本研究嘗試探討手部拉筋設備 (hand-stretching device) 介入中風患者手部痙 攣問題之療效。本研究收取21 位有手部痙攣問題 (Modified Ashworth Scale , MAS ≥ 1) 之慢性中風患者，並隨機分配至實驗組（11 人）與控制組（10 人）。兩組皆 接受1 小時／天，5 天／週，共3 週的訓練。其中實驗組之訓練包含20 分鐘之手 部拉筋設備介入、40 分鐘功能性訓練；而控制組則進行1 小時的功能性訓練。介 入效果使用MAS、Fugl-Meyer Assessment (FMA)、The Action Research Arm Test (ARAT)、Functional Independence Measure (FIM)、Stoke Impact Scale (SIS)等工具 於介入前、中、後，及介入後1 個月／3 個月時評估，來了解手部拉筋設備之效果。 結果發現於後測時，實驗組MAS 分數明顯低於控制組 (p = .02)，進行組內比較也 可發現實驗組後測的MAS 分數較前測低 (p = .06)，控制組則否，顯示手部拉筋設 備的介入可有效改善中風患者手部痙攣問題，效果也可持續至介入後1 個月。但 改善痙攣問題於動作功能及日常生活表現上未有顯著效益，推測原因可能是痙攣 問題的改善對於慢性中風患者（尤其本研究所納入的患者平均發病病程為 3.48 ± 1.88 年）動作與日常生活功能之改善效果有限；抑或本研究未納入嚴重痙攣 之個案 (MAS > 3)，無法真正呈現痙攣改善之效益。故為真正了解此設備的成效 與痙攣問題對中風患者的影響，以及早期介入之重要性，未來需要納入各種痙攣 程度與病程時間的中風患者來深入探討。

Objective. This study attempted to investigate the effect of a hand-stretching device for treatment of hand spasticity in chronic stroke patients. Methods. This study recruited 21 stroke patients with hand spasticity problem (Modified Ashworth Scale , MAS ≥ 1) and randomly assigned them to the experimental group(EG)(11 patients) and control group (CG)(10 patients). Each groups received treatment for 1h/d and 5 d/wk for 3 weeks. EG accepted stretching device training for 20mins and functional training for 40mins; CG underwent only functional training for 60mins. The effect of intervention was assessed using the MAS, Fugl-Meyer Assessment (FMA), The Action Research Arm Test (ARAT), the Functional Independence Measure (FIM), and Stoke Impact Scale (SIS) in pre-, mid-, post-treatment, and two follow-up after intervention. Results. At post-treatment evaluation, MAS scores of EG were significantly lower than CG (p = .02). Within the EG , the MAS score of post-treatment were also lower than the MAS score of pre-treatment (p = .06). There was no significant improvement noted in functional evaluation both in EG and CG. Conclusion. The hand-stretching device was effective in relieving hand spasticity in chronic stroke patients, but it can’t improve the motor and daily life performance in our study. Because the stroke patients in our study were very chronic patients(onset time was 3.48 ± 1.88 years), and we didn’t include patients with severe spasticity, those would be the reasons why relieving hand spasticity showed limited improvement in motor and daily life performance in our patients. To realize the actually effect of hand-stretching device and the importance of earlier intervention, we need further study to investigate.