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研究生：	張茹茵 Chang, Ru-Ing
論文名稱：	即時回饋及終端回饋學習方式對盂肱關節鬆動術學習效果之影響 Effects of Concurrent and Terminal Feedback on Learning Joint Mobilization
指導教授：	張冠諒 Chang, Guan-Liang 徐阿田 Hsu, Ar-Tyan
學位類別：	碩士 Master
系所名稱：	工學院 - 醫學工程研究所 Institute of Biomedical Engineering
論文出版年：	2002
畢業學年度：	90
語文別：	英文
論文頁數：	68
中文關鍵詞：	動作學習、終端回饋、即時回饋、關節鬆動術
外文關鍵詞：	motor learning, concurrent feedback, terminal feedback, joint mobilization
相關次數：	點閱：129 下載：3
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關節鬆動術（Joint Mobilization）為治療師以特定程度之力施於目標關節上進行關節評估或治療，目前於學習此技術上仍缺乏客觀量化的方式。本研究目的為：（1）建立一套可提供量化之視覺回饋的盂肱關節模擬學習系統；（2）比較即時回饋（concurrent feedback）及終端回饋（terminal feedback）對學習關節鬆動術之影響，以期能提供較客觀且有效的學習方式。
盂肱關節模擬學習系統（Joint Translation Simulator，簡稱JTS）以伺服馬達模擬關節動作時組織之阻力反應，所需的視覺回饋由螢幕呈現。本實驗使用之標準第二級、第三級力（Kaltenborn之分級方式）。依其定義由材料測試所得之負載-位移關係（load-displacement relationships）算出。36位物理治療系學生為受試者，隨機平分為四組：控制組、無回饋組（no feedback group）、即時回饋組（concurrent feedback group）、及終端回饋組（terminal feedback group）。控制組不參與訓練，無回饋組於訓練時不給予任何資訊回饋。即時回饋組及終端回饋組則於訓練時分別給予量化之即時回饋及終端回饋，每項動作重複75次。所收集之施力化為第二級、第三級力之標準化絕對誤差（normalized absolute errors）進行統計分析。除前測試外，立即記憶測試（immediate retention test）於訓練完成10分鐘後進行，延遲記憶測試（delayed retention test）則於5天後進行。結果顯示於學習期即時回饋及終端回饋組明顯有較正確且一致的表現且明顯優於無回饋組。於2次記憶測試結果顯示，訓練時給予量化回饋所得之學習效果仍存在，但兩組織表現並無明顯差異。即時回饋及終端回饋皆可增進關節鬆動術之學習效果。

The aim of this study was to evaluate the effect of quantitative concurrent feedback and terminal feedback of performance on learning of joint mobilization. A Joint Translation Simulator (JTS) was designed to simulate tissue response during mobilization. Load-displacement relationships recorded from material testing of specimens were used as practicing models. The Grade II and Grade III force were determined experimentally based on Kaltenborn’s definition of Grades of mobilization. Thirty-six physical therapy students were randomly assigned into four groups: control group, no feedback group, concurrent feedback group, and terminal group. Control group received no skill training, and no feedback group learned to perform joint mobilization without any quantitative feedback. Concurrent or terminal feedback of the performance which contained standard force and applied force was given respectively to the two feedback groups via a monitor. The three experimental groups practiced for 75 trials in each grade of each model while applied forces were measured. This testing was done prior to training (pretest), immediately after training (immediate retention test), and five days after learning phase (delayed retention test). Normalized absolute errors were calculated and analyzed. The results indicated that both concurrent and terminal feedback groups performed more accurately and consistently during acquisition phase than did the no feedback group. Performance of subjects who received feedback while practicing significantly improved during immediate retention tests and five days after training sessions. However, results of our study did not provide further support for the guidance hypothesis. Learning effects of mobilization skills can be enhanced either by quantitative concurrent feedback or by terminal feedback.

中文摘要	…………………………………………………………………	I
ABSTRACT	…………………………………………………………………	III
誌謝	………………………………………………………………	V
CONTENTS	………………………………………………………………	VI
TABLE LIST	………………………………………………………………	VIII
FIGURE LIST	………………………………………………………………	IX

CHAPTER 1	INTRODUCTION	1
1.1	Joint Mobilization ………………………	1
1.2	Grading Principles of Joint Mobilization ………………………………	3
1.3	Conventional Methods to Quantify Joint Mobilization Force ……………	5
1.4	Methods of Performance Assessment after Learning …………………………	9
1.5	Feedback and Guiding Hypothesis for Skill Learning …………………………	10
1.6	Learning of Joint Mobilization with Feedback ………………………………      15
1.7	Motivations and Purposes ……………………………………………………	18
CHAPTER 2	MATERIALS AND METHODS	19
2.1	Instrumentation Design ………………………………………………………	19
	2.1.1	Establishment of the Criterion Models ………………………………	19
	2.1.2	Determination of Standard Grade II and Grade III Force ……………	22
	2.1.3	Calibration of Force Transducer ………………………………………	25
	2.1.4	Joint Translation Simulator Design ……………………………………	26
2.2	Experimental Procedures ………………………………………………………	32
	2.2.1	Subject Assignment and Instruction …………………………………	32
	2.2.2	Practice ………………………………………………………………	33
	2.2.3	Pretest …………………………………………………………………	34
	2.2.4	Skill Acquisition ………………………………………………………	34
	2.2.5	Immediate Retention Test ……………………………………………	35
	2.2.6	Delayed Retention Test ………………………………………………	36
2.3	Data Processing and Analysis …………………………………………………	38
CHAPTER 3	RESULTS	40
3.1	Learning Performance during Skill Acquisition ………………………………	40
3.2	Effect of Different Categories of Feedback on Skill Learning ………………	44
3.3	Effect of Long-Term Transfer of Learning ……………………………………	49
CHAPTER 4	DISCUSSION	51
4.1	Skill Acquisition of Joint Mobilization ………………………………………	51
4.2	Effects of Different Categories of Feedback …………………………………	56
4.3	Long-Term Transfer of Learning ………………………………………………	59
4.4	Limitations ……………………………………………………………………	61
CHAPTER 5	CONCLUSIONS	64
REFERENCES …………………………………………………………	65
                                    

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校內：2003-07-29公開
校外：2003-07-29公開

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