摘要
目的：本研究目的為探討復健運動課程對腦中風患者平衡能力及憂鬱狀況之
影響。方法：招募 40 位腦中風患者為研究對象，分為 3 組：醫院運動組 17 位、
居家運動組 9 位及控制組 14 位。醫院運動組除醫院傳統的物理/職能治療課程與
醫生處方外，增加由教練指導復健運動課程(每週三次，每次 60 分鐘) ；居家運動
組除醫院傳統的物理/職能治療課程或醫療處方外，增加給予復健運動課程小冊
子在家自我練習； 控制組僅進行醫院傳統的物理/職能治療課程或醫療處方。 並於
復健運動課程前、後實施平衡能力(伯格氏平衡量表)與憂鬱狀況(貝式憂鬱量表)
測驗。使用描述性統計、相依樣本 t 檢定和單因子共變數分析，比較各項測量值
之差異情形，顯著水準訂為 α = .05。結果：一、經過復健運動課程介入後，平衡
能力，醫院運動組與居家運動組優於控制組，統計達顯著差異；( p < .05 )。二、
經過復健運動課程介入後 ，憂鬱狀況， 醫院運動組與居家運動組沒有優於控制組，
統計未達顯著差異( p > .05 )。結論：腦中風患者經過復健運動課程介入後平衡能
力有顯著的改善效益，將有助於減少跌倒風險，並進一步提高日常生活品質與獨
立生活能力，提供腦中風患者新的運動選項。

Abstract
Objective: The purpose of this study was discussion the effects of rehabilitative
exercise on balance and depression in stroke patients. Method: Forty patients with
stroke patients were recruited in cooperation. Into 3 groups according : the do
rehabilitative exercise on hospital group 17 patients, another is do rehabilitative
exercise at home group 9 patients and the control group 14 patients. Do physical
therapy / occupational therapy for three group, besides group on hospital is extra do
extra do 12-week rehabilitative exercise by coaches instruct. And group at home is
extra do extra do 12-week rehabilitative exercise by rehabilitative exercise book at
home. Result: 1. Balance ability, hospital group and home group, their balance ability
were the superior to control group, statistical significant difference.(p< .05) 2.
Depression, hospital group and home group, their were not the superior to control
group, statistics did not reach significant difference. ( p >.05) Conclusion: Stroke
patients after 12 weeks of rehabilitative exercise interventional balance after a
significant improvement in the effectiveness of the situation. Will help to reduce the
risk of falls, and further improve the quality of daily life and independent living ability
to provide stroke patients with new exercise option.

參考文獻
行政院衛生福利部統計處（2016 年，8 月 5 日）。104 年度死因統計。取自
http://www.mohw.gov.tw/cht/DOS/Statistic.aspx?f_list_no=312&fod_list_no=62
01
行政院經濟建設委員會（2012，8 月 24 日）。中華民國 2012 年至 2060 年人口
推估【行政院經濟建設委員會】 。取自
http://cdnet.stpi.narl.org.tw/techroom/policy/2012/policy_12_037.htm
李昭慶（2000）。憂鬱症與運動，大專體育，50，82-88。
李肇中、王瑞瑤、楊雅如 （2003） 。中風患者功能性平衡評估測試之相關性探討。
物理治療，28，139-146。
