全球失智症患者數量逐年增加，最常見的失智症為阿茲海默症(Alzheimer’s disease, AD)，其臨床前期為輕度認知障礙 (mild cognitive impairment, MCI)。研究發現輕度認知障礙的感覺輸入不良以及肌肉骨骼系統和神經系統的退化會導致手功能下降，透過手指協調與力量訓練得以改善手部功能並增進生活品質。近年來透過科技輔助減輕護理人員負擔，成為熱門話題。本研究將以過去已證明能強化認知功能之手功能評估訓練系統(Pressing Evaluation and Training System; PET)為研發基礎，發展能應用於居家及社區之大腦強化器材(Tipr)，進行力量訓練同時結合音樂節奏輔助手指按壓運動，探討高齡者在對於不同音樂快慢節奏中執行手指力量控制的腦部活化情形。
本研究將24位健康老人平均分為兩組，實驗組 (Music-based game training) 使用改良式手指按壓評估訓練系統結合音樂節奏，進行精細動作訓練，每次約30 分鐘，共 3 次，控制組(Non-music-based game training)進行相同訓練，但訓練過程中沒有音樂節奏介入。全部受試者在第一次訓練前和三次訓練後使用近紅外光譜儀器 (Near-infrared spectroscopy, NIRS) 評估不同音樂節奏在兩種遊戲難度過程中的大腦活化狀況。結果發現受試者無論在進行簡單或困難的遊戲關卡時在所有腦區相較單純聽音樂有更高的腦部活化，且左側顳上回在快速節奏的的音樂下有較高的活化。訓練後控制組在困難關卡下兩側前額葉及左側運動輔助區較訓練前不活化，而訓練組在右側顳上回於聽快音樂時活化狀況顯著降低。手指力量訓練相較於被動的聆聽音樂能獲得更好的認知訓練刺激效果，並且透過音樂結合或許可以提供老年人在訓練刺激上的持續效果。未來研究可以增加樣本數量、更嚴謹的實驗設計，以擴展研究發現。

The population of dementia patients worldwide is increasing. Alzheimer's disease (AD) is the most common cause of dementia, and the preclinical stage of AD is mild cognitive impairment (MCI). Studies had found that poor sensory input and degeneration of the musculoskeletal and nervous systems in MCI can lead to decreased hand function. Finger coordination and strength training can improve hand function and improve quality of life. In recent years, reducing the burden of caregivers through technology assistance has become a trending. Based on the research and development of the Pressing Evaluation and Training System (PET), which has been proven to enhance cognitive function in the past, this research developed an modified version (Tipr), to perform strength training while embedded music rhythm to assisted finger pressing. And explore the brain activation of the elderly in performing finger force control in response to different music tempo.
In this study, 24 healthy elderly people were equally divided into two groups. The experimental group (Music-based game training) used the finger pressing training system combined with music rhythm to perform fine motor training for about 30 minutes each session, 3 times in total. Control group (Non-music-based game training) performed the same training without musical rhythm intervention. All subjects used Near-infrared spectroscopy (NIRS) to evaluate the brain activation of different music tempo and two game difficulties before the first training and after three training sessions. The results showed that the subjects had higher brain activation in all brain regions when playing easy or difficult game than listening to music alone, and the left superior temporal gyrus had higher activation under fast-paced music. After training, the activation of bilateral prefrontal cortex and left supplementary motor area in the control group were lower in difficult game compared with those before training, while the activation of the right superior temporal gyrus in the training group was significantly reduced when listening to fast music. Finger force control training had better cognitive stimulation than listen to music alone, and through the combination of music, it may provide a sustained effect in older adults. Future studies can expand the findings with increased sample sizes and more controlled trial and adding follow-up evaluation.

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