初探慢性腦中風患者之注意力、衝動性以及自發性使用患側上肢

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Title:	初探慢性腦中風患者之注意力、衝動性以及自發性使用患側上肢
Authors:	林靖敏
Contributors:	心理學系
Keywords:	注意力、衝動性、自發使用患側上肢、慢性腦中風、Attention、Impulsivity、Spontaneous affected upper extremity use、Chronic stroke
Date:	2018
Issue Date:	2018-07-12 09:01:31 (UTC+0)
Publisher:	亞洲大學
Abstract:	動作功能損傷與認知功能缺損在慢性腦中風患者當中為常見症狀，其中上肢功能損傷、注意力缺損和抑制功能缺損為常見的功能缺損。研究顯示自發性使用患側上肢的量、注意力和衝動性皆與慢性腦中風患者的日常生活功能有關，然而，過去研究鮮少將慢性腦中風患者的注意力與衝動性對自發性使用患側上肢量關聯進行研究，本研究針對此議題進行探討。本研究招募21位於慢性期中之初次腦中風患者。注意力與衝動性以彩色路徑描繪測驗（Color Trails Test）評估、自發性使用患側上肢量以上肢動作活動記錄（Motor Activity Log）測量、患側上肢基本動作功能以傅格-梅爾量表（Fugl-Meyer Assessment）評估。研究發現注意力缺損中和高衝動性在慢性腦中風患者中佔有相當之比例，此外較少自發使用患側上肢的慢性腦中風患者可能有較高的衝動性，然而研究亦發現患者在衝動性指標上的表現具有明顯異質性。慢性腦中風患者中的高衝動性可能與低自發性使用患側上肢有關，慢性腦中風患者之注意力缺損可能與高衝動性相關，進而減損自發性使用患側上肢之能力。針對患者衝動性的偵測與介入或許為提升其生活功能之方式，然患者中衝動性的異質性亦需受到關注。 Motor and cognitive impairments are common among patients with chronic stroke, especially impairments in the upper extremity, attention, and inhibition. Research has suggested that the amount of spontaneous affected upper extremity (UE) use, attention, and impulsivity are associated with the activities of daily living functioning among chronic stroke patients respectively. However, very limited studies have evaluated the impacts of attentional impairments and impulsivity on the amount of affected UE among patients with chronic stroke. Thus, the current study aimed to explore these issues. Twenty one chronic patients survived after the first episode of stoke were recruited. Attention functioning and impulsivity were evaluated by using the Color Trials Test (CTT). The amount of spontaneous use and basic motor functions of the affected UE were assessed by using the Motor Activity Log and the Fugl-Meyer Assessment, respectively. The average performance level between patients who often use their affected UEs spontaneously and patients who rarely use their affected UEs spontaneously did not differ on any indices reflecting attention and impulsivity. However, higher ratio of patients who rarely used their affected UEs spontaneously exhibited deficits on an index reflecting impulsivity, as compared to the ratio among patients who often used their affected UEs spontaneously. These findings suggest that impaired attention may be associated with impulsivity among chronic stroke patients. In addition, the impulsivity may be correlated with the reduced spontaneous affected UE use among the patients. However, heterogeneity in impulsivity may also be common among patients with chronic stroke.
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