中風病人上肢動作功能的恢復往往留下功能缺失，而影響日常生活功能的表現。近年由於神經科學的進展快速，中風病人的復健治療對大腦重組與動作功能恢復已有更進一步的瞭解，因此依實證結發展出一套有效的臨床評估及訓練中風病人上肢動作功能的方法，將有助於減少中風病人上肢動作功能的殘留缺失及提增日常生活功能的表現，近而促進中風病人的生活品質。
本研究主要目的在分析中風病人上肢伸手動作功能的運動學測量建構，並分析各運動學變項在區別正常人及中風個案伸手動作的運動學測量模式。同時結合雙側上肢同時動作、阻力動作、機械協助治療治療策略，設計出兩側性阻力引導動力式上肢功能訓練器。並分析其訓練慢性中風病人上肢動作功能的恢復效果。
研究結果發現上肢伸手動作的運動學測量主要有二個概念，概念一在反映動作速度與平順度，概念二在反映動作策略。而概念一之測量變數皆與臨床評估中風病人上肢動作功能及不正常肌力程度相關。在區別正常與不正常的伸手動作時，利用最大速度及運動單位數兩測量變項便可建立精簡的測量模式。同時發現中風病人在執行兩側同時伸手動作時並未有兩側上肢聯合的效應存在，運動學分析發現反而使患側上肢動作控制能力及品質變差，推論在執行兩側性伸手動時將增加中風病人對動作控制的注意力及困難度。
另本研究亦成功發展出結合兩側性上肢運動、阻力及機械協助治療之兩側性上肢阻力引導動力式上肢功能訓練器，初步結果發現慢性中風病人在接受為期8週，每週3次的治療後發現病人自覺患側上肢進步情形包括上肢肌力、動作能力、穩定性、細巧性、肌張力、顫抖及水腫等。進一步的前-後測及追蹤量化測量研究發現病人在接受兩側性上肢阻力引導動力式上肢功能訓練8週(每週3次)後，在患側上肢的臨床動作功能評估包括堆、拉肌力、動作能力、握力皆有明顯進步。而運動學參數包括運動時間、最大運動速度、標準化急動值、運動單位數、及達最大運動速度百分比等參數也皆有明顯進步。在8個星期的追蹤評估發現患側上肢的臨床動作功能評估雖未見明顯退步，但伸手動作的運動學參數卻顯示有明顯退步情形。
本研究成果除建立上肢伸手動作的運動學評估模式外，並設計出一套有利於中風患側上肢功能恢復之兩側性阻力引導動式上肢訓練器，研究成果未來將可推廣應用在臨床及社區之急、慢性中風病人上肢功能的復健治療及療效評估。

Patients with stroke often remain affected upper limb motor impairment and demonstrate disability in performing activities of daily living. Due to the growth of neuroscience, the relationships between brain reorganization and therapy-induced motor recovery have been further explored. Thus, the development of evaluation and therapeutic modality, based on neuroscience evidence, for the interventions of paretic upper motor recovery will contribute to the recovery of motor function, and consequently increase the quality of life for patients with stroke.
The primary purposes of this study are to analyze the constructs of kinematic measure in reaching, and to establish a kinematic model for discriminating normal and abnormal reaching. Besides, this study will design a purpose-built robot-aided bilateral force-induced isokinetic arm movement trainer for stroke upper limb motor rehabilitation. Then, we will further analyze the effects of our robot-aided device training on the paretic upper limb motor recovery for patients with chronic stroke.
Findings in this study showed that the kinematic reaching variables could be categorized into two common factors. Common factor I reflected the characteristics related to movement speed and smoothness, and common factor II reflected the characteristics related to motor control strategy in reaching. Variables loading on common factor I were significantly correlated with the clinical motor assessment scales (Fugl-Meyer motor assessment, Modified Ashworth scale), Peak velocity and number of movement unit can be used to established a parsimony model for discriminating between normal and abnormal reaching. Furthermore, our results showed interlimb coupling effect did not benefit the quality of motor control during bilateral reaching. It is hypothesized bilateral reaching was more attention demanded and challenge to patients with chronic stroke as compared to unilateral reaching.
Additionally, this study developed a robot-aided bilateral force-induced isokinetic arm movement trainer. A preliminary subject reports from the stroke subjects after 8 week’s training demonstrated improvements in strength, motor function, stability, muscle tone, tremor, hand dexterity and edema were reported. Further quantitative measures with pr-post and retention research design showed strength, motor function, and reaching performance were significantly improved after 8 weeks’ training. From the retention tests, the remaining effects only presented in strength and motor function but not in reaching kinematics.
This study developed a kinematic model and robot-aided device for the assessment and treatment of the paretic upper limb motor function for patients with stroke. These findings could be exploited to the clinical settings for stroke rehabilitation. The robot-aided device could also be applied to the long-term care and home care settings for maintaining and improving the paretic upper limb motor function for patients with chronic stroke.

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