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實驗室簡介

本實驗室成立之宗旨為建立生物力學相關的評量儀器來協助臨床專業研究者從事臨床研究，期望發展出更確切、合適之臨床治療方案及策略；並提供客觀具體化的數據，在病理機轉的了解、損傷失能的分析、治療變化的偵測上，有更深入的剖析。

實驗室主持人

吳菁宜老師

陳嘉玲醫師

實驗室成員

陳貞夙老師

沈宜璇老師

連恆裕老師

林燕慧老師

張雅如老師

劉文瑜老師

程欣儀老師

陳信壅老師

李冠逸老師

朱彥穎老師

研究方向及研究計畫

l   研究方向

本實驗室研究方向以行為與神經復健為主軸，在轉譯科學的後實證治療(Evidence-base practice)的時代，藉由生物力學之基礎科學知識，提供科學性的評估方式，對於神經復健治療前後肢體動作變化，提供動作控制機轉的量化證據。在臨床上適用於以下個案：

1.      神經性疾病患者，如腦中風、腦外傷、腦性麻痺之上肢肢體協調性與步態分析

2.      骨科方面之病患，用於肢體損傷或重建術後之動作評估。

詳細具體之研究方向大致可分為以下幾項：

1.  動作控制分析

上、下肢是執行功能的重要肢體，軀幹扮演穩定肢體以進行任何功能性活動的角色，兩者隨著環境的變化而做適當的調整，以形成協調性的結構進行目標性任務，除了動作執行系統外，感覺系統、注意力、前庭系統等也會共同協助姿勢的控制，對於因神經損傷而引發之姿勢與肢体動作障礙，其動作系統、感覺系統、知覺系統、環境系統等如何被中斷或受損，須深入探討以了解障礙的原因，利於下一步評量與介入模式的演進。

常檢測的活動包括上肢活動 (如：伸臂動作、伸手取物動作、兩手協調活動等)、下肢活動 (如：行走的步態)、軀幹動作(如神經性疾患平衡的維持、脊椎疾病之軀幹動作特徵等)、臉部動作 (如：口腔周圍肌肉協調性)、眼球活動(如：閱讀時眼球掃描型態)等。

2.  神經肌肉控制

運動學、運動力學、肌肉電學等之分析可收集不同層面的動作與神經資料，經由電腦化資料處理與計算的程式，將人體神經肌肉特質加以連續性參數量化，有助於了解神經疾患神經肌肉控制機轉。

3.  動作學習

近年來學習科學之研究重點在於研究動作學習之神經控制機制並以近代腦科學與神經行為科學理論為本，開發中樞神經系統疾患復健策略。在動作學習領域的研究上著重於感覺-動作整合歷程之研究，藉由生物力學分析，可監控動作學習過程的變化以及成果。

4.  整治性復健方案之探討

由於知識的累積、實証醫學的倡行、科技的快速發展，治療方式的創新與演進，探討治療的效果與適用的症狀或對象為神經復健學中的顯學之ㄧ，主要目的是設計整治性的復健治療手法(restorative rehabilitation)，其復健方案包含由感覺刺激法、動作任務訓練誘發腦重組、認知知覺功能訓練、複合式訓練等四大類，為探求治療的全面性療效，需應用科學化的評量方式來評估治療的機轉與效果，生物力學提供最佳之工具達至此目的。

l   目前進行中之研究計畫

Ø   吳菁宜老師

1.  分離與結合式中風復健治療手法之機制與長期療效探討

2.  以醫院和居家環境為基礎的中風病人近代上肢訓練計畫其相對成效及預測性模型之發展與探討

3.  機器輔助性雙側訓練對於中風病人之動作控制、動作功能及日常生活功能的訓練及治療強度效應之探討

Ø   陳貞夙老師

1.  臨床研究探討微創人工髖關節手術之成效

2.  進行單側人工髖關節完全置換術的老年個案跨越障礙物時之動態平衡之探討：三種不同手術手法及術後密集復健其成效之比較 (第二年)

