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題名:以運動學變數作為探討腦性麻痺孩童上肢介入療效指標之研究:文獻回顧
書刊名:臺灣職能治療研究與實務雜誌
作者:林思瑜王湉妮陳昱倫黃晨維陳顥齡
作者(外文):Lin, Szu-yuWang, Tien-niChen, Yu-lunHuang, Chen-weiChen, Hao-ling
出版日期:2016
卷期:12:2
頁次:頁101-114
主題關鍵詞:腦性麻痺運動學分析上肢復健Cerebral palsyKinematicsUpper limbTherapy
原始連結:連回原系統網址new window
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目的:腦性麻痺孩童上肢復健的手法不勝枚舉,本文藉由彙整各療效研究所使用的運動學相關療效指標,了解不同上肢復健方案對腦性麻痺孩童改善上肢動作之療效,同時探討運動學變數與臨床評估工具結果的相關性。方法:經由Pubmed、Scopus等電子資料庫,使用Cerebral Palsy、kinematic以及與治療、上肢相關用詞為搜尋關鍵字,搜尋期限至2015年5月止,篩選出以上肢運動學結果作為腦性麻痺孩童上肢復健方案療效評估之文獻。本回顧將運動學變數分為端點控制、關節徵招及關節間協調、軀幹控制三類;並將治療訓練方法分為任務取向/相關訓練以及特定任務訓練來彙整文獻之結果。結果:共收錄22篇文獻,受試者以半側偏癱腦性麻痺孩童居多,治療形式以任務取向及相關訓練為大宗,而大多數運動學分析的動作任務為汲取任務。回顧結果顯示多數研究以端點控制之運動學變數來量化動作表現,大部分的介入能在運動學分析上看到顯著的療效,包括:動作時間減少、端點速度提升、動作流暢度及精準度提升。探討運動學變數與臨床評估工具之相關性研究,結果顯示運動學變數與墨爾本單側上肢測驗結果大多一致,但與日常生活相關臨床評估工具之相關性文獻仍不足。結論:上述結果顯示不論是任務取向/相關訓練抑或是特定任務訓練,皆能藉由運動學分析方式,敏感、客觀的量化動作進步程度,然而探討運動學變數與臨床評估工具的相關性文獻較少。建議未來研究可進一步探討運動學變數與臨床評估工具之間的相關性,以增加運動學變數在臨床上作為療效指標之實用性。
OBJECTIVE: There are many kinds of therapies for children with Cerebral Palsy (CP) to improve their upper limb function. Thus, this study reviewed the literature using kinematic variables to evaluate the efficacy of upper limb therapies for children with CP. Moreover, association between kinematic variables and clinical tools were also investigated. METHODS: Pubmed and Scopus databases dated to May 2015 were searched to identify relevant studies. The key words were cerebral palsy, kinematics and words related to therapy and upper limb. The inclusion criteria in this study were the trials that had to include upper limb training program and kinematic assessments. Three kinematic variables, namely endpoint control, joint recruitment and inter-joint coordination and trunk involvement, were used to investigate the efficacy of interventions. RESULTS: In total, twenty-two studies were included in this review. Most of the subjects in the studies were children with hemiplegic CP. Majority of training program were task-oriented training. Considering different kinds of kinematic variables, endpoint control variables were common variable to quantify the motor performance of upper limb in most of studies. In brief, almost all of the intervention could improve upper limb motor function measured by kinematic analysis, including reduced movement time, improved endpoint velocity and movement smoothness and accuracy. However, studies investigating the association between kinematic variables and clinical tools were still limited. CONCLUSIONS: This study aims to review the efficacy of the upper limb interventions based on kinematic measures for children with CP. According to the results, all of the improvements on upper limb training program could reveal by kinematic analysis. Kinematic analysis can sensitively and objectively detect the subtle changes of motor performance. However, studies on association between kinematic variables and clinical tools were still limited. Further research might explore more on the associations between the results of kinematic variables and clinical tools, which help improve the clinical practicability of kinematic measures to function as outcome measures.
期刊論文
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會議論文
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