腕隧道症候群 (Carpal Tunnel Syndrome, CTS)患者因正中神經受壓迫而出現多種神經症狀，其中手指麻、痛的情形，容易造成患者在執行某些日常生活活動上的困難，寫字便是其中之一。由於寫字過程中必須不斷調控力道與動作，需要大量的感覺回饋方能順利進行，對於觸覺異常的CTS 患者相當不利。但是與分析寫字生物力學相關的工具甚少，因此本研究建立一套可測量握筆力量、具有信效度之研究工具，以紀錄寫字過程中之動力學資訊，並藉由分析CTS 患者與正常族群寫字動作之生物力學參數，以探討該疾病對於寫字表現的影響。
首先本研究以嚴謹的校正技術與統計分析方法，檢測工具之再測信度與效標效度。研究設計採用混合型實驗設計，以方便取樣招募15 名CTS 患者與14 名性別年齡(或工作型態)配對之對照組，CTS 組於術前術後各進行一次資料收集，對照組僅進行一次。藉由所收集之生物力學資訊轉換成具有代表意義之參數，並使用統計方法檢定各組間參數是否具有顯著性差異。
結果顯示工具具有良好之再測信度與效標效度，並在安全邊界值、力量比值與調節指數等生物力學參數部分顯示顯著性之差異。由該結果發現腕隧道正群患者在筆尖施力之調節能力較差，且手指在力量調控的能力上亦較差。此發現可作為職能治療臨床介入上的重要方向參考，而具有信效度之工具可提供日後更多寫字生物力學相關研究使用。

Patients with carpal tunnel syndrome suffer from neurological symptoms which
are caused by the compression on median nerve. Some of the symptoms, like pain and
numbness, may increase the difficulty to execute activities of daily living.
Handwriting task is one of the activities which are easily influenced by the sensory
disturbance, because people need lots of sensory feedback to regulate strength and
movement constantly when doing handwriting task. However, there are few apparatus
for analyzing the biomechanical aspect of handwriting. Thus, this study develops an
apparatus to measure the strength of pen grip and to investigate the
handwriting-related kinetics. By analyzing the data from CTS and normal group, we
could probe into how this disease influencing handwriting movements.
We used a concrete calibration technology and statistical analysis to examine the
test-retest reliability and criterion-related validity of the apparatus. This research
recruited 15 CTS patients and 14 control subjects which are age and sex matched as
the experimental and control group, respectively. The CTS group embraced test twice,
before and after operation, and the normal group proceeded only once to record their handwriting performance via the pen apparatus and motion capture system. Each
complete test contained filling investigation form, clinical evaluation, and writing task.
After data collecting, the recorded information was translated into several meaningful
parameters, and then suitable statistical analyses were used to examine whether
significance difference between groups existence or not.
The results show good test-retest reliability and criterion-related validity of the
apparatus. For those defined parameters, safety margin, modulation index, and force
ratio, some of the experimental results show significant difference between groups.
According to the results, the CTS patients with worse ability of pen-tip force and
finger force regulation were shown. This discovery might provide valuable
information to take part in the clinical intervention of occupational therapy in the
development of new evaluation and treatment strategies. More handwriting
biomechanics- related topic will also be suggested studying using this apparatus with
good reliability and validity in the further works.

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