腦血管疾病（又稱腦中風）經常造成不同嚴重程度失能，導致日常生活受影響。其中，上肢動作功能受損是中風後常見的神經功能障礙之一，許多患者無法回復先前的手臂功能。過去許多文獻指出中風患者在執行合併下肢動作與認知功能的雙重任務上出現困難，然而缺乏上肢的雙重任務相關研究，中風患者在上肢的雙重任務上是否顯現同樣的限制不得而知，仍有待研究探討。因此，本篇研究目的為探討腦中風患者在執行上肢動作與認知的雙重任務表現。本研究共招募中風患者與性別及年齡相仿的健康成人各20名，並透過一項上肢動作功能評估（積木與盒子測驗）與三項認知功能任務（倒數數字、連續減三和連續減七測驗）來探討單一任務情境與雙重任務情境中，兩組受試者間認知動作干擾的差異，此外也探討中風患者的患、健側上肢間執行任務的差異。最後，本研究也探討整體的雙重任務效應和任務優先性是否與上肢功能及執行功能有關。研究結果主要發現：本研究所參與之腦中風患者整體的雙重任務效應和健康成人無顯著差異，且其認知動作干擾類型相似於健康成人，然而，中風患者在認知負荷較低之雙重任務上會採取以動作為優先之反應策略，而健康成人在所有的認知任務情境皆以認知為優先。本研究成果可提供臨床治療師作為訓練中風患者的參考基礎，建議治療師在施予復健介入時，除了強化上肢動作功能表現外，也考量認知任務對患者動作表現的影響。

Purpose. This study aimed to investigate the differences in cognitive-motor interference (CMI) between patients with stroke and healthy individuals during the execution of upper extremity motor task and cognitive tasks. In the stroke group, we also explored the differences between the paretic and non-paretic arm. In addition, given that dual tasking ability may be an indicator of executive functioning, we further explore the relationship between the executive function and dual-task effect.
Method. Twenty patients with stroke (mean age 56.75 ± 8.21) and 20 healthy, gender and age-matched (mean age 55.25 ± 8.11) control subjects performed Box and Block Test in isolation and in conjunction with three cognitive tasks (Counting backwards by 1’s, Serial 3's and 7's subtraction tasks). Besides, this study measured executive function by using Color Trail Test.
Results. In the single task condition, the patients with stroke had reduced upper extremity dexterity than the controls, with the paretic arm being more affected (p<.05). In the dual task condition, although no total dual-task effect and patterns of CMI seen between two groups and side differences in stroke patients, the two groups showed different pattern of task priority when the task demanding was high. However, there were no correlations between the total dual-task effect, task priority and executive function.
Conclusions. Patients with stroke and healthy adults may employ different strategies during dual tasking. We thus concluded that interference between cognitive and motor tasks should be taken into account in clinical assessments and for the design of interventions for both cognitive and motor rehabilitation.

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https://dep.mohw.gov.tw/DOS/lp-3352-113.html
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https://dep.mohw.gov.tw/DOS/cp-3734-39021-113.html
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