手腳協調訓練對腦中風病患之初步改善成效──個案報告

The Primary Improvement of Hands and Feet Coordinate Training on Stroke Patients - Case Report

隨社會高齡化比重增加，臺灣65歲以上人口比例已達13.49%，此族群罹患腦血管疾病的比例也逐漸攀升。105年國人十大死因中，腦血管疾病位居第四位。此疾病造成腦部血液循環不良，腦細胞受損影響認知、動作完成的順暢度，導致平衡下降、走路速度慢、血管性失智症…等。手腳協調訓練是藉由感覺、運動以及神經系統的整合讓動作對稱、精準。本研究目的是希望藉由手腳協調訓練改善腦中風病患的動作流暢度，進一步改善其平衡、走路速度、心肺耐力與認知。研究方法：本研究以3位腦中風個案，其能力皆為Brunnstrom stage V以上，無不正常張力，於亞急性期開始執行手腳協調訓練，一週2次，每次60分鐘，為期12週。於介入前後以伯格式平衡量表、五公尺行走測試、六分鐘行走測驗與聖路易大學心智狀態測驗評估。研究結：三位病患結束訓練後，平衡分數改變均進步9分以上；走路速度亦均改善大於0.1公尺／秒；心肺耐力皆有增加59公尺以上，其中一位在前測時無法完成，但三個月後可完成測驗；認知分數亦均進步7分以上。結論：手腳協調訓練對於腦中風病患除有功能上改善的成效，在認知方面也有進步的成效。未來可運用在輕度認知障礙之患者上，降低社會與醫療成本的支出。 With the increase in the proportion of aging society, Taiwan's population over the age of 65 has reached 13.49%. The proportion of this ethnic group suffering from cerebrovascular disease has also gradually increased. Among the top ten causes of death in 105 years, cerebrovascular diseases ranked fourth. This disease causes poor blood circulation in the brain. The damage of brain cells affects the smoothness of cognition and the completion of movements, resulting in decreased balance, slow walking, and vascular dementia. The coordination of hands and feet is the symmetry and precision of movements through the integration of feeling, movement and nervous system. The purpose of this study is to improve the fluency of stroke patients with hand-foot coordination training and further improve their balance, walking speed, cardiorespiratory endurance and cognition. Research Methods: In this study, 3 stroke cases with the ability to be above Brunnstrom stage V and no abnormal tension were performed. In the subacute phase, hand and foot coordination training was started. It was performed twice a week for 60 minutes for 12 weeks. Before and after the intervention, the Boer format balance scale, the five-meter walking test, the six-minute walking test, and the assessment of the mental state of the Saint Louis University were used. Results: After the three patients finished training, the changes in balance scores all improved by more than 9 points; the walking speed also improved by more than 0.1 meters/second; both cardio-pulmonary endurance increased by 59 meters and one of them could not be tested before. Completed, but the test can be completed after three months; cognitive scores also improve by more than 7 points. Conclusion: The hand-foot coordination training has a functional improvement effect on cerebral stroke patients, and it also has a progressive effect in terms of cognition. In the future, it can be used in patients with mild cognitive impairment to reduce social and medical costs.