研究設備

本實驗室佔地約38坪，除了置有以下生物力學相關設備與電腦，亦有研讀整理資料之空間供研究生使用。

1.    三度空間分析儀（3-D motion analysis system）

共有8台攝影機，可發出紅外線光，追蹤貼在人體上的反光球，以記錄動作的時間、空間特性，作運動學（kinematics）的分析。

2.  肌電圖（Electromyologram）：

測知運動瞬間肌肉活化的程度活化的時序，肌肉功用程度，用力的相對程度。

3.  測力板（force plate）

共有2塊力塊板，可測知人體站立時，足部與地面之作用力。

4.  眼動儀 (Eye tracker)

可追蹤並記錄眼球動作的軌跡，搭配適合的軟體可進行視覺及注意力相關的研究分析。

5.  懸吊運動支持系統 (Suspension exercise system)

包含懸吊之繩索及上方之軌道，在個案進行相關動作任務時提供支持，搭配三度空間分析儀及測力板可協助進行步態及平衡方面之分析研究。

研究成果

l   以下為本實驗室近期之生物力學相關研究之期刊發表論文(* 通訊作者)

Ø   吳菁宜老師

1.  Wu, C-Y., Chuang, L-L., Lin, K-C., Jang, Y. (submitted for publication). Reproducibility, responsiveness, and validity of two measures of instrumental ADL function in stroke survivors after rehabilitation. Disability and Rehabilitation. (SSCI)

2.  Wu, C-Y., Chuang, L-L., Lin, K-C., Chen, H-C., & Liu, J-S. (accepted for publication). Distributed constraint-induced therapy compared with bilateral arm training for the rehabilitation of upper limb motor control and functional abilities after stroke. Neurorehabilitation and Neural Repair. (SCI)

3.  Lin, K-C., Chuang, L-L., Wu, C-Y.,* & Hsieh, Y-W. (accepted for publication). Responsiveness and validity of three outcome measures of dexterous function in stroke rehabilitation. Journal of Rehabilitation Research and Development. (SSCI)

4.  Lin, K-C., T. Fu, Wu, C-Y.* Hsieh, Y-W., Chen, C-L., & Lee, P-C. (2010). Psychometric comparisons of the Stroke Impact Scale 3.0 (SIS 3.0) and Stroke-Specific Quality of Life Scale (SS-QOL). Quality of Life Research. 19, 435-443. (SCI)

5.  Lin, K-C., Fu, T., Wu, C-Y.,* Wang, Y-H., Liu, J-S., & Hsieh, C-J. (2010). Minimal detectable change and clinically important difference of the Stroke Impact Scale in stroke patients. Neurorehabilitation and Neural Repair, 24, 486-492. (SCI)

6.  Lin, K-C., Chung, H-Y., Wu, C-Y.*, Liu, H-L., Chen, C-L., Wai, Y-Y., Chen, I-H., Hsieh, Y-W., & Liu, J-S. (2010). Constraint-induced therapy versus control intervention in patients with stroke: An fMRI study. American Journal of Physical Medicine and Rehabilitation, 89, 177-185. (SCI)

7.  Lin, K-C., Chen, Y-A., Chen, C-L., Wu, C-Y.*, Chang, Y-F. (2010). The effects of bilateral arm training on motor control and functional performance in chronic stroke: a randomized controlled study. Neurorehabilitation and Neural Repair, 24, 42-51. (SCI)

8.  Lin, K-C., Chang, Y-F., Wu, C-Y.*, & Chen, Y-A. (2009). Effects of constraint-induced therapy versus bilateral arm training on motor performance, daily functions, and quality of life in stroke survivors. Neurorehabilitation and Neural Repair, 23(5), 441-448. (SCI)

9.  Lin, K-C. Hsieh, Y-W., Wu, C-Y.*, Chen, C-L., Jang, Y., & Liu, J-S. (2009). Minimal detectable change and clinically important difference of the wolf motor function test in stroke patients. Neurorehabilitation and Neural Repair, 23(5), 429-434. (SCI)

