週邊前庭神經病變所引起的眩暈會造成重心失衡，進而影響日常生活的品質，雖然可以藉由外科手術或前庭神經抑制藥物減緩眩暈症狀，但是此類藥物多有副作用，所幸前庭功能復健運動已被認為可以有效改善眩暈症狀。但是，復健過程由於過於單調，缺乏具有挑戰性且可調適(adaptive)的訓練內容，同時缺乏以運動分析為基礎的評估方法，以至於降低了復健運動的復健成效。本研究運用虛擬實境技術，包括立體影像技術、互動技術以及動畫遊戲技術，根據臨床所使用之Cawthorne-Cooksey前庭復健訓練運動，開發新型互動式復健訓練系統，同時也運用感測器技術以及運動分析技術，開發了平衡度評估系統。本研究進行了臨床試驗(32 subjects, 6 training sessions)，於實驗過程中，完整的量測並記錄病人的任務表現資料、重心偏移分佈之歷時資料以及主觀感受之問卷資料。實驗結果經由任務表現評估以及平衡度分析，顯示本系統對於協助病人進行眩暈復健訓練具有顯著性療效，此外根據分析各項任務表現，初步檢驗復健項目對病人的克服難易度，臨床問卷的回饋也顯示病人具有更高的意願與動機使用此一新穎的系統進行復健。

Dizziness caused by the peripheral vestibular nerve disease may lead to imbalance of the center of gravity, affecting quality of daily life. Fortunately, vestibular function rehabilitation exercise is thought to be able to effectively reduce the symptom of dizziness. However, since rehabilitation process may be bored for patients, lacking of task challenges, adaptive training contents, and assessment method based on exercise analysis, the effectiveness of rehabilitation exercise is thus reduced. In this research, virtual reality technology was applied, involving stereo image technology, interactive technology, and animation game technology. A new interactive rehabilitation training system was developed based on the Cawthorne-Cooksey vestibular rehabilitation exercise which is commonly used in the clinical. The sensor technology and exercise analysis technology was used to develop evaluation system for testing the level of balance. Thirty-two subjects were asked to perform 6 training sessions for the clinical test. During the experimental process, the task performance data, the historical data of the deviation distribution of center of gravity, and the subjective feeling questionnaire survey data of the patient was completely measured and recorded. Through the task performance evaluation and the analysis of level of balance, the experimental result has proved the medical effect of this system in assisting the patients to perform dizziness rehabilitation training. According to performance of each task, the difficult level was verified and applied based on the individual capability. The clinical observation also shows that the patients have higher willingness and motivation to use such new system to perform rehabilitation.

﹝1﹞Monsell EM, Balkany TA, Gates GA, et al. “Committee on hearing and equilibrium guidelines for the diagnosis and evaluation of therapy in Meniere''s disease”, Otolaryngol Head Neck Surg, Vol 113, no.3 181-185, September 1995.
﹝2﹞Susan J. Herdman., Vestibular Rehabilitation Second Edition(Contemporary Perspectives in Rehabilitation). F.A. Davis Company., Philadelphia, 2000.
﹝3﹞H. Luukinen, M. Herala, K. Koski, R. Honkanen, P. Lappala, S.-L. Kivela, “Fracture risk associated with a fall according to type of fall among the elderly”, Osteoporosis International, Vol 11, no.7 631-634, August 2000.
﹝4﹞Susan L. Greenspan, Elizabeth R. Myers, Lauri A. Maitland, Neil M. Resnick, Wilson C. Hayes, “Fall Severity and Bone Mineral Density as Risk Factors for Hip Fracture in Ambulatory Elderly”, JAMA, Vol 271, no.2 128-133, January 1994.
﹝5﹞Gauchard GC, Jeandel C, Perrin PP, “Physical and Sporting Activities Improve Vestibular Afferent Usage and Balance in Elderly Human Subjects”, Gerontology, Vol 47, no.5 263-270, September 2001.
﹝6﹞Michael C. Schubert, Susan L. Whitney, “From Cawthorne-Cooksey to Biotechnology: Where We Have Been and Where We Are Headed in Vestibular Rehabilitation?”, Journal of Neurologic Physical Therapy, Vol 34, no.2 62-63, June 2010.
