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題 名 | 大腦運動控制評估系統之研製與臨床評估=The Development and Clinical Evaluation of Brain Motor Control Assessment System |
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作 者 | 陳友倫; 張恆雄; 張傳濱; 林晉豐; 鄧復旦; 郭德盛; | 書刊名 | 中華醫學工程學刊 |
卷 期 | 20:1 2000.03[民89.03] |
頁 次 | 頁19-24 |
分類號 | 410.1644 |
關鍵詞 | 脊髓損傷; 大腦運動控制評估; 表面肌電圖; 運動控制剖析; SCI; Spinal cord injury; SEMG; Surface electromyography; BMCA; Brain motor control assessment; MCP; Motor control profile; |
語 文 | 中文(Chinese) |
中文摘要 | 脊髓損傷(SCI)的病患,在臨床上一般可區分為兩類:1.完全脊髓損傷(complete SCI),指在受傷後受傷部位以下運動及感覺功能完全喪2.不完全脊髓損傷(incomplete SCI),指在受傷後受傷部位以下運動神經及感覺神經功能部分喪失。近年來,臨床人員發現完全脊髓損傷的病患,有些並非完全沒有神經傳導反應,而可用一些臨床刺激技巧,來測試病患的神經傳導反應。這些誘發神經反應的方法,即統稱為大腦運動控制估制(BMCA),經由此系統可誘發出神經傳導反應之完全脊椎損傷病患稱為非完全脊髓損傷(discomplete SCI)。本研究研製、整合一套功能完整的BMCA系統,主要擷取SCI病患平躺姿勢時其左、右下肢,腹部及椎邊肌等十二大肌群的表面肌電圖(SEMG)同時加上一些有意義的臨床評個方法:包括加強動作反應(頸部彎曲、Jendrassik’s maneuvers)及自主性、被動性的動作,其目的在於:1.診斷出非完全脊髓損傷的病患;2.由病患受傷的象動控制決定未來復健治療的方針;3.以客觀方法評估病患接受復健或其他治療後其運動控制改善之情況。本研究中,重新定義了運動控制(MCP),用以表示脊髓損傷病患整體的運動控制功能表現。其間共收集10位正常人,10位不完全脊髓損傷病患及20位完全脊髓損傷病患,進行大腦運動控制評估。在完全脊髓損傷病患中,發現有8位屬於非完全脊髓損傷病患;同時,對完全與非完全脊髓損傷二組病患的SEMG資料進行獨立t檢定;得p<0.05,證明二組間有明顯差異存在。又對正常人、完全、非完全及不完全脊髓損傷四組病患進行ANOVA分析;得p<0.05,表示四組間有明顯差異存在。初步測試證實,本研究所研製整合之大腦運動控制評估系統,具臨床診斷價值。 |
英文摘要 | In clinical diagnosis, spinal cord injury (SCI) patients can generally be classified into two major groups: 1)complete spinal cord injury, those individuals who have lost all sensory and motor functions after injury; 2)incomplete spinal cord injury, those who have several degree of sensory and motor recovery injury. Recently, investigators have found that a proportion of complete SCI patients show some residual superaspinal control monitored by multi-channel surface electromyography (SEMG). The term discomplet SCI was given to denote the patient still have some residual supraspinal control. Recording techniques of SEMG of lower limbs and trunk can be used to test nerve and muscle responses from the complete SCI group to determine whether or not a patient are discomplete SCI. This technique is called the brain motor control assessment (BMCA). The BMCA could be used to: 1)determine whether or not a patient has a discomplete injury; 2)decide the strategy of rehabilitation and/or intervention program; 3)determine whether or not the motor control pattern has improved after rehabilitation to forms of intervention program. In this study, a new modified motor control profile (MCP) was applied to denote the total motor performance of SCI. There are 10 normal subjects, 10 incomplete and 20 complete SCI were recruited. Among the complete SCI, 8 discomplete SCI patients were found. Independent t-test and ANOVA test were applied. Results showed the difference between complete and discomplete SCI is significant; p<0.05, and also showed the significant difference among normal, complete SCI, discomplete SCI and incomplete SCI; p<0.05. Therefore, this development and integration of BMCA system had a great potential of clinical applications. |
本系統中英文摘要資訊取自各篇刊載內容。