10.Lin, K-C., Wu, C-Y.*, Liu, J-S., Chen, Y-T., Hsu, C-J. (2009). Constraint-induced therapy versus dose-matched control intervention to improve motor ability, basic/extended daily functions, and quality of life in stroke. Neurorehabilitation and Neural Repair. , 23(2), 160-165. (SCI)

11.Lin, K-C., Huang, Y-H., Hsieh, Y-W., & Wu, C-Y.* (2009). Potential predictors of motor and functional outcomes after distributed constraint-induced therapy for patients with stroke. Neurorehabilitation and Neural Repair, 23(4), 336-342. (SCI)

12.Lin, K-C., Wu, C-Y.*, Liu, J-S. (2008). A randomized controlled trial of constraint-induced movement therapy after stroke. Acta Neurochirurgica, suppl. 101, 61-64. (SCI)

13.Wu, C-Y., Lin, K-C. (2007). Letter to the editor: Authors’ response. Neurorehabilitation and Neural Repair, 21(6), 574-575. (SCI)

14.Wu, C-Y., Chou, S-H., Chen, C-L., Kuo, M-Y., Lu, T-W., & Fu, Y-C. (2009). Kinematic analysis of a functional and sequential bimanual task in patients with left hemiparesis: Intra-limb and interlimb coordination. Disability and Rehabilitation, 31(12), 958-966. (SSCI)

15.Wu, C-Y., Chou, S-H., Kuo, M-Y., Chen, C-L., Lu, T-W., & Fu, Y-C. (2008). Effects of object size on intralimb and interlimb coordination during a bimanual prehension task in patients with left cerebral vascular accidents. Motor Control, 12(4), 296-310. (SCI)

16.Wu, C-Y., Chen, C-L., Tang, S. F., Lin, K-C., Huang, Y-Y. (2007). Kinematic and clinical analyses of upper-extremity movements after constraint-induced movement therapy in patients with stroke: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 88, 964-970. (SCI)

17.Lin, K-C., Wu, C-Y.*, Chen, C-L., Chern, J-S., Hong, W-H. (2007). Effects of object use on reaching and postural balance. American Journal of Physical Medicine and Rehabilitation, 86, 791-799. (SCI)

18.Lin, K-C., Wu, C-Y.*, Lin, K-H., & Chang, C-W. (2008). Effects of task instructions and target location on reaching kinematics in persons with and without cerebrovascular accident: A Study of the Less Affected Limb. American Journal of Occupational Therapy, 62(4), 456-465. (SSCI)

19.Chen, H-C., Lin, K-C., Chen, C-L., & Wu, C-Y.* (2008). The beneficial effects of a functional task target on reaching and postural balance in patients with right cerebral vascular accidents. Motor Control, 12(2), 122-135. (SCI)

20.Wu, C-Y., Lin, K-C., Chen, H-C., Chen, I-H., & Hong, W-H. (2007). Effects of modified constraint-induced movement therapy on movement kinematics and daily function in patients with stroke: A kinematic study of motor control mechanisms. Neurorehabilitation and Neural Repair, 21(5), 460-466. (SCI)

21.Lin, K-C., Wu, C-Y.*, Wei, T-H., Lee, C-Y, & Liu, S-J. (2007). Effects of modified constraint-induced movement therapy on reach-to-grasp movements and functional performance after chronic stroke: A randomized controlled study. Clinical Rehabilitation, 21(12), 1075-1086. (SCI)

22.Wu, C-Y., Chen, C-L., Tsai, W-C., Lin, K-C., Chou, S-H. (2007). A randomized, controlled trial of modified constraint –induced movement therapy for elderly stroke survivors: Changes in motor impairment, daily functioning, and quality of life. Archives of Physical Medicine and Rehabilitation, 88, 273-278. (SCI)

23.Hong, W-H., Lee, Y-H., Chen, H-C., Pei, Y-C., Wu, C-Y*. (2005). Influence of heel height and shoe insert on comfort perception and biomechanical performance of young female adults during walking. Foot and Ankle International, 12(26), 1042-1048. (SCI)