﹝7﹞Badke MB, Shea TA, Miedaner JA, Grove CR, "Outcomes after rehabilitation for adults with balance dysfunction", Archives of Physical Medicine and Rehabilitation, Vol 85, no.2 227-233, February 2004.
﹝8﹞Brown KE, Whitney SL, Wrisley DM, Furman JM, "Physical therapy outcomes for persons with bilateral vestibular loss", Laryngoscope, Vol 111, no.10 1812-1817, October 2001.
﹝9﹞S. Corna, A. Nardone, et al. "Comparison of Cawthorne-Cooksey exercises and sinusoidal support surface translations to improve balance in patients with unilateral vestibular deficit", Archives of Physical Medicine and Rehabilitation, Vol 84, no.8 1173-1184, August 2003.
﹝10﹞Bittar RS, Pedalini ME, et al. "Treating vertigo with vestibular rehabilitation: results in 155 patients", Rev Laryngol Otol Rhinol (Bord), Vol 123, no.1 61-65, 2002.
﹝11﹞Ivan E. Sutherland,”The Ultimate Display”, Information Processing Techniques Office, ARPA, OSD, Proceedings of IFIP Congress, 506-508, 1965.
﹝12﹞Mikkel Viager, Analysis of Kinect for mobile robots, Technical university of Denmark, individual course report, March 2011.
﹝13﹞Microsoft Research, Kinect for Windows SDK beta Programming Guide, Microsoft Research, July 22, 2011.
﹝14﹞PrimeSense Inc., PrimeSense TM NITE Controls User Guide, PrimeSense Inc., 2011.
﹝15﹞PrimeSense Inc., PrimeSense. NITE Algorithms 1.5, PrimeSense Inc., 2011.
﹝16﹞Shih-Ching Yeh, 「Motor and Visual Principles In a Human-computer Interface Training System for Rehabilitation」, University of Southern California, Doctor of Philosophy, December 2008.
﹝17﹞OpenCV, http://opencvlibrary.sourceforge.net/
﹝18﹞Maria Crotty, et al. ”Is use of the Nintendo Wii Fit in physiotherapy as effective as conventional physiotherapy training for hospitalised older adults? ”, International Conference on Virtual Rehabilitation 2011, pp. 1-2, ETH Zurich Science City, Switzerland, June 2011.
﹝19﹞Heidi Sugarman , Aviva Weisel-Eichler, ”Use of the Wii Fit system for the treatment of balance problems in the elderly: A feasibility study”, Virtual Rehabilitation International Conference 2009, pp. 111-116, Kiryat Ono, Israel, June 2009.
﹝20﹞Kulcu D. G., et al. "Efficacy of a home-based exercise program on benign paroxysmal positional vertigo compared with betahistine", J Otolaryngol Head Neck Surg, Vol 37, no.3 373-379, June 2008.
﹝21﹞Ribeiro Ados, S. and J. S. Pereira, "Balance improvement and reduction of likelihood of falls in older women after Cawthorne and Cooksey exercises", Braz J Otorhinolaryngol, Vol 71, no.1 38-46, January 2005.
﹝22﹞Szturm T, et al. "Comparison of different exercise programs in the rehabilitation of patients with chronic peripheral vestibular dysfunction", J Vestib Res., Vol 4, no.6 461-479, November 1994.
﹝23﹞Horak FB, et al. "Effects of vestibular rehabilitation on dizziness and imbalance", Otolaryngol Head Neck Surg., Vol 106, no.2 175-180, February 1992.
﹝24﹞Fujino, et al. "Vestibular training for benign paroxysmal positional vertigo", Arch Otolaryngol Head Neck Surg., Vol 120, no.5 497-504, May 1994.
﹝25﹞A. Solari, et al. "Physical rehabilitation has a positive effect on disability in multiple sclerosis patients", Neurology, Vol 52, no.1 57-62, January 1999.
﹝26﹞Vaz Garcia F. "Treatment failures in benign paroxysmal positional vertigo. Role of vestibular rehabilitation", Rev Laryngol Otol Rhinol (Bord), Vol 126, no.4 271-274, 2005.
﹝27﹞Hain TC, Fuller L, Weil L, Kotsias J., "Effects of T''ai Chi on Balance", Arch Otolaryngol Head Neck Surg, Vol 125, no.11 1191-1195, November 1999.
