Journal of Taiwan Occupational Therapy Research and Practice
動作協調障礙是生理障礙領域職能治療師常處理的問題，臨床上，職能治療師依據動作學習理論設計活動讓患者練習並給予口語回饋，循序漸進增加個案的動作技巧，並強化其動作精確度以改善不協調。然而研究指出傳統復健型式耗費時間、人力與資源，且受個案配合度影響，而重複練習難以維持個案動機，同時缺乏提供一致回饋。本研究之目的是調查職能治療師在臨床上有關動作協調訓練的現況，同時了解治療師對於互動式聲光協調訓練設備應具備的功能之期待。本研究為設計互動式協調訓練設備之先導研究，以問卷調查方式蒐集職能治療有關協調訓練的現況，以及治療師對協調訓練設備的期待，以提供設計互動式協調訓練設備的參考。本研究以配額採樣方法依據地區以及機構屬性比例決定取樣數，再採便利樣本（a convenience sample）共收集200份問卷。結果顯示在協調訓練現況方面，臨床上最常使用傳統活動來訓練協調，除此之外也使用機械設備輔助訓練（68.5%），少數治療師使用科技化產品（20.5%），如X-Box、互動式健康服務系統（Hot Plus）及Wii等。對互動式協調訓練設備的期待方面，治療師希望互動式協調訓練設備具備多功能、多種刺激、可調整刺激、提供多種回饋以及可量化表現。治療師期望所提供的刺激及回饋型式有視覺、聽覺及本體覺。視覺以影像及圖片為主，聽覺以音效及語音為主，本體覺則為震動。除了配備上述的感覺刺激與回饋外，未來互動式協調訓練設備的設計應同時考量治療師活動困難度分級的需求，具備刺激以及回饋皆可調整的設計，以達到協調訓練的目的。
Motor incoordination is one of the most prevalent clinical conditions that occupational therapists dealing with. Traditionally, occupational therapists design therapeutic activities for clients and give verbal feedbacks for their performance. By grading up demands for more controlled and precise movements, motor coordination can be improved sequentially. However, studies have demonstrated conventional rehabilitation to be time-consuming, labor- and resource-intensive. Also, repeated practice decreases motivation of clients, and the feedbacks have been inconsistent over time. This study was the pilot study conducted to collect information for designing interactive multi-sensory coordination training devices. Current clinical practices regarding coordination training and the expectations of occupational therapists about interactive coordination training modalities are surveyed by the questionnaire. Occupational therapists in Taiwan that work in the field of physical dysfunction were stratified based on districts and the institute class, and followed by convenient sampling. 200 occupational therapists were sampled. The results indicate that traditional low-tech modalities (100%), robotic-assisted devices (such as bimanual hand bikes) (68.5%), and daily activities (62%) are the most frequently used therapeutic tools for coordination training. A few therapists (20.5%) also use off-the-shelf products of interactive games such as X-Box, Hot Plus, and Wii. Therapists have denoted a desire for devices that combines multiple functions with variable and adjustable stimulus/feedbacks that provides quantitative outcomes. The most desired sensory stimulus and feedbacks provided by the device including images and pictures for visual stimulus/feedback; sound effects and speech output for auditory stimulus/feedback; and vibration for proprioceptive stimulus/feedback. In conclusion, aforementioned sensory stimulation and feedback modes can be considered when designing interactive multi-sensory coordination training devices, also the challenges of activities as well as stimulations and feedbacks should be adjustable in order to fulfill the needs of activity grading.