Journal of Taiwan Occupational Therapy Research and Practice
本研究旨在探討左腦中風患者在功能性雙側協調活動之運動學表現，並比較不同前導手（首先啟動之手）的動作表現差異。15位左腦傷中風患者與13位健康成人執行伸手抓握瓶子，並將蓋子打開的雙手協調活動。所有受測者皆執行兩種任務：健側手（左手）為拿瓶子手，患側手（右手）為開蓋子手；或相反。利用三維運動學分析來量測執行雙手協調活動時的單側肢體表現及雙側肢體協調。 結果顯示當患側手為前導手時，患側肢體顯著地較健常人沒有效率、動作軌跡不平順且仰賴事後回饋，然而，在動作結束時仍然可以雙手同步；而當健側手為前導手時，患側肢體的表現趨近健常人，同時也在達到動作目標時雙側同步結束。 在雙手協調活動中，患者患側肢體的表現型態隨著前導手的不同而有所差異，但雙側同步性仍被保留下來。臨床應用上可以透過以健側手為前導手的雙側協調活動，來促進患側肢體的動作表現。
Most studies investigating impaired hand function in patients with stroke have focused on either the affected or the unaffected hand alone. Coordination of the affected and unaffected hand during bimanual tasks in the stroke population is not well understood. The present study examined bimanual coordination using a jar-opening task under hand constraint in fifteen patients with left cerebral vascular accident (CVA) and thirteen age-matched healthy controls. Participants were instructed to reach to grasp a jar with one hand (i.e., the leading hand) and to open the cap with the other hand (i.e., the non-leading hand). The roles of the two hands (reaching to grasp the jar and opening the cap) were varied. Participants with left CVA moved less efficiently and directly, and depended more on feedback control with the affected hand when the affected hand initiated the task, but moved with similar patterns when the unaffected hand initiated the task compared to the healthy adults. Moreover, interlimb coordination was not significantly different between the two groups. The results indicated that the bimanual movement performance after left CVA varied depending on the side of the leading hand but bimanual coordination was preserved.