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研究生:陳明義
研究生(外文):Ming-I Chen
論文名稱:功能性膝支架對膝反弓之中風患者步態的效應研究
論文名稱(外文):Effects of Functional Knee Brace on gait pattern in Stroke Patient with Knee Hyperextension
指導教授:游忠煌
指導教授(外文):Chung-huang Yu
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:復健科技輔具研究所
學門:醫藥衛生學門
學類:復健醫學學類
論文種類:學術論文
論文出版年:2004
畢業學年度:92
語文別:中文
論文頁數:92
中文關鍵詞:腦中風膝反弓功能性膝支架
外文關鍵詞:Strokeknee hyperextensionfunctional knee brace
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本研究是針對中風後膝反弓現象在病患穿戴膝部矯具行走時臨床效應的研究。
本研究總共有十二病患參與受測,所有受測者皆完成所有動力學(Kinetics)與運動學(Kinematics)的測驗。運動學的資料是以VICON370動作分析系統來收集資料,經由軟體程式之計算出下肢各關節角度活動度的大小、步寬、步長與步態周期時間等之運動學資料,並以三塊AMTI三維測力板系統,與運動學資料同步收集受試者水平步行(level walking)時地面反作用力及力矩。再以Inverse dynamic method反推踝、膝與髖等關節之力矩(moment)的改變狀況。
運動學結果顯示,健側下肢各關節角度變化在在髖關節伸直—屈曲活動度、髖關節內展—外展、膝關節伸直—彎曲之活動度達統計上顯著差異,而患側下肢各關節角度變化則在髖關節伸直—彎曲、膝關節伸直—彎曲、踝關節背曲—蹠曲之活動度達統計上顯著差異。其它運動學變數如步寬、健側步長、患側步長,達統計顯著差異,而週期時間不論是健側與患側均未達統計上顯著差異。動力學結果顯示,穿戴功能性膝矯具後對於健側下肢各關節肌肉群力矩未達統計上顯著差異,而穿戴功能性膝矯具後對於患側腳有—無穿戴功能性膝矯具後達統計上顯著的差異分別是:髖關節最大伸直力矩減少 -51.74%、髖關節最大外轉肌力矩減少-33.3 %。對於患側腳膝關節而言,膝關節最大外轉肌力矩減少-17.41%、膝關節最大伸直肌力矩減少 -33.78%、膝關節最大外轉肌力矩減少 -26.18%、膝關節最大屈曲肌力矩減少 -38.48 % 。對於患側腳踝關節而言,踝關節最大外翻肌力矩減少 -92.25 % 、踝關節最大背曲肌力矩,但是踝關節最大蹠曲肌力矩則增加+25.74%。
結論:穿戴功能膝矯具確實對於膝反弓之腦中風患者在健側腳與側側腳運動學變數如步寬、步長、與下肢各關節活動度達統計上顯著差異 ,對於動力學的變數有統計上顯著差異的分別為:患側腳髖關節最大伸直力矩、髖關節最大外轉肌力矩、膝關節最大外轉肌力矩、膝關節最大伸直肌力矩、膝關節最大外轉肌力矩、膝關節最大屈曲肌力矩、踝關節最大外翻肌力矩與踝關節最大背曲肌力矩。至於健側腳下肢各關節最大作用肌力矩則均無統計上顯著的差異。
Objectives: The purpose of this study was to compare lower extremity joint kinematics and kinetics during level walking with and without a functional knee brace in stroke patients with knee hyperextension.
Design: VICON370 Motion analysis systems were collected kinematics data and synchronize collected kinetics data with AMTI 3-dimentational force platform system, 12 hemipelgia subjects were including our study.
Setting: A gait laboratory.
Main Outcome Measures: Step width, step length, cycle time and ROM over lower limb kinematics variables and max hip, knee, and ankle joint moment kinetics variables during level walking.
Results: Step width, sound side stride length, affective side stride length, sound side hip flexion-extension, hip abduction-adduction, knee flexion-extension and affective side hip flexion-extension, knee flexion-extension, and ankle plantarflexion-dorsiflexion were significant difference (p, < 0.05). The kinetics variables were significant difference over affective lower extremity including Max hip extensor moment, hip external rotator moment, knee abductor moment, knee extensor moment, knee external rotator moment, knee flexor moment, ankle eversion moment, ankle plantarflexor moment and ankle dorsiflexor moment (p, < 0.05)..
Conclusion: Stoke patients with knee hyperextension applying functional knee brace may lead the more step width, step length and less ROM over sound and affective lower extremity and required less hip flexor, knee flexor, knee extensor, ankle dorsiflexor, but required more ankle plantarflexor moment.
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