24.Wu, C-Y., Lin, K-C., Lin, K-H., Chang, C-W., & Chen, C-L. (2005) Effects of task constraints on reaching kinematics by healthy adults. Perceptual and Motor Skills, 100, 983-994. (SSCI)

25.Wu, C-Y., Wong, M-K., Lin, K-C., & Chen, H-C (2001). Effects of task goal and personal preference on seated reaching kinematics after stroke. Stroke, 32(1), 70-76. (SCI)

26.Lin, K-C., Tang, F-T., Chen, H-C., Wu, C-Y.*, & Shen, I-H. (2001). Effects of contextual constraints on reaching performance in adults without disabilities: A kinematic study. Occupational Therapy Journal of Research, 21(3), 168-184. (SSCI)

27.Wu, C-Y., Trombly, C. A., Lin, K-C., & Tickle-Degnen, L. (2000). A kinematic study of contextual effects on reaching performance in persons with and with out stroke: Influences of object availability. Archives of Physical Medicine and Rehabilitation, 81, 95-101. (SCI)

28.Wu, C-Y., Trombly, C. A., Lin, K-C., & Tickle-Degnen, L. (1998).Effects of object affordances on reaching performance in persons with and without cerebrovascular accident. American Journal of Occupational Therapy, 52(6), 447-456. (SSCI)

29.Lin, K-C., Wu, C-Y.*, & Trombly, C. A. (1998). Effects of task goal on movement kinematics and line bisection performance in adults without disabilities. American Journal of Occupational Therapy, 52(3), 179-187. (SSCI)

30.Wu, C-Y., Trombly, C. A., & Lin, K-C. (1994). The relationship between occupational form and occupational performance: A kinematic perspective. American Journal of Occupational Therapy, 48(8), 679-687. (SSCI)

Ø   陳貞夙老師

1. Chern, J-S., Lo, C-Y., Wu, C-Y., Chen, C-L., Yang, S-W., & Tang. (accepted for publication). Dynamic postural control during trunk bending and reaching in healthy adults and stroke patients. American Journal of Physical Medicine and Rehabilitation. (SCI)

2. Chen, P-P., Chen, S-S., Chern, J-S.*, & Huang, M-Y. (2009). Analysis of the usage of disability fund on promotion of employment rate in Taiwan: Taoyuan County as an example. Journal of Taiwan Occupational Therapy Research and Practic,. 5(2), XXX.

3. Jang, Y., Chern, J-S., Lin, K-C. (2009). Validity of the Lowenstein Occupational Therapy Cognitive Assessment (LOTCA) in people with intellectual disabilities. The American Journal of Occupational therapy, 63(4), 414-22(SSCI)

4. Lung, C-W., Chern, J-S., Hsieh, L-F., & Yang, S-W. (2008). The differences in gait pattern between dancers and non-dancers. Journal of Mechanics, 24(4), 451-457. (SCI)

5. Tseng, I-F. & Chern, J-S.* (2008) Bilateral foot centr ofpressure during trunk forward bending and reaching. Proceedings of the First International Conference on Biomedical Engineering and Informatics. Hinan, China.

6. Tsai, P-J., Chern, J-S.*, Chang, S-T., & Yang, S-W. (2008). A Study of dual-task effects on postural stability in stroke patients. Journal of Taiwan Occupational Therapy Research and Practice, 4(1), 45-54.

7. Chang, S-T., Chern, J-S.*, Long, C-W., Yang, L-Y., & Tang, F-D. (2007). Comparing the effects of two types of ankle-foot-orthoses on balance ability and walking performance in stroke patients. Journal of Taiwan Occupational Therapy Research and Practice, 3(2). 94-109.

