| Summary: | 碩士 === 國立臺灣大學 === 物理治療學研究所 === 97 === Background and Purpose: Children with spastic diplegia (SD) are characterized with muscle weakness and movement control deficits causing limitation of motor function. For them, the immediate effects of the load on sit-to-stand (STS) movements tended to increase peak extension power and movement smoothness. The loaded STS resistance exercise training also showed positive effects on the body function and the activity level. However, children usually had poor adherence and were uninterested in resistance exercise training. They exerted very much and took longer time during the loaded STS movement. Hence, how to increase the motivation in children’s resistance training is an important issue. Patterned Sensory Enhancement (PSE) is a kind of therapeutic music which utilizes music element to cue movements. Previous studies indicated music not only enhanced motivation but also increased peak capacity, and improved movement control and the ability of the exercises. The carry-over effects of music were still controversial. The purposes of the study were to investigate immediate effects of PSE on the execution and motivation of the loaded STS movement in children with SD. Methods: This study had recruited 20 children with SD aged 5 to 12 years and GMFCS I-III. The digital video, VICON 512 motion analysis system, 2 AMTI force platforms, and the Intrinsic Motivation Inventory-Chinese version (IMI-C) were used to collect data. The experiment took 2 separate days within 2 weeks to accomplish. On the first day, the 1-Repetition Maximum (1-RM) STS load of each time was determined. The phase time and the movement execution of the 50% 1-RM load of the STS movement were recorded by a digital video. Then the physical therapist and the music therapist composed the components of the individualized PSE according to the performance of each child in the video. The music therapist composed an individualized PSE music file for each child for the second day’s study. On the second day, children conducted the loaded STS movement with 50% 1-RM load repetitively for 8 trials in Music and No-music (control) conditions assigned randomly and the video, kinematic and kinetic data of and the IMI-C were collected. In Music condition, PSE music played only in the first 5 trials as the PSE condition, and music was then switched off in the last 3 trials as the Continuation condition. The parameters included: the peak extension power of lower extremities, parameters of motor control (the smoothness, the movement time, the maximal trunk flexion angle, the directness, and the inter-trial variability), parameters of motor ability (the successful rate and the number of attempts) and scores of the IMI-C. Paired t or Wilcoxon signed rank test was used to compare the parameters between the PSE and Continuation conditions. The carry-over effects of the PSE music were examined parameters between the Continuation and the control conditions with Pair t or Wilcoxon signed rank test for those effective parameters of PSE. α was set at 0.05 (one-tailed). Results: During the loaded STS movements, comparing with the control condition, the PSE music showed effects on increased knee peak extension power (p=0.042), better motor control (better center-of-mass smoothness (p=0.009), decreased movement time (p=0.006), and maximal trunk flexion angle (p=0.036), and higher IMI-C scores (p=0.002). There were no significant effects on the inter-trial variability, and the movement abilities. The carry-over effects of the PSE music were also not significant. Discussion and Conclusion: The PSE music with the loaded STS movement to a certain degree could alter peak extension power, motor control and the motivation immediately; however, such effects could not last once the music was switched off. No significant effects on movement ability were found. The duration of entrainment contingency and learning processing may be too short to achieve the carry over effect as well as to cause the motor ability change in this study. Future studies are needed to investigate the long-term effects and its neurological mechanism of the PSE music on the resistance exercise, including muscle strength, motor control, motor ability, and motivation.
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