一般而言，老年人或較年長者可能在維持身體平衡的三要素「視覺、前庭、本體感覺」的感覺訊息輸入方面相較於年輕人有退化的跡象，以致老年人在平時居家環境中，以站立或行走活動之狀態執行認知或手部相關作業時，可能會因為執行該動作而影響身體平衡之穩定，進而產生跌倒的風險。本實驗之研究目的在於了解是否可以利用播放環境音樂與白噪音的方式，使老年人在居家環境中執行雙重作業時，能夠達到更加穩定的平衡，意即能否利用聲音的刺激作為老年人姿勢平衡能力退化的補償，進而降低跌倒的可能性。
本研究徵求健康20-30歲的年輕人（平均年齡23.93±1.66歲）與健康60歲以上的老年人（平均年齡67.8±3.96歲）各15位參與，使用音響播放6種不同型態（高中低頻率與高低音量）的白噪音混入電子吉他音樂予研究參與者聆聽，並搭配以下三種測試情境：一、穿衣任務結合站立平衡；二、普渡樁版任務結合站立平衡；三、數學減算任務結合步態行走。站立測試期間，研究者將測量壓力中心(Center of pressure)之身體晃動面積、晃動時的位移路徑距離、前後方向晃動及左右方向晃動等四個平衡參數，以評估研究參與者實際的身體搖晃程度；此外透過肌肉電位訊號來分析站立測試時的下肢肌肉活動狀況，以辨別研究參與者的下肢肌群使用差異；步態測試期間，研究者將測量跨步長、步寬、擺盪時間、單腳承重時間等四個平衡參數，衡量研究參與者在步行時的平衡狀況；最後以完成個數來衡量手部與認知任務的表現。實驗結束後將針對以上平衡與任務相關的數據結果進行統計分析，以評估何種頻率或音量的白噪音混入電子吉他音樂具有改善平衡穩定或任務表現的效果。
本研究結果顯示，混合了白噪音的電子吉他音樂對於從事雙重作業人員的靜態平衡與手部作業的表現產生了負面影響，其中中頻率1000Hz的白噪音所造成的負面影響是相對較多的。此外，在執行認知任務結合步態行走之雙重作業時，聆聽混入50dB適中音量白噪音的電子吉他音樂對於步態平衡的穩定有正面幫助，而混合白噪音的電子吉他音樂對於認知任務表現方面的影響則較不明顯。 最後在年齡差異的比較中，不同頻率與音量的白噪音對於年輕與老年組之間的動靜態平衡、肌肉共同收縮與作業表現都難以產生顯著的差別，只看得出因為年齡老化的部分生理功能退化因素所造成的表現差異。未來研究方向將考慮納入過去有發生跌倒歷史的老年參與者進行研究，並且除了比較不同頻率與音量的白噪音混合電子吉他音樂對於表現所造成的差別外，亦可以採納直接使用耳機的聆聽方式，以及不同困難程度的次要作業對於平衡表現的差異情況進行更深入的探討。

