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研究生: 李澤羲
Li, Ze-Si
論文名稱: 探討認知功能正常與輕度障礙高齡者平衡與步態表現之差異
Difference in Balance and Gait Performance between Normal Cognition and Mild Cognitive Impairment Elderly People
指導教授: 邱文信
Chiu, Wen-Hsin
口試委員: 相子元
Shiang, Tzyy-Yuang
涂瑞洪
Tu, Jui-Hung
學位類別: 碩士
Master
系所名稱: 竹師教育學院 - 運動科學系
Physical Education
論文出版年: 2023
畢業學年度: 111
語文別: 中文
論文頁數: 38
中文關鍵詞: MoCA認知篩檢步態變異性平衡能力姿勢控制
外文關鍵詞: MoCA cognitive screening, gait variability, balance ability, posture control
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  • 目的:探討認知功能正常與輕度障礙兩組高齡者平衡與步態之差異。方法:本研究於新竹市C級照護據點招募41名高齡者,事先透過30秒椅子坐立與MoCA認知檢測進行篩選與分組,共納入30名作為收案對象,再藉由Zebris足底壓力板進行靜態平衡能力與步態表現檢測。統計方法採用獨立樣本t檢定針對各項參數進行組間考驗。結果:在平衡方面,輕度認知障礙組無論是X或Y軸位移以及COP晃動面積皆顯著大於認知功能正常組;輕度認知障礙族群在標準化步長、行走速度皆低於認知功能正常組,而步態不對稱指標則顯著高於認知正常組;最後在步態變異性的部分,輕度認知障礙族群於行走速度、雙腳支撐期、步幅時間之變異性皆高於認知功能正常組(p < .05)。結論:由上述結果可得知,在輕度認知障礙族群中可觀察到與認知功能相關的平衡與步態變化,又以COP晃動面積、標準化步長、行走速度與不對稱指標達顯著差異。換言之,當人體無法有效控制行走動作時,會藉由調整行走策略以提升穩定性。若無法有效處理與整合訊息,將導致步態週期間出現較大變異性,進而增加跌倒的機率。由此可知,步態檢測可作為評估認知功能的預測指標。使用步態表現評估認知功能優劣時,需特別著重行走速度、標準化步長,另可將步態變異性與不對稱指標納入探討。建議未來學者在從事相關議題的研究時,可考慮將失智症患者納入研究,以藉此提供醫療人員或職能治療單位更完整的學理知識,並提出藉由步態表現預測認知功能優劣的具體執行方法。


    Purpose: This study investigated the differences in balance and gait between elderly people with normal cognitive function and those with mild cognitive impairment. Method: Subjects were recruited at a C-level care site in Hsinchu City, and were excluded and grouped by a 30-second chair sit-to-stand and MoCA cognitive function screening, and then tested for static balance and gait performance using a Zebris foot pressure plate. The Zebris foot pressure plate was then used to test static balance and gait performance. The post-test was conducted using independent sample t-tests for each parameter. Result: In terms of balance, the mild cognitive impairment group had significantly greater X- or Y-axis displacement and COP sway area than the cognitively normal group; the mild cognitive impairment group had lower standardized stride length and walking speed than the cognitively normal group, while the gait asymmetry was significantly higher than the cognitively normal group. Finally, the gait variability was higher in the group with mild cognitive impairment than in the group with normal cognitive function (p < .05). Conclusion: From the above results, it can be seen that balance and gait changes related to cognitive function were observed in the mild cognitive impairment group, with the most significant changes in COP sway area, standardized stride length, walking speed, and asymmetry indicators. In other words, when the body cannot effectively control walking movements, it will adjust its walking strategies to improve stability. In the case of muscle weakness, the key to maintaining gait stability is the ability to perform and process cognitive functions such as speed, and the inability to effectively process and integrate information will lead to greater variability in gait cycle and increase the probability of falls. Therefore, it is recommended that future occupational therapy units should incorporate appropriate cognitive stimulation in their training programs to enhance the cognitive functions, postural control, and multi-tasking abilities of the elderly. In addition, when conducting gait testing or related experiments, researchers can take into account the cognitive function of the subjects and conduct in-depth studies on gait variability.

    摘要 II 誌謝 V 目次 VI 表次 VIII 圖次 VIII 第一章 緒論 1 第一節 研究背景 1 第二節 研究目的 3 第三節 研究假設 3 第四節 名詞操作型定義 3 第五節 研究範圍與限制 6 第二章 文獻探討 7 第一節 老化對生理與認知功能的影響 7 第二節 認知對平衡能力的影響 9 第三節 認知對步態的影響 10 第四節 文獻總結 11 第三章 研究方法 13 第一節 研究架構 13 第二節 研究對象 13 第三節 研究日期與地點 14 第四節 研究器材與設備 14 第五節 實驗場地與儀器架設 16 第六節 實驗流程與步驟 17 第七節 資料處理 18 第八節 統計方法 19 第四章 結果 20 第一節 受試者基本資料 20 第二節 認知功能正常與輕度認知障礙組平衡表現差異 21 第三節 認知功能正常與輕度認知障礙組步態參數差異 21 第四節 認知功能正常與輕度認知障礙組步態變異性差異 22 第五章 討論與結論 23 第一節 討論 23 第二節 結論與建議 27 參考文獻 28

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