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研究生： 王怡雯
Wang, Yi-Wen
論文名稱： 應用擴增實境之嚴肅遊戲於帕金森氏症平衡感復健系統
Applying Serious Games based on Augmented Reality to the Balance Rehabilitation System for Parkinson's Disease Patients
指導教授： 陳建旭
Chen, Chien-Hsu
林彥呈
Lin, Yang-Cheng
學位類別： 碩士
Master
系所名稱： 規劃與設計學院 - 工業設計學系
Department of Industrial Design
論文出版年： 2021
畢業學年度： 109
語文別： 英文
論文頁數： 77
中文關鍵詞： 帕金森氏症 、平衡感 、擴增實境 、嚴肅遊戲
外文關鍵詞： Parkinson's disease, Balance, Augmented reality, Serious games
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    • 帕金森氏症患者因神經退化造成運動障礙，特徵為靜止時手臂及下肢震顫、肢體僵硬、步態紊亂和姿勢不穩定等，常造成跌倒等傷害，嚴重影響生活品質，若罹患帕金森氏症的人數持續增加，將會使照護人口需求上升。因藥物治療與手術治療的限制，復健是較能持續改善症狀的方式，但必須舟車勞頓往返復健中心降低復健的意願。因此本研究以提供帕金森氏症患者更便利且有效的復健方式為目標，應用擴增實境發展復健嚴肅遊戲系統，期望能藉由提升患者步距以減少小碎步發生，並且穩定姿勢進而改善平衡感。
    本研究的實驗共招募了10位症狀介於Hoehn-Yahr分期第一到第三期患者，分為5名以擴增實境復健嚴肅遊戲進行訓練的實驗組，與5名進行以現有復健方式訓練的對照組，分析的參數包含：伯格氏平衡量表、平衡信心量表、重心總位移、跨步距離和跨步高度。經過為期4週的實驗後，透過結果觀察兩組實驗前後的變化，實驗組在重心總位移從前測 (M = 1.63, SD = 1.1)與後測 (M = 1.07, SD = 0.89)相比P = 0.031，跟跨步距離 (M = 43.5, SD 5.45)與後測(M = 48.91, SD = 6.81)相比P = 0.031有顯著的進步，而對照組則是沒有顯著的進步。在重心總位移的訓練成效實驗組 (M = -0.57, SD = 0.46)與對照組 (M = 0.58, SD = 0.83)相比P = 0.004有顯著的差異。整體而言，此復健嚴肅遊戲比起現有復健模式有相似的訓練效果甚至更有效。根據SUS系統使用性量表與半結構式訪談的結果顯示使用性得到良好的回饋，有受測者表示實驗後提升了對轉彎能力的自信心，此復健遊戲對現有復健方式不便的方面也有所改善。目前在帕金森氏症復健的相關研究中，對於轉彎能力以及下肢的訓練尚嫌不足，本研究設計了擴增實境復健嚴肅遊戲，透過給予患者視覺目標以促進步伐，和透過轉彎訓練改善平衡感，實驗結果可供未來相關的研究參考。

