臺灣博碩士論文加值系統

接受人工膝關節置患手術之病人，手術後病人滿意度相當高，但是仍可於實驗室中觀察到步行速度變慢與不正常步態，本體感覺功能異常有可能是導致步行功能不正常的原因之一。本研究目的：1)建立臨床膝關節本體感覺功能檢查方法；2)檢測雙側人工膝關節置換術後病人膝關節之本體感覺功能，並與同年齡之正常人作比較；3)進一步檢測膝關節本體感覺功能與步行功能間之相關性。本研究同時採用單側模式與雙側模式之本體感覺測試方法，目標角度之位置擺位方式包括被動擺位及主動動作擺位。在角度配對誤差之數據分析上，採用三種數據分析方法固定誤差、變異誤差、與平方根誤差。在步行評估中本研究於四種步行情境下：一般路面與正常視線、一般路面與周邊視覺限制、軟墊路面與正常視線、軟墊路面與周邊視覺限制，測試步行速度，以進一步分析本體感覺功能與步行功能間的相關性。結果共收集16位雙側人工膝關節患者與16位年齡配對之控制組，發現以雙側被動模式測試，固定誤差之分析方式，可明顯檢測出病人組的膝關節本體感覺功能比對照組差（p＜0.05）。病人組之步行速度在四種步行情境下均明顯比控制組慢，但是步行速度與本體感覺功能間並無相關性，此結果並不支持實驗假設。本研究結果顯示人工膝關節患者本體感覺功能下降，但是在本體感覺功能與步行功能間之關係，則需再進一步之研究探討。

The purposes of this research are 1) to establish a new reliable assessment method for proprioceptive function of knee joint in clinical use, 2) to assess the propriopceptive function of the total knee replacement （TKR）patients and 3) to exam the relationship of proprioception and ambulating function. There were 16 TKR patients and 16 aged matched control group in this study. Two assessment model for propriocetive function — unilateral and bilateral model were used, and subjects were test with active method and passive method separately. In data analysis, the constant error, variable error, and root mean square error were used.. Result showed that the proprioceptive function of the TKR patient was poor, and the walking velocity was slower than aged matched control group. There was no correlation between propriocpetion and walking speed in the TKR patients. Finding of this study supports that the proprioceptive function of patient after TKR is decreased. Further research is needed to exam the influence of the diminished proprioceptive function on the functional performance of TKR patients.

第一章、前言------------------------------------------------1-12
第一節、研究背景-------------------------------------------1-9
第二節、研究目的--------------------------------------------10
第三節、研究問題--------------------------------------------10
第四節、實驗假設--------------------------------------------11
第五節、使用名詞定義-------------------------------------11-12
第二章、方法-----------------------------------------------13-18
第一節、受試者-------------------------------------------13-14
第二節、儀器及測驗程序-----------------------------------14-16
第三節、資料分析與統計--------------------------------------17
第四節、研究限制與困難--------------------------------------18
第三章、結果-----------------------------------------------19-23
第一節、本體感覺功能測試
再測信度--------------------------------------------19
病人組與控制組膝關節本體感覺功能
之比較----------------------------------------------20
第二節、功能評估
膝關節功能分數(HSS rating score)-------------------21
行走功能評估------------------------------------21-22
第三節、功能評估與本體感覺評估之相關性
HSS分數與本體感覺功能、步行速度間
之相關性--------------------------------------------23
步行速度與本體感覺功能間之相關性--------------------23
第四章、討論-----------------------------------------------24-43
第一節、膝關節本體感覺功能之再測信度---------------------25-26
第二節、病人組與控制組膝關節本體感覺功能
之比較-------------------------------------------26-30
第三節、功能評估-----------------------------------------30-34
第四節、功能評估與膝關節本體感覺相關性之探討-------------34-39
第五節、結論------------------------------------------------40
第六節、臨床運用與未來研究方向---------------------------41-43

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