學院

醫學院

系所

職能治療學系

題名

Influences of Target Distance and Trunk Restraint on Reaching-for-Object Performance after Stroke: A Kinematic Analysis

作者

魏慈慧(Tzu-Hui Wei);許瑋丹(Wei-Dan Xu);吳菁宜(Ching-Yi Wu);林克忠(Keh-Chung Lin)

期刊名稱

職能治療學會雜誌 25(1) 45-58

發表日期

2007年7月

著作性質

原始論著

語文

中文

關鍵字

伸手及物動作,軀幹侷限,距離效應,健側手; reaching, trunk restraint, distance effect, ipsilesional arm

摘要

目的:一為探討不同目標物距離與軀幹侷限如何影響中風患者伸手及物動作;二為研究不同中風型態患者的動作表現。方法:25位中風患者使用健側手在四種實驗情境下執行伸手及物動作,實驗情境包括:近距離及軀幹侷限、遠距離及軀幹侷限、近距離及軀幹不侷限、遠距離及軀幹不侷限。結果:目標物距離及軀幹侷限對多數運動學參數與關節角度變化量呈現顯著且高度的效應(p<.01,效應值r=.72-.97)。不論目標物距離遠近,軀幹侷限將增加手臂的關節角度(p<.01,效應值r= .97-.99)。軀幹侷限且目標物在近距離的情境中,動作流暢度明顯改善,運動軌跡趨近於直線(r=.43)。結論:本研究結果發現疾病特質及物理環境皆會左右個體的動作表現。進一步分析顯示左腦傷者及神經學嚴重度高者在手臂動作軌跡的控制出現明顯的失能,而軀幹控制能力也對伸手及物動作之時間參數產生影響,臨床評估及介入應針對不同臨床特徵與損傷程度設計適切之治療方案。

Objective: This study examined the effects of target distance and trunk restraint on reaching performance in persons with stroke. The second aim was to investigate the impact of the clinical characteristics of persons with stroke on motor performance. Methods: Twenty-five persons with stroke used less-affected arm to perform an upper-extremity reaching task under four experimental conditions: near distance with trunk restraint, far distance with trunk restraint, near distance without trunk restraint, and far distance without trunk restraint. Results: Significant and large effects of target distance and trunk restraint were found on increasing shoulder and elbow joint ranges (p<.01, r=.72-.97). Movement smoothness was improved under condition of trunk restraint and target placed in near distance (r=.43). Conclusions: The results of this study indicated that the individual characteristics and physical environment influenced reaching performance. Participants with left brain damage and with more severe neurological impairment showed deficits in trajectory control. The ability of trunk control affected the temporal performance of reaching movement. Findings of this study suggest that treatment and evaluation should be tailored to clinical characteristics of persons with stroke.