8. Lin, K-C., Wu, C-Y., Chen, C-L., Chern, J-S., & Hung, W-H. (2007). Effects of task object on upper-arm reaching and postural balance while standing in patients with unilateral stroke and healthy controls. American Journal of Physical Medicine and Rehabilitation, 86(10), 792-99. (SCI)

9. Chern, J-S., Yang, S., & Wu, C-Y. (2006). Whole body reaching as a measure of dynamic balance in stroke patients. American Journal of Physical Medicine and Rehabilitation, 85, 201-208. (SCI)

10. Chern, J-S., Wu, C-Y., & Yang, S. (2005). The effects of target locations on shifting of center of pressure during whole body reaching in normal adults. Journal of Taiwan Occupational Therapy Research and Practice, 1, 1-10.

l   近五年完成之計劃

Ø   吳菁宜老師

Ø   陳貞夙老師

l   研究生論文發表 (以粗體底線標示者為本實驗室已畢業之研究生；以斜體底線標示者為目前仍就讀之研究生；*通訊作者)

1.      Wu, C-Y., Hsieh, Y-W., Lin, K-C., Chang, Y-F., Liu, H-L., Chen, C-L., Lin, K-H., Wai, Y-Y. (accepted for publication). Brain reorganization after bilateral arm training and distributed constraint-induced therapy in stroke patients: A preliminary functional magnetic resonance imaging study. Chang Gung Medical Journal.

2.      Lo, M-W., Huang, S-K., Lin, K-C., & Wu, C-Y. * (accepted for publication). The effects of mirror therapy in clinics and its brain mechanisms: A literature review. Journal of Taiwan Occupational Therapy Research and Practice.

3.      Huang, W-C., Yang, C-L., Wu, C-Y.,* & Lin, K-C. (2009). Effects of different bilateral arm training in stroke rehabilitation: A literature review. Journal of Taiwan Occupational Therapy Association, 27, 29-48.

4.      Yang, C-L., Lin, K-C., Chen, H-U., Chen, H-Y., Chao, P-C., Lin, P-C., & Wu, C-Y.* (accepted for publication). Effects of robot-assisted therapy in stroke patients: A literature review. Journal of Taiwan Occupational Therapy Research and Practice.

5.      Lin, K-C., Chung, H-Y., Wu, C-Y.*, Liu, H-L., Chen, C-L., Wai, Y-Y., Chen, I-H., Hsieh, Y-W., & Liu, J-S. (2010). Constraint-induced therapy versus control intervention in patients with stroke: An fMRI study. American Journal of Physical Medicine and Rehabilitation, 89, 177-185. (SCI)

6.      Chen, Y-A., Lin, K-C., Wu, C-Y.*, Lin, Y-C., Chu, N-K., Ke, J-Y., Wu, P-H. (accepted for publication). Effects of distributed constraint-induced therapy on trunk control, daily function, and quality of life in patients with chronic stroke. Taiwan Journal of Physical Medicine and Rehabilitation.

7.      Lin, K-C., Chen, Y-A., Chen, C-L., Wu, C-Y.*, Chang, Y-F. (2010). The effects of bilateral arm training on motor control and functional performance in chronic stroke: a randomized controlled study. Neurorehabilitation and Neural Repair, 24, 42-51. (SCI)

8.      Lin, K-C., Chang, Y-F., Wu, C-Y.*, & Chen, Y-A. (2009). Effects of constraint-induced therapy versus bilateral arm training on motor performance, daily functions, and quality of life in stroke survivors. Neurorehabilitation and Neural Repair, 23(5), 441-448. (SCI)

9.      Chang, Y. F., Tsai, W. C., Chung, C. Y., Lin, Y. C., Chen, Y. T., Wu, C. Y.*, & Lin, K-C. (2009). [Effects of modified constraint-induced therapy versus bilateral movement training on upper extremity performance in patients with chronic stroke: A kinematic analysis.] Taiwan Journal of Physical Medicine and Rehabilitation, 37(1), 19-30.

10.  Hsieh, Y-W., Wu, C-Y., Lin, K-C. Chang, Y-F., Chen, C-L., & Liu, J-S. (2009). Responsiveness and validity of three outcome measures of motor function following stroke rehabilitation. Stroke, 40, 1386-1391. (SCI)

11.  Chang, Y-F., Huang, W-C., Lin, N-L., Huang, Y., Chi, H-J., & Wu, C-Y.* (2008). [Efficacy of bilateral training in patients with stroke: A literature review](Chn). Journal of Taiwan Occupational Therapy Research and Practice, 4(1), 1-16.

