背景與目的：中風患者上肢功能缺損，因而影響日常生活功能及社會參與，甚至於生活品質降低。平板電腦遊戲可否成為一個合適之治療媒介，提升病人主動參與，並能改善中風患者上肢動作與功能，進而促進患側在日常生活的使用。本研究旨探討藉由平板電腦遊戲上肢功能訓練合併傳統上肢功能訓練，應用在中風後患側上肢功能的訓練成效進行分析比較。

方法：本研究共招募9位中風患者作為研究對象，利用方便取樣的方法，透過國立台灣大學附設醫院竹東分院復健科轉介收案，每位患者接受每次介入一小時，一週3-5次，共計12次介入，並在介入前、介入後進行評估，評估內容包括上肢功能測量（傅格梅爾上肢評量、簡易上肢機能檢查）及動作活動日誌。過程中，患者進行30 分鐘的平板電腦遊戲上肢功能訓練及30分鐘的職能治療訓練，治療師皆在一旁提供指導及協助。

結果：9位患者在傅格梅爾上肢評量（p=0.007）、簡易上肢機能檢查常模分數（p=0.018）及動作活動日誌使用量（p=0.011）及生活品質（p=0.012），介入前後的比較中皆出現顯著進步。對於慣用手是否為患側手、使用智慧型手機平板經驗、玩遊戲應用程式經驗與成效無顯著差異。中風天數與動作活動日誌使用量結果 (r=-.689*)呈現中度相關。患者表示玩平板電腦遊戲時是享受的且覺得平板電腦遊戲能促進上肢動作功能。

結論：透過本研究，平板電腦遊戲合併傳統職能治療介入對腦中風患者上肢動作功能及日常生活功能是有幫助的。中風患者對於平板電腦遊戲作為介入媒介是可接受的，但需要進一步發展及探討平板電腦遊戲在中風復健治療中的療效範圍及作用機制。

Stroke patients with upper-extremity impairments will affect the daily activities, social participation and even the quality of life. In recent years, tablet games might be suitable for rehabilitation by facilitating hand movement. The aim of the study to utilizing tablet games training combined with convention occupational therapy may improve upper-extremity function and activities of daily living of stroke patients. Nine subacute stroke patients were recruited in this study. All participants received the intervention for one hour in every session, 3~5 sessions per week. A complete intervention includes 12 sessions. Researchers evaluated the participant’s performances two times, pre- and post- intervention, during the studying period. Assessments include Fugl-Meyer Assessment(FMA-UE), Simple Test for Evaluating Hand Function(STEF) and motor activity log(MAL). The occupational therapists will provide guidance and assistance in every training session. The results showed the FMA-UE, STEF and MAL mean scores had significant improvement between pre- and post-intervention. The days post-stroke affects the amount of use of patients more-affected arm during the functional activities. Participants reported enjoying the experience and thought the apps may have potential for stroke rehabilitation to improve performance of the stroke-affected hand. In conclusion, this study showed that the tablet games training with convention occupational therapy helps stroke patients improve their UE motor function and activities of daily living after receiving a 12 hours intervention. The tablet games can used be acceptable tools in rehabilitation.

