 47 13 未來建議 48 14 結論 49 參考文獻 90 圖 目 錄 圖 1：FMA自然恢復量與本研究個案FMA進步量之比較 50 圖 2：生物標記HbA1c與CRP的相關性 51 圖 3：生物標記HbA1c和FMA後測的相關性 52 圖 4：生物標記HbA1c與CRP和ABILHAND變化量的相關性 53 圖 5：生物標記HbA1c與CRP和肌力變化量的相關性 54 表 目 錄 表 1：機器輔助治療之系統性文獻回顧整理 55 表 2：急性與亞急性期機器輔助治療隨機控制研究 57 表 3：Bi-Manu-Track文獻統整 59 表 4：人口學資料 62 表 5：身體功能與構造層級結果 (FMA、MSS) 64 表 6：身體功能與構造層級結果 (MRC、遠端肌力) 66 表 7：身體功能與構造層級結果 (MAS、Accelerometer) 70 表 8：活動層級主要成效結果 (FIM、WMFT) 72 表 9：活動層級次要成效結果 (ARAT、BBT) 74 表 10：活動層級次要成效結果 (MAL、ABILHAND) 76 表 11：活動層級次要成效結果 (mRS、FAC、PASS) 77 表 12：參與層級結果 (SIS、EQ-5D) 78 表 13：生物標記結果 82 表 14：急性與亞急性期中風個案接受機器輔助治療FMA進步量 84 表 15：個案藥物資訊 86 | |
| dc.language.iso | zh-TW | |
| dc.subject | 中風 | zh_TW |
| dc.subject | 動作功能 | zh_TW |
| dc.subject | 生物標記 | zh_TW |
| dc.subject | 復健 | zh_TW |
| dc.subject | 機器 | zh_TW |
| dc.subject | Motor function | en |
| dc.subject | stroke | en |
| dc.subject | robotics | en |
| dc.subject | rehabilitation | en |
| dc.subject | biomarker | en |
| dc.title | 機器輔助亞急性中風治療：動作功能與生物標記之個案系列研究 | zh_TW |
| dc.title | Effects of robot-assisted therapy on motor function and biomarkers in subacute stroke patients: a case series | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 101-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 吳菁宜(Ching-Yi Wu),陳喬男(Chiao-nan Chen) | |
| dc.subject.keyword | 動作功能,生物標記,復健,機器,中風, | zh_TW |
| dc.subject.keyword | Motor function,biomarker,rehabilitation,robotics,stroke, | en |
| dc.relation.page | 100 | |
| dc.rights.note | 同意授權(全球公開) | |
| dc.date.accepted | 2013-08-16 | |
| dc.contributor.author-college | 醫學院 | zh_TW |
| dc.contributor.author-dept | 職能治療研究所 | zh_TW |
| 顯示於系所單位： | 職能治療學系 | |
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