12.  Wu, C-Y., Chou, S-H., Chen, C-L., Kuo, M-Y., Lu, T-W., & Fu, Y-C. (2009). Kinematic analysis of a functional and sequential bimanual task in patients with left hemiparesis: Intra-limb and interlimb coordination. Disability and Rehabilitation, 31(12), 958-966. (SSCI)

13.  Chang, Y-F., Wu, C-Y., Ke, J-Y., Wu, K-P., Cheng, J-W., Chen, Y-T., Lin, K-C. (2008). [Effects of stroke rehabilitation on motor and daily functions: A comparison trial of modified constraint-induced therapy and bilateral movement training](Chn). Journal of Taiwan Occupational Therapy Association, 26(1), 37-52.

14.  Chen, Y-T., Wu, C-Y., Lin, K-C., Chang, Y-F., & Hsu, C-J. (2008). [A comparison trial of modified constraint-induced therapy and intensity-controlled traditional rehabilitation in patients with chronic stroke](Chn). Journal of Taiwan Occupational Therapy Research and Practice, 4, 93-103.

15.  Wu, C-Y., Chou, S-H., Kuo, M-Y., Chen, C-L., Lu, T-W., & Fu, Y-C. (2008). Effects of object size on intralimb and interlimb coordination during a bimanual prehension task in patients with left cerebral vascular accidents. Motor Control, 12(4), 296-310. (SCI)

16.  Wu, C-Y., Lin, K-C., Chen, H-C., Chen, I-H., & Hong, W-H. (2007). Effects of modified constraint-induced movement therapy on movement kinematics and daily function in patients with stroke: A kinematic study of motor control mechanisms. Neurorehabilitation and Neural Repair, 21(5), 460-466. (SCI)

17.  Wu, C-Y., Chen, C-L., Tsai, W-C., Lin, K-C., Chou, S-H. (2007). A randomized, controlled trial of modified constraint –induced movement therapy for elderly stroke survivors: Changes in motor impairment, daily functioning, and quality of life. Archives of Physical Medicine and Rehabilitation, 88, 273-278. (SCI)

18.  Lin, H-J., Lin, K-C., Wu, C-Y., & Hsu, W-D. (2007). [Efficacy of modified constraint-induced movement therapy for children with cerebral palsy with asymmetric motor impairments: Kinematic analyses and Clinical Evaluation](Chn). Journal of Taiwan Occupational Therapy Research and Practice, 3, 19-29.

19.  Huang Y-Y., Wu, C-Y*., Hong, W-H., Chen, C-L., & Lin, K-C. (2006). [A kinematic study of modified constraint-induced movement therapy in patients with stroke] (Chn). Formosan Journal of Medicine, 10(3), 319-327.

20.  Lin, H-J., Wu, C-Y.*, Chen, C-L. (2007). Modified constraint-induced movement therapy in spastic cerebral palsy: a pilot study. Taiwan Journal of Physical Medicine and Rehabilitation, 35, 215-222.

21.  Lu, C-H., Wu, C-Y.*, Hong, W-H., Chen, C-L., Lin, K-H., Aou, S-H. (2006). [Effects of weight bearing at different locations on reach-to-grasp kinematics in patients with intention tremor] (Chn). Formosan Journal of Medicine, 10(2), 147-155.

22.  Chou, S-H., Wu, C-Y., Chen, C-L., Kuo, M-Y., Lu, T-W. (2007). [Movement coordination on bimanual prehension movements in persons with left cerebral accidents and healthy adults: A kinematic study](Chn). Journal of Taiwan Occupational Therapy Research and Practice, 3, 30-40.

23.  Chang, Y-F., Wei, T-H., & Wu, C-Y. (2006). [Cortical reorganization after constraint-induced therapy and bilateral training in patients with stroke: A review of mechanisms and empirical evidence] (Chn). Journal of Taiwan Occupational Therapy Research and Practice, 2(2), 74-81.