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篇名 探討下身穩定度與不同書寫工具對腦性麻痺學童書寫姿勢的影響
卷期 31:1
並列篇名 The Effect of Lower Body Stabilization and Different Writing Tools on Writing Posture in Children with Cerebral Palsy
作者 俞雨春連悅如朱彥穎程欣儀
頁次 094-110
關鍵字 腦性麻痺生物力學書寫姿勢異軸筆Cerebral palsyBiomechanicsHandwritingPostureBiaxial penTSCI
出刊日期 201306

中文摘要

腦性麻痺學童因異常肌肉張力而影響書寫時之身體姿勢,進而影響學習及動 作靈活度。本篇目的在探討提供下半身穩定的椅子及搭配使用不同書寫工具對腦 性麻痺學童在書寫時身體姿勢的影響。本研究比較腦性麻痺學童下半身固定與否 (固定/未固定) 及使用不同書寫工具(一般筆/限制高度筆/異軸筆) 時之書寫生物 力學參數。受試者進行描繪阿基米德螺旋迷宮,並使用肌電圖,電子量角器及照 相標記法以蒐集生物力學參數。統計使用重複測量二因子變異數分析分析下半身 固定與否及不同書寫工具對以上參數造成的影響。研究結果顯示,不同筆的使用 對身體角度變化,如肩部水平傾斜角度、頭部水平傾斜角度及軀幹側傾角度變化 參數上呈現統計顯著差異。在固定下半身的椅子使用部分,發現軀幹側傾角度、 軀幹前傾角度、視線角度均有顯著差異。筆與椅的交互作用亦對部分參數有顯著 影響。上肢之肌電訊號則無明顯差異。本研究結果可提供針對腦性麻痺學童進行 書寫時的生物力學方面之參考。本研究結果亦指出下肢固定及使用雙軸設計的筆 可以有效改善書寫姿勢的問題,其概念與應用可以做為輔具筆設計及改良的參 考。未來也可在其他有書寫姿勢問題的特殊需求學童做進一步的探討及應用。

英文摘要

Failure to a ain proper writing biomechanics in children with cerebral palsy o en leads to problems such as soreness, kyphosis, easy fatigue and myopia.  ese problems inevitably impact on children’s learning and academic success.  e aims of this study were to investigate the in uence of lower body stabilization and pen design on writing biomechanics in children with cerebral palsy. Fourteen children with cerebral palsy were included. Two different ways of lower body fixation and three different pen designs were evaluated in this study. Electromyography, electrogoniometer and photography were used to investigate handwriting biomechanics. Two-way repeated measures ANOVA was used for statistically analysis. No signi cant di erence was noted in EMG in either variable. Signi cant di erences were found in pens for variables including shoulder horizontal inclination, head horizontal inclination, and trunk slant angle. As for the e ects on chair, signi cant di erences were found in trunk tilt inclination, visual focus-vertical and trunk forward inclination angle, indicating a chair which provided proper positioning was effective in improving writing posture. Biaxial pen and positioning chair could improve writing posture e ectively, but not the upper extremity muscle exertion. Current results may provide guidelines for parents, teachers and clinicians information regarding the selection of writing tools and proper sitting supports. The rationale of biaxial pen design also provides information regarding the design of assistive writing devices. Future application studies can be conducted in disabled children with poor handwriting posture.

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