目的：肌肉無力是中風病人常見的動作缺損，無論是患側上肢近端肌群或手部肌群肌力的不足，都將影響病人日常生活功能的獨立。慢性中風病人在接受下肢漸進式阻力訓練後，在兩側下肢肌力、站立時間、平衡能力及動作表現、步態與行動能力皆有改善，但阻力訓練對於中風病人患側上肢動作功能的改善成效，文獻結果仍不一致，機械協助式上肢阻力訓練與推拉箱上肢阻力訓練為臨床上常用的方法而不知其優劣。因此，本研究之目的為探討兩種上肢阻力訓練對於改善中風病人上肢肌力、與動作功能之療效，並做此兩種訓練效果之比較。方法：本研究計畫採前測-後測設計、單盲隨機分配試驗。共選取30 位慢性中風病人，並以隨機方式分派至兩組。一組施以機械協助式單側上肢阻力訓練；另一組則接受推拉箱上肢阻力訓練。兩組受試者之治療頻率皆為每週三次，每次治療時間為20 分鐘，共計8 週。主要療效評量則針對上肢肌肉張力（修正版艾許沃斯氏量表）、上肢動作（中風復健動作評估上肢次量表）、上肢功能性動作（上肢功能研究量，箱子和木塊測驗）與上肢肌力（手部握力，肩關節及肘關節肌力）等方面加以評估，二次之評估時間點分別為：治療前、治療8 週後。結果：兩組在上肢動作、功能性動作及肌力等所有評量項目皆無差異，在所有療效評量項目中並無統計學上之顯著差異。機械上肢阻力訓練組在上肢功能性動作及肌力方面在兩次評估期間之進步量達統計學上之顯著差異（p＜.05），其治
療效應主要發生在箱子和木塊測驗（ F=28.76, p ＜ .0001, effect size: partial
η2=.69）、手部握力（F=13.9, p=.002, effect size: partial η2=.50），皆達中度效應以上；而推拉箱阻力訓練組在上肢動作、功能性動作及肌力方面之進步量亦達統計學上之顯著差異（p＜.05），其治療效應主要發生在箱子和木塊測驗（F=14.74, p=.004,effect size: partial η2=.62）、肘關節肌力（F=14.6, P=.002, effect size: partial η2=.52），也達中度效應以上。結論：雖然兩組治療模式不同，但兩種阻力訓練對於中風病人上肢功能皆有改善，且不會增加上肢不正常張力，顯示傳統復健加入此兩種阻力訓練方式皆為有
效提升慢性中風病人上肢功能之臨床治療方式。

Patients with stroke will suffer from significant motor impairments on
upper limb that drastically impacts the performance of functional abilities in activities of daily living and upper limb weakness is commonly found post-stroke. This study was to examine the effects of two resistance trainingsrobot-assisted device and sanding box activity, on functional recovery of upper limb in patients with chronic stroke.
A single-blind randomized controlled trial, pre-and post-test research
design was applied in this study. Thirty participants, who had unilateral strokes for at least 6 months, were enrolled in this study. Subjects were randomly assigned to one of the two training groups: the robotic-assisted group and the sanding box group. Both groups were exposed to the training for 20 minutes in a session, three sessions per week for 8 weeks.
Main outcome measurements included paretic upper-limb’s muscle tone
(Modified Ashworth Scale), arm movement (Stroke Rehabilitation Assessment
of Movement), motor function (Action Research Arm Test and Box and Block
Test) and strength (Jamar Hydraulic Hand Dynamometer and Lafayette
Electronic Manual Muscle Tester).There was no significant difference between the two groups in muscle tone,arm motor, motor function and strength. Statistically significant gains between baseline test and post-test for the robotic-assisted group were found in the Box and Block Test (F=28.76, p＜.0001, effect size: partial η2=.69) and arm grip
strength (F=13.9, p=.002, effect size: partial η2=.50). Statistically significant gains between the baseline test and post-test for the sanding box group were found in the Box and Block Test (F=14.74, p=.004, effect size: partial η2=.62) and elbow strength (F=14.6, p=.002, effect size: partial η2=.52).Both robotic-assisted and the sanding box resistive arm trainings can positively increased strength and promoted functional improvement without increasing spasticity in the study participants. These findings suggested that robotic-assisted and the sanding box training programs should be integrated as parts of rehabilitation programs.