    Parkinson’s disease (PD) causes tremors, rigidity, abnormal gait, and postural instability, and these symptoms lead to falls and diminish patients’ quality of life. Continuous rehabilitation for patients with PD may be more effective in the long term than either pharmacotherapy or surgical treatment. Nevertheless, the patient's motivation is reduced due to the difficulty of frequent visits to the rehabilitation center. This research applies augmented reality (AR) to develop a rehabilitation serious game to achieve the goal of providing patients with PD with a more convenient and effective rehabilitation method which can increase the patient’s step length to reduce the situation of festinating gait and stabilizing the posture to improve the sense of balance.
    In the 4-week experiment of this research, this research invited 10 patients diagnosed with Hoehn and Yahr stages I–III. They were divided into an experiment group and a control group. The analyzed parameters include Berg Balance Scale, Activities-Specific Balance Confidence Scale, the center of gravity (COG) displacement, step length, and step height. Through the results to observe the difference of the two groups before and after the experiment. The experiment group has two items with significant differences. Respectively, the COG displacement is compared from the pre-test (M = 1.63, SD = 1.1) with the post-test (M = 1.07, SD = 0.89), P = 0.031, and the step length is compared from the pre-test (M = 43.5, SD 5.45) with the post-test (M = 48.91, SD = 6.81), P = 0.031, while the control group showed no significant difference. There is a significant difference between the experiment group (M = -0.57, SD = 0.46) and the control group (M = 0.58, SD = 0.83) in the training effectiveness of the COG displacement at P = 0.004. Overall, this rehabilitation serious game has similar training effects and be even more effective than existing rehabilitation methods. According to the results of the System Usability Scale and semi-structured interviews, the usability is well-rewarded. This rehabilitation game also improves the inconvenience of existing rehabilitation methods. This research designed an AR rehabilitation serious game, which promotes the step length and improves sense of balance, and the experimental results can be used as a reference for future related research.

    摘要 ii SUMMARY iii ACKNOWLEDGEMENTS iv TABLE OF CONTENTS v LIST OF TABLES viii LIST OF FIGURES ix CHAPTER 1 INTRODUCTION 1 1.1 Research Background 2 1.2 Research Motivation 3 1.3 Research Purpose 5 1.4 Research Framework 7 CHAPTER 2 LITERATURE REVIEW 10 2.1 Parkinson's Disease 10 2.1.1 Introduction to Parkinson's Disease 10 2.1.2 Causes and Mechanisms of Parkinson's Disease 11 2.1.3 Ways to Improve Parkinson’s Balance 13 2.2 Introduction to Augmented Reality and Serious Games 14 2.2.1 Augmented Reality 14 2.2.2 Serious Game 16 2.3 Innovative Ways to Improve Parkinson's Balance 16 2.3.1 Improve Balance of Parkinson's Disease Patients with Multiple Exercise Methods 16 2.3.2 Applying Augmented Reality to Improve Parkinson's Disease 18 2.3.3 Serious Games Applied to Rehabilitation System 19 2.4 Evaluation Method 19 2.4.1 Balance and Gait Evaluation Methods 20 2.4.2 System Usability Evaluation 20 2.5 Summary 21 CHAPTER 3 METHODOLOGY 23 3.1 Observation and Interview 23 3.1.1 Rehabilitation Center Observation 23 3.1.2 Expert Interview 25 3.2 Augmented Reality Rehabilitation Serious Game Design 26 3.2.1 Game Equipment 26 3.2.2 Concept Development 28 3.2.3 Content of the Game 30 3.3 Evaluation and Experiment 36 3.3.1 Purpose of the Experiment 37 3.3.2 Subjects 37 3.3.3 Experiment Design 38 3.3.4 Experiment Setup 38 3.3.5 Experiment Steps 40 3.3.6 Evaluation of Balance and Gait Ability 41 3.3.7 Usability Evaluation 44 CHAPTER 4 RESULTS 46 4.1 Experiment Process 46 4.2 Balance and Gait Outcome 47 4.3 System Usability Outcome 51 CHAPTER 5 DISCUSSION 53 5.1 Balance and Gait Discussion 53 5.2 System Usability Discussion 55 5.3 Discussion Summary 57 CHAPTER 6 CONCLUSION 58 6.1 Research Summary 58 6.2 Future Research 59 REFERENCES 61 Appendix A BERG BALANCE SCALE 68 Appendix B ACTIVITIES-SPECIFIC BALANCE CONFIDENCE 71 Appendix C SYSTEM USABILITY SCALE 72 Appendix D SEMI STRUCTURED-INTERVIEW 73 Appendix E RESEARCH ETHICS APPROVAL 74 Appendix F INFORMED CONSENT 75

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