吳玟蕙（2012）。 我國老人憂鬱程度，健康狀況與醫療服務利用之相關性探討-2005
年國民健康訪問調查資料分析（未出版之碩士論文） 。亞洲大學，台中市。
吳家碧、劉兆達（2007）。憂鬱症的運動治療，大專體育，90，170-176。
吳姿蓉、李美樺、劉紋妙（2012） 。初次腦中風病患記憶表現及其相關因素探討。
澄清醫護管理雜誌，8，36-44。
吳英黛、劉千綺、鄭建興（2008） 。慢性中風病人的物理治療需求。腦中風會訊，
15，13-16。
何正宇、王志龍、盧玉強、孫淑芬、張兆宏、蔡欣宜（2010）。以 Wii
TM
建構虛
擬實境輔助慢性中風患者復健訓練之療效評估。台灣復健醫學雜誌，38，
11-18。
何祖華、薛漪平、謝清麟（1999） 。腦中風患者復健入院時平衡能力與出院日常
生活功能之關聯。慈濟醫學，12，43-48。
林昭宏、柴惠敏、廖龍仁、黃昭郎、陳美汀、廖小瑤（2003） 。社區居民腦中風
患者日常生活活動和生活品質的調查研究。物理治療，28，243-250。
邱弘毅（2008） 。腦中風之現況與流行病學特徵。腦中風會訊，15，2-4。
37
邱弘毅 （2015） 。亞急性暨長期照護之現況與未來～以中風為例～。 腦中風會訊，
22，4-7。
徐敏、趙安安、鍾灼輝、劉華孝、高尚仁（2010） 。國際研究對中醫心理學之貢
獻: 以針灸、氣功、太極、靜坐爲例。應用心理研究，46，93-123。
高毓霠、 徐文峰（2008） 。淨化身心靈重建健康之本。禪天下，80，56-57。
柯慧貞（1989）。內因性與非內因性憂鬱症在腎上腺素抑制反應、認知偏差及生
活壓力上之比較（未出版之博士論文） 。台灣大學心理研究所，台北市。
陳家慶、林春香、陳俐君、魏于鈞、蕭蓉、林南岳、梁忠詔（2010） 。復健運動
對於改善社區骨關節炎及中風老人身體功能之成效：前驅研究。台灣復健醫
學雜誌，38，97-105。
程遠揚、周正亮、鄭舜平、劉作仁、詹瑞棋（2005）。中老年人中風後憂鬱症之
危險因子相關分析。臺灣復健醫學，33，149-159。
張文典、楊雯如、莊文玲、黎秉東（2011）。居家物理治療方案成果之先驅性研
究： 以苗栗縣某服務單位爲例。長期照護雜誌，15，121-129。
張家銘（2009 年，2 月，27 日）。EQ 殺手-認識憂鬱【台灣憂鬱症防治協會】 。取
自 http://www.depression.org.tw/
傅中玲（2000）。腦中風後病患的精神問題。腦中風會訊，7，9-10。
黃鳳珍、江秀珠、黃玉雰、羅良月（2007）。一位腦中風後身體心像紊亂患者之
照護經驗。長期照護雜誌，11，392-401
廖建彰、李采娟、林瑞雄、宋鴻樟（2006） 。2000 年台灣腦中風發生率與盛行率
的城鄉差異。臺灣公共衛生雜誌，25，223-230。
蔡宜秀、孫明輝、陳秋美、郭憲文、洪麗珍（2003）。急性缺血性腦中風病患延
遲到醫相關因素之探討。 Mid-Taiwan Journal of Medicine，8，36-42。
劉芹芳、江秀珠、黃玉雰 （2006）。 一位腦中風病患之照護經驗。高雄護理雜誌，
23，54-66。
蕭淑貞（2005）。腦中風病患之日常活動自我效能及其相關因素（未出版之碩士
38
論文） 。高雄醫學大學，高雄市。
謝清麟（1999）。居家職能治療對剛出院中風病人之療效。行政院國家科學委員
會專題研究計畫成果報告。 （編號：NSC88-2418 -B-002-283），未出版。
謝明鴻、賴德仁 （2005）。 老年憂鬱症：目前之議題。臺灣精神醫學，19 ，85-99。
胡名霞（2004）。腦中風復健的第一步-擺位與翻身。 健康世界 ， 222 ， 17-20 。
羅靜婷、蔡家梅、李麗娜、陳昭吟、林麗味、陳美妃（2002）。成人慢病護理學。
台北市：新文京。
American Physical Therapy Association (2003). Guide to physical therapist practice.
Alexandria, VA : American Physical Therapy Association.
Billinger, S. A., Arena, R., Bernhardt, J., Eng, J. J., Franklin, B. A., Johnson, C. M., ...
& Shaughnessy, M. (2014). Physical Activity and Exercise Recommendations for
Stroke Survivors A Statement for Healthcare Professionals From the American
Heart Association/American Stroke Association. Stroke, 45, 2532-2553.
Bean, J. F., Vora, A., & Frontera, W. R. (2004). Benefits of exercise for
community-dwelling older adults. Archives of Physical Medicine and
Rehabilitation, 85, 31-42.
