過去研究發現外在線索可以提升巴金森病人的動作表現，然而過去研究較少探討外在線索訓練對上肢及軀幹協調動作（如：伸手向前取物）的影響。外在線索的提供可透過虛擬實境工具進行精確的調節，因此本研究以虛擬實境接球做為實驗組訓練活動，希望能探討：一. 外在線索訓練對巴金森病人的上肢動作及姿勢穩定的影響。二. 虛擬實境訓練與真實情境訓練對巴金森病患上肢動作及姿勢穩定能力的影響的差異。
本研究將巴金森患者隨機分配於虛擬實境訓練組或真實情境訓練組，前者採用虛擬實境接球介面，後者則以發球機作為訓練工具。第一天進行上肢功能及姿勢穩定平衡動作的前測資料蒐集後，接著進行第一次訓練，並在接續的兩天進行兩次訓練，於第三次訓練結束後24小時進行後測，以瞭解訓練活動的保留效益。
針對研究問題一，結果發現巴金森患者在短期的外在線索動作訓練後，上肢及姿勢穩定平衡參數的動作表現在動作時間、動作速度上有進步，且訓練的效益在於穩定驅幹，讓手能更快速的拿物，並增加動作效率及安全性，且24小時後仍有保留效益。針對研究問題二，結果發現虛擬實境訓練與真實訓練的效果一致。
本研究結論為：外在線索訓練能對巴金森患者上肢及姿勢穩定平衡動作有效，且虛擬實境訓練與真實訓練所帶來的效益相同。顯示巴金森患者進行復健活動時，利用虛擬實境工具所設計的外在線索訓練是值得關注、且有實證療效的。

Research has supported the use of external cuing to improve movement in patients with Parkinson’s disease. However, there has been little research on the effect of cueing training on arm movement and postural control of Parkinson’s disease (PD) patients. External cues can be easily controlled and graded in virtual reality (VR). Therefore, this study used ball catching activities as training (1) to examine the effects of cueing training on arm movement and posture stability performance in PD patients, and (2) to compare the effects of ball catching training between VR and physical reality activities in PD patients.
We used a randomize pretest-posttest control group design. Participants were randomly assigned to either VR training group or physical reality training group and practiced ball catching in the respective context for three consecutive days. All participants were tested on their arm movement and balance performance before the first training session (pretest) and 24 hours after the last training session (posttest).
For our first research aim, the results showed that a short term external cuing training could improve hand and balance performance of PD patients, especially in decreasing movement time and increasing movement velocity. The patients tended to stabilize their trunk and speed up their hands to perform a safer and more efficient movement after training. Also, the training effect could be retained at least 24 hours after training. For our second research aim, the results showed that VR training had similar effect as physical reality training among PD patients.
In conclusion, external cuing training is effective for PD patients, and while using VR tools to conduct an external cuing training, VR training had similar effects as physical reality training for PD patients. Therefore, our research showed evidence-based therapeutic effect of VR external cuing training in PD patients. Future research could put more emphasis on VR external cuing training.

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