In general, the elderly may have indication of deterioration compared to young people in terms of body balance control, which is maintained by the three sensory elements of "visual, vestibular, and proprioception". Therefore, when the elderly performs cognitive or hand-related work in the state of standing or walking in the home-dwelling environment, the stability of the body balance may be affected by the execution of the task, thereby causing a risk of falling. The purpose of our re-search is to understand whether it is possible to use white noise with music mixed to achieve a more stable balance when the elderly performs dual tasks in the home-dwelling environment, that is, whether the stimulation of the sound can be used as a compensation for the deterioration of the posture balance ability of the elderly, thereby reducing the possibility of falls.
Our research enrolled 15 young people (mean age 23.93±1.66 years old) and healthy elder people aged 60 years or older (mean age 67.8±3.96 years old) to participate, using speaker to play 6 different types of sounds (low, medium and high frequency; medium and high loudness). The white noise which is mixed into the electronic guitar music for the participants to listen to, and the sound is played with the following three test: First, the dressing task combined with standing bal-ance; Second, the Purdue Pegboard task combined with the standing balance; Third, the mathe-matical Subtraction task combined with the gait walking. During the standing test, we will meas-ure the body sway radius of the Center of pressure, the distance of the displacement path during body sway, the body sway in the anterior-posterior direction, and the body sway in medial-lateral direction. The resulting data will be used to quantify the actual degree of body sway. In addition, we also analyze the activation of lower limb muscles during the standing test through electromy-ography to identify differences in the use of lower limb muscle in the participants. During the gait test, we measure the stride length, step width, swing time, and step time to measure the balance of the participants during walking. Finally, the number of completions is used to measure the per-formance of the hand and cognitive tasks. After the experiment, the results of the balance and task-related data will be analyzed to evaluate which type of white noise mixed into the electronic guitar music has the effect of improving balance stability or task performance.
The results of our research show that the electronic guitar music mixed with white noise has a negative impact on the the performance of static balance and the hand tasks of the participants. The negative impact caused by the white noise of medium frequency 1000 Hz is relatively more. In addition, when performing cognitive tasks combined with gait walking, listening to electronic guitar music mixed with 50dB moderate loudness white noise is positive for the stability of gait balance. On the other way, mixed white noise electronic guitar music for cognitive task perfor-mance, the impact is less obvious. At last, in the comparison of age differences, the white noise of different frequencies and loudness is make no significant difference of the static and dynamic balance, the muscle co-contraction and the performance of the task between the young and the old group. Only the significant differences in performance caused by internal factors of ageing were observed. In the future research, it may be possible to consider the inclusion of elderly research participants who have had a fall experience, and could also include different states of using head-phone, and secondary tasks with different levels of difficulty to compare differences in balance control.

第一章 緒論 10
1.1. 研究背景與動機 10
1.2. 研究目的與範圍 14
1.3. 研究架構與流程 14
第二章 文獻回顧 17
2.1. 平衡對人體的重要性 17
2.1.1. 前庭感覺與聽覺的關係 20
2.2. 聽覺、聲音與白噪音之基本描述 22
2.3. 不同型態的聲音對於人的作業與姿勢平衡的影響 24
2.3.1. 聲音影響姿勢平衡 24
2.3.2. 聲音影響手部作業 27
2.3.3. 聲音影響步態作業 28
2.3.4. 聲音影響認知作業 29
2.3.5. 小結 31
2.4. 雙重作業下對姿勢平衡的影響 32
2.4.1. 手部動作 32
2.4.2. 認知作業 33
2.5. 老年人的平衡情況與居家行為限制 35
2.5.1. 老化對平衡的影響 36
2.5.2. 老化對雙重任務執行的影響 37
第三章 研究方法 39
3.1. 問題定義與描述 39
3.2. 實驗流程 39
3.2.1研究對象與使用器材 39
3.2.2實驗方法與步驟 44
3.3 數據分析 46
3.4 統計分析 48
第四章 實驗結果 49
4.1 靜態平衡 49
4.1.1壓力中心與肌電訊號 49
4.1.1.1 頻率 52
4.1.1.2 音量 61
4.1.2手部作業表現 68
4.1.2.1 頻率 69
4.1.2.2 音量 72
4.2 動態平衡 75
4.2.1步態表現 75
4.2.1.1 頻率 77
4.2.1.2 音量 80
4.2.2認知作業表現 84
4.3 年齡 86
4.3.1 靜態姿勢平衡與肌電訊號 88
4.3.2 手部作業表現 94
4.3.3 步態平衡 95
4.3.4 認知作業表現 96
第五章 討論 98
5.1 聲音對於動靜態平衡表現的影響 98
5.2 聲音對於手部與認知作業表現的影響 103
5.3 年齡所造成的表現差異 106
5.4 研究限制 109
第六章 結論與未來方向 110
參考文獻 111

 

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