Berg, K., Wood-Dauphine, S., Williams, J. I., & Gayton, D. (1989). Measuring balance
in the elderly: preliminary development of an instrument. Physiotherapy Canada,
41, 304-311.
Berg, K., W ood-Dauphinee, S., & Williams, J. I. (1995). The Balance Scale: reliability
assessment with elderly residents and patients with an acute stroke. Scandinavian
Journal of Rehabilitation Medicine, 27, 27-36.
Chen, I. C., Cheng, P. T., Hu, A. L., Liaw, M. Y., Chen , L. R. , Hong, W. H., & Wong,
M. K. (2000). Balance evaluation in hemiplegic stroke patients. Chang Gung
Medical Journal, 23, 339-346.
Corriveau, H., Hebert, R., Raiche, M., & Prince, F. (2004). Evaluation of postural
39
stability in the elderly with stroke. Archives of Physical Medicine and
Rehabilitation, 85, 1095-1101.
Dettmann, M. A., Linder, M. T., & Sepic, S. B. (1987). Relationships among walking
performance, postural stability, and functional assessments of the hemiplegic
patient. American Journal of Physical Medicine & Rehabilitation, 66, 77-90.
Duncan, P., Studenski, S., Richards, L., Gollub, S., Lai, S. M., Reker, D., ... & Johnson,
D. (2003). Randomized clinical trial of therapeutic exercise in subacute stroke.
Stroke, 34, 2173-2180.
Eyigor, S., Karapolat, H., & Durmaz, B. (2007). Effects of a group-based exercise
program on the physical performance, muscle strength and quality of life in older
women. Archives of Gerontology and Geriatrics, 45, 259-271.
Forster, A., & Young, J. (1995). Incidence and consequences of falls due to stroke: a
systematic inquiry. British Medical Journal, 311, 83-86
Feng, W., Hendry, R. M., & Adams, R. J. (2010). Risk of recurrent stroke, myocardial
infarction, or death in hospitalized stroke patients. Neurology, 74, 588-593.
Jorgensen, H. S., Nakayama, H., Raaschou, H. O., Vive-Larsen, J., Stoier, M., & Olsen,
T. S. (1995). Stroke rehabilitation: Outcome and speed of recovery. Part II: Speed
of recovery. The Copenhagen Stroke Study. Archives of Physical Medicine and
Rehabilitation, 76, 406-412.
Hsieh, L., & Kao, H. (2005). Depressive symptoms following ischemic stroke: a study
of 207 patients. Acta Neurologica Taiwanica, 14, 187.
Hamzat, T. K., & Kobiri, A. (2008). Effects of walking with a cane on balance and
social participation among community-dwelling post-stroke individuals.
European Journal of Physical and Rehabilitation Medicine, 44, 121-126.
Hales, R. E., & Yudofsky, S. C. (1996). Synopsis of psychiatry. Washington: American
Psychiatry Press
40
Hackett, M. L., Yapa, C., Parag, V., & Anderson, C. S. (2005). Frequency of
depression after stroke. Stroke, 36, 1330-1340.
Kirker, S. G., Jenner, J. R., Simpson, D. S., & Wing, A. M. (2000). Changing patterns
of postural hip muscle activity during recovery from stroke. Clinical
Rehabilitation, 14, 618-626.
Kvam, S., Kleppe, C. L., Nordhus, I. H., & Hovland, A. (2016). Exercise as a
treatment for depression: A meta-analysis. Journal of Affective Disorders, 202,
67-86.
Martinsen, E. W. (1990). Benefits of exercise for the treatment of depression. Sports
Medicine, 9, 380-389.
Mead, G. E., Greig, C. A., Cunningham, I., Lewis, S. J., Dinan, S., Saunders, D. H., ...
& Young, A. (2007). Stroke: a randomized trial of exercise or relaxation. Journal
of the American Geriatrics Society, 55, 892-899.
Maeda, N., Kato, J., & Shimada, T. (2009). Predicting the probability for fall incidence
in stroke patients using the Berg Balance Scale. Journal of International Medical
Research. 37, 697-704.
Nichols, D. S. (1997). Balance retraining after stroke using force platform biofeedback.
Physical Therapy, 77, 553-558.