Ameer, K., & Ali, K. (2017). iPad use in stroke neuro-rehabilitation. Geriatrics, 2(1), 2.
Andriotis, P., Tryfonas, T., Oikonomou, G., & Yildiz, C. (2013, April). A pilot study on the security of pattern screen-lock methods and soft side channel attacks. In Proceedings of the sixth ACM conference on Security and privacy in wireless and mobile networks (pp. 1-6). ACM.
Bangor, A., Kortum, P., & Miller, J. A. (2008). The system usability scale (SUS): An empirical evaluation. International Journal of Human-Computer Interaction, 24(6), 574-594.
Billinghurst, S. S., & Vu, K. P. L. (2015). Touch screen gestures for web browsing tasks. Computers in Human Behavior, 53, 71-81.
Burnett, G., Crundall, E., Large, D., Lawson, G., & Skrypchuk, L. (2013, October). A study of unidirectional swipe gestures on in-vehicle touch screens. In Proceedings of the 5th International Conference on Automotive User Interfaces and Interactive Vehicular Applications (pp. 22-29). ACM.
Caprani, N., O’Connor, N. E., & Gurrin, C. (2012). Touch screens for the older user. In Assistive technologies. InTech.
Chang, Y. J., Chen, S. F., & Huang, J. D. (2011). A Kinect-based system for physical rehabilitation: A pilot study for young adults with motor disabilities. Research in developmental disabilities, 32(6), 2566-2570.
Choi, Y. H., Ku, J., Lim, H., Kim, Y. H., & Paik, N. J. (2016). Mobile game-based virtual reality rehabilitation program for upper limb dysfunction after ischemic stroke. Restorative neurology and neuroscience, 34(3), 455-463.
Gladstone, D. J., et al. (2002). "The fugl-meyer assessment of motor recovery after stroke: a critical review of its measurement properties." Neurorehabil Neural Repair 16(3): 232-240.
Gray, J. M. (1998). Putting occupation into practice: Occupation as ends, occupation as means. American Journal of Occupational Therapy, 52(5), 354-364.
Hinrichs, U., & Carpendale, S. (2011, May). Gestures in the wild: studying multi-touch gesture sequences on interactive tabletop exhibits. In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems (pp. 3023-3032). ACM.
Hoonhorst, M. H., Nijland, R. H., van den Berg, J. S., Emmelot, C. H., Kollen, B. J., & Kwakkel, G. (2015). How do Fugl-Meyer arm motor scores relate to dexterity according to the action research arm test at 6 months poststroke?. Archives of physical medicine and rehabilitation, 96(10), 1845-1849.
Jang, S. H. and W. H. Jang (2016). "The effect of a finger training application using a tablet PC in chronic hemiparetic stroke patients." Somatosens Mot Res 33(2): 124-129.
Jeong, H., & Liu, Y. (2017). Effects of touchscreen gesture’s type and direction on finger-touch input performance and subjective ratings. Ergonomics, 1-12.
Joo, L. Y., Yin, T. S., Xu, D., Thia, E., Chia, P. F., Kuah, C. W. K., & He, K. K. (2010). A feasibility study using interactive commercial off-the-shelf computer gaming in upper limb rehabilitation in patients after stroke. Journal of rehabilitation medicine, 42(5), 437-441.
Kizony, R., et al. (2016). "Tablet Apps and Dexterity: Comparison Between 3 Age Groups and Proof of Concept for Stroke Rehabilitation." J Neurol Phys Ther 40(1): 31-39.
Kong, K. H., et al. (2016). "Efficacy of a Virtual Reality Commercial Gaming Device in Upper Limb Recovery after Stroke: A Randomized, Controlled Study." Top Stroke Rehabil 23(5): 333-340.
Lang, C. E., MacDonald, J. R., Reisman, D. S., Boyd, L., Kimberley, T. J., Schindler-Ivens, S. M., ... & Scheets, P. L. (2009). Observation of amounts of movement practice provided during stroke rehabilitation. Archives of physical medicine and rehabilitation, 90(10), 1692-1698.
Langhorne, P., & Legg, L. (2003). Evidence behind stroke rehabilitation. Journal of Neurology, Neurosurgery & Psychiatry, 74(suppl 4), iv18-iv21.
Langhorne, P., Bernhardt, J., & Kwakkel, G. (2011). Stroke rehabilitation. The Lancet, 377(9778), 1693-1702.
Morris, J., Mueller, J., & Jones, M. (2010). Toward mobile phone design for all: meeting the needs of stroke survivors. Topics in stroke rehabilitation, 17(5), 353-361.
Nijland, R. H., van Wegen, E. E., Harmeling-van der Wel, B. C., & Kwakkel, G. (2010). Presence of finger extension and shoulder abduction within 72 hours after stroke predicts functional recovery. stroke, 41(4), 745-750.
Pollock, A., et al. (2014). "Interventions for improving upper limb function after stroke." Cochrane Database Syst Rev(11): CD010820.
Portney, L. G. and M. P. Watkins (2015). Foundations of clinical research: applications to practice, FA Davis.
Pugliese, M., et al. (2018). "Mobile tablet-based therapies following stroke: A systematic scoping review of administrative methods and patient experiences." PLoS One 13(1): e0191566.
Rand, D., et al. (2013). "The use of the iPad for poststroke hand rehabilitation; A pilot study." 109-113.
Shah, N., Amirabdollahian, F., & Basteris, A. (2014, June). Designing motivational games for stroke rehabilitation. In Human System Interactions (HSI), 2014 7th International Conference on (pp. 166-171). IEEE.
Shindo, K., et al. (2015). "Psychometric properties of the simple test for evaluating hand function in patients with stroke." Brain Inj: 1-5.
Short, N., Harmsen, R., Kjellgren, G., O'neill, C., Pinney, H., Rivera, A. D., & Warnaar, V. (2017). Use of Dexteria application to improve fine motor coordination in the nondominant hand. Journal of Hand Therapy, 30(1), 106-108.
Singer, B. and J. Garcia-Vega (2017). "The Fugl-Meyer Upper Extremity Scale." J Physiother 63(1): 53.
Sveen, U., Bautz-Holter, E., MARGRETHE SODRING, K. A. R. E. N., BRUUN WYLLER, T. O. R. G. E. I. R., & Laake, K. (1999). Association between impairments, self-care ability and social activities 1 year after stroke. Disability and rehabilitation, 21(8), 372-377.
Taub, E., Uswatte, G., King, D. K., Morris, D., Crago, J. E., & Chatterjee, A. (2006). A placebo-controlled trial of constraint-induced movement therapy for upper extremity after stroke. Stroke, 37(4), 1045-1049.
White, J., et al. (2015). "Tablet technology during stroke recovery: a survivor's perspective." Disabil Rehabil 37(13): 1186-1192.
邱弘毅. (2008). 腦中風之現況與流行病學特徵. 腦中風會訊, 15, 2-4.
何怡靜, 梁昭鉉, 游穎軒, & 唐玄輝. (2016). 發展遲緩兒童使用平板電腦訓練手部精細動作與手寫功能之療效. 北市醫學雜誌, 13(4), 490-501.