| Summary: | 碩士 === 國立成功大學 === 生物醫學工程學系 === 107 === Stroke patients usually suffer from poor hand function which causes significant inconvenience in their daily activities. The abnormal synergy pattern and impaired sensation result in the deficits of force control especially poor digit independence, and poor digit coordination. Clinically, task oriented training is widely used for post-stroke recovery. There are also several novel hand coordination trainings had been proposed. However, there’s still lacking a strongly recommended training method that’s effective and specific for digit force control and finger independence.
In this study, 15 stroke patients voluntarily involved in this experiment. Grasping Training System (GTS) with visual biofeedback was used to train and evaluate finger function. All subjects finished 12 times 30 minutes training with the frequency of 2 to 3 times per week. The training program consisted two parts: (1) stably meet target force and (2) accurately meet target angle. To evaluate participants’ hand function improvements, besides clinical assessments, GTS and Pressing Evaluation Training System (PETS) were also used in evaluation. The evaluations were conducted before, after and 1 month after training.
The results showed that subjects’ performance generally improved after GTS training. Patients’ digit independence and hand steadiness were significantly improved after training and the training effects could be maintained in follow-up test. The temporal coupling between grip force and load force was also significantly decreased. Clinical hand function test and grasping and pinch force showed trend of improvement but no statistical difference. However, the GTS training didn’t have effect on sensory improvement which is reasonable as the training programs were not focus on sensory function.
Overall, GTS provide clinicians and stroke patients an effective and innovative way to train hand function and digit control. Moreover, it can also be used to quantify patients’ performance which provide clinicians a clearer image of patients’ rehabilitation progress. In the future, studies can increase the sample size of subjects which can possibly lower the variability of stroke patients. Furthermore, to make GTS training and evaluation system more widely used in clinics and commercialized, the device can be simplified so that it can be cheaper and easier for therapists to operate.
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