Niam, S., Cheung, W., Sullivan, P. E., Kent, S., & Gu, X. (1999). Balance and physical
impairments after stroke. Archives of Physical Medicine and Rehabilitation, 80,
1227-1233.
Overstall, P. W., Exton-Smith, A. N., Imms, F. J., & Johnson, A. L. (1977). Falls in the
elderly related to postural imbalance. British Medical Journal, 1, 261-264.
Pulaski,K.(2003).Adult neurological dysfunction. Willard & Spackman’s Occupational
Therapy, 767-788.
Perry, J., & Burnfield, J. M. (1992). Gait analysis: normal and pathological function.
41
Second Edition
Robertson, M. C., Devlin, N., Gardner, M. M., & Campbell, A. J. (2001a).
Effectiveness and economic evaluation of a nurse delivered home exercise
programme to prevent falls. 1: Randomised controlled trial. British Medical
Journal, 322, 697.
Robertson, M. C., Gardner, M. M., Devlin, N., McGee, R., & Campbell, A. J. (2001).
Effectiveness and economic evaluation of a nurse delivered home exercise
programme to prevent falls. 2: Controlled trial in multiple centres. British
Medical Journal, 322, 701.
Robinson, R. G., & Spalletta, G. (2010).Poststroke depression: review. Canadian
Journal of Psychiatry, 55, 341–349.
Sivan, M., & Bhakta, B. (2008). Restoring mobility: theories, technologies and
effective treatments. Clinical Medicine (London, England), 8, 596-600.
Sackley, C. M., Baguley, B. I., Gent, S., & Hodgson, P. (1992). The use of a balance
performance monitor in the treatment of weight-bearing and weight-transference
problems after stroke. Physiotherapy, 78, 907-913.
Skelton, D., Dinan, S., Campbell, M., & Rutherford, O. (2005). Tailored group
exercise (Falls Management Exercise—FaME) reduces falls in
community-dwelling older frequent fallers (an RCT). Age and Ageing, 34,
636-639.
Stevenson, T. J., & Garland, S. J. (1996). Standing balance during internally produced
perturbations in subjects with hemiplegia: validation of the balance scale.
Archives of Physical Medicine and Rehabilitation, 77, 656-662.
Solomon, N. A., Glick, H. A., Russo, C. J., Lee, J., & Schulman, K. A. (1994). Patient
preferences for stroke outcomes. Stroke, 25, 1721-1725.
Shimada, H., Uchiyama, Y., & Kakurai, S. (2003). Specific effects of balance and gait
42
exercises on physical function among the frail elderly. Clinical Rehabilitation, 17,
472-479.
Schmid, A.A., Van Puymbroeck, M., Altenburger, P. A., Schalk, N. L., Dierks, T.A.,
Miller, K.K., … & Williams, L. S. (2012). Poststroke balance improves with yoga:
a pilot study. Stroke, 43, 2402-2407.
Saeys, W., Vereeck, L., Truijen, S., Lafosse, C., Wuyts, F. P., & Van de Heyning, P.
(2012). Randomized controlled trial of truncal exercises early after stroke to
improve balance and mobility. Neurorehabilitation and Neural Repair, 26,
231-238.
Skelton, D. A., Young, A., Greig, C. A., & Malbut, K. E. (1995). Effects of resistance
training on strength, power, and selected functional abilities of women aged 75
and older. Journal of the American Geriatrics Society, 43, 1081-1087.
Skelton, D. A., & McLaughlin, A. W. (1996). Training functional ability in old age.
Physiotherapy, 82, 159-167.
Teasell, R. W., Foley, N. C., Bhogal, S. K., & Speechley, M. R. (2015). An
evidence-based review of stroke rehabilitation. Topics in Stroke Rehabilitation, 10,
29-58.
Tyson, S. F., Hanley, M., Chillala, J., Selley, A., & Tallis, R. C. (2006). Balance
disability after stroke. Physical Therapy, 86, 30-38.
Tung, F. L., Yang, Y. R., Lee, C. C., & Wang, R. Y. (2010). Balance outcomes after
additional sit-to-stand training in subjects with stroke: a randomized controlled
trial. Clinical Rehabilitation, 24, 533-542.