﹝28﹞Peter M. Wayne, et al. "Can Tai Chi Improve Vestibulopathic Postural Control", Arch Phys Med Rehabil., Vol 85, no.1 142-152, January 2004.
﹝29﹞Gillespie LD, Gillespie WJ, Robertson MC, Lamb SE, Cumming RG, Rowe BH, "Interventions for preventing falls in elderly people", Cochrane Database Syst Rev., no.4, 2003.
﹝30﹞Peterson CL, et al. "Evaluation of neuropsychological domain scores and postural stability following cerebral concussion in sports", Clin J. Sports Med., Vol 13, no.4 230-237, July 2003.
﹝31﹞Myron K. Krueger, Artificial Reality, New York, Addison-Wesley Publishing Company, 1991.
﹝32﹞Howard Rheingold , Virtual Reality, New York, Simon and Schuster, July 1991.
﹝33﹞Shapiro, M. A, & McDonald, D. “I’m Not a Real Doctor, But I Play One in Virtual Reality: Implications of Virtual Reality for Judgments about Reality”, Journal of Communication, Vol 42, no.4 94-114, December 1995.
﹝34﹞Uttama Lahiri, Zachary Warren, Nilanjan Sarkar, “Design of a Gaze-Sensitive Virtual Social Interactive System for Children With Autism” , IEEE Trans Neural Syst Rehabil Eng., Vol 19, no.4 443-452, August 2011.
﹝35﹞Rizzo AA, Bowerly T, et al. “A Virtual Reality Scenario for All Seasons: The Virtual Classroom”, CNS Spectr., Vol 11, no.1 35-44, January 2006.
﹝36﹞Rizzo AA, Bowerly T, Buckwalter JG, et al. “Virtual environments for the assessment of attention and memory processes: the virtual classroom and office”, International Conference on Disability, Virtual Reality and Associated Technology 2002, pp. 17-19, Vesaprem, Hungary, September 2002.
﹝37﹞LIU Xia, QIAO Jiangang, “Research on Chinese Museum Design based on Virtual Reality”, IEEE International Workshop on Modelling, Simulation and Optimization 2008, pp. 372-374, Taiyuan Inst. of Technol., Taiyuan, December 2008.
﹝38﹞Sergei V. Adamovich, Gerard G, et al. “Incorporating Haptic Effects Into Three-Dimensional Virtual Environments to Train the Hemiparetic Upper Extremity”, IEEE Trans. Neural Systems and Rehabilitation Engineering, Vol 17, no.5 512-520, October 2009.
﹝39﹞Gil-Gomez, Roberto Llorens "Effectiveness of a Wii balance board-based system (eBaViR) for balance rehabilitation: a pilot randomized clinical trial in patients with acquired brain injury", J Neuroeng Rehabil., Vol 8, no.30, May 2011.
﹝40﹞Tony Pigford, A. Williams Andrews, "Feasibility and Benefit of Using the Nintendo Wii Fit for Balance Rehabilitation in an Elderly Patient Experiencing Recurrent Falls", Journal of Student Physical Therapy Research, Vol 2, no.1, 2010.
﹝41﹞Michael W. Kennedy, et al "Enhanced Feedback in Balance Rehabilitation using the Nintendo Wii Balance Board", IEEE International Conference on e-Health Networking, Applications and Services 13th, pp. 162-168, MO, USA, June 2011.
﹝42﹞Y.P. Danilov, et al. "Efficacy of electrotactile vestibular substitution in patients with peripheral and central vestibular loss", Journal of Vestibular Research, Vol 17, no.2 119-130, November 2007.
﹝43﹞Davis, F. D., Bagozzi, R. P., Warshaw, P. R., “User acceptance of computer technology: a comparison of two theoretical models”, Management Science, Vol 35, no.8 982-1003, August 1989.
﹝44﹞Cristiane Akemi Kasse, Graziela Gaspar Santana, et al. ”Vestibular rehabilitation exercises in acute vertigo”, Braz J Otorhinolaryngol, Vol 76, no.5 623-629, 2010.
﹝45﹞Michael A. Province, et al. "The Effects of Exercise on Falls in Elderly Patients A Preplanned Meta-analysis of the FICSIT Trials. Frailty and Injuries: Cooperative Studies of Intervention Techniques", JAMA, Vol 273, no.17 1341-1347, May 1995.