臺灣博碩士論文加值系統

本研究的目的在於探討兩種目前較常被使用的復健型膝支架, 對步行中膝
關節運動之影響, 藉以評估其是否能對術後脆弱的 組織提供保護功能。
利用尤拉角及螺旋軸的理論及三維空間動態分析系統, 我們可以得到在平
板步道走路時, 膝關節六自由度之運動學資料。實驗對象分為實驗組及對
照組, 前者包括七位左膝前十字韌帶斷裂的病人, 其中六位接受過韌帶重
建手術, 另一位則韌帶為部份斷裂。對照組為以往無背痛或下肢異常的正
常人。兩組在測試時, 均以自然的速度前進, 實驗組則又分別穿上
ROM splint及 4-Point brace 接受測試。結果顯示整個步態週期中, 不
論是旋轉或平移的圖形或幅度, 受試兩組間並無顯著差異。其中,膝關節
三軸向的旋轉角度變化以彎曲/ 伸直最大,外展/ 內收最小, 而三 軸向平
移以前/ 後位移最大, 內/ 外位移最小。在擺動期中, 有最大的彎曲、
外展及外轉, 大腿相對於小腿向後 、向上及向內位移的最大值, 也在此
期出現。 至於支架對步行速率之影響則因人而異, 平均來看, 只稍微減
慢 ,而站立期於步態週期中所占的比例, 並無明顯改變。 兩種支架雖然
並未改變膝關節各軸向旋轉或平移的變化圖形, 但變化幅度明顯減少,顯
示兩種支架應具有協助關節穩定之保護功能。其中 ROM splint在各軸向
運動的限制都較 4-Point brace 明顯, 可能與其支架本身較長、與使用
者大腿之接觸面較廣及環帶之設計有關。本實驗的理論及設備可準確獲得
膝關節運動之三維六自由度資料. 雖然在多數的情況下, 探討膝關節運動
只要三個自由度已經足夠, 但 若涉及十字韌帶或支架設計之研究, 三軸
向的平移量是不該忽略的。

The purpose of this study was to evaluate the influence of two
currently available rehabilitative knee braces on knee motion
and to evaluate their ability of protection against the
postoperative tissue. By the theory of Euler angle and finite
helical axis and the use of 3-D motion analysis system,we could
measure all six degrees of freedom (DOF) of knee motion during
level walking. The experimental group consisted of seven left
ACL-deficient patients. Six of them had received ligament
reconstruction and the other one had received partial
meniscectomy only because of partial tear of the ACL. Six
normal subjects comprised the control group and all of them
were free of any pathological change on the back or lower limbs
that might have an effect of their gait. Four test conditions
were investigated:(1) injured limb, (2) control limb, (3)
injured limb with ROM splint, (4)injured limb with 4-Point
brace. There were no apparent differences in the graphical
patterns and amplitude values for any of the six DOF of knee
movement between the two unbraced conditions. Among the three
rotational angles,the change in knee flexion/extension was the
largest and that in knee abduction/adduction was the smallest
one. Among the three translational components,the change in the
anterior/posterior translation was the largest and that in the
medial/lateral translation was the smallest. We could note that
the graphical patterns of five of the parameters(DOF)all had
swing phase peaks that appeared time related to flexion/
extension. Both brace applications were shown to significantly
reduce the values of all six parameters of knee motion ,which
seemed to be more marked when ROM splint was used,but no
noticeable changes could be found in the graphical patterns
,walking velocity and percentage of left or right stance phase
in the gait cycle.