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研究生:陳貞吟
研究生(外文):Chen-Yin Chen
論文名稱:中風患者坐姿前伸和獨立坐姿站起能力之相關性研究
論文名稱(外文):Relationships between forward reach and the sit-to-standactivity in patients with stroke
指導教授:王瑞瑤
指導教授(外文):Ray-Yau Wang
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:物理治療研究所
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:46
中文關鍵詞:坐姿站起坐姿前伸軀幹前傾中風
外文關鍵詞:sit to standforward reachtrunk forwardstroke
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中風患者坐姿前伸和坐姿站起能力之相關性研究
中文摘要
背景與目的:坐姿站起的動作在日常生活中是一個很重要的活動。其中牽涉到姿勢的轉變及重心的轉移,患者如能由坐姿升高重心到站立的姿勢,才能進一步在站立姿勢下練習重心的轉換及跨步的動作,以增加患側下肢的負重,作為行走訓練的準備。而在坐姿站起的過程中需要利用軀幹的前傾將重心轉移至下肢,下肢用力使坐姿站起活動順利完成。日常生活的獨立程度與病患於坐姿下執行伸取的活動,以及伸取的範圍有很大的關係。坐姿前伸需要病患能做較遠的軀幹前傾,也需要有很好的軀幹功能,才能有好的表現。而坐姿站起的動作過程中也需要軀幹前傾以幫助將重心前移,才有利於下肢用力將身體重心撐起。中風患者的坐姿前伸能力與坐姿站起能力都明顯較健康人差,但是,卻很少有學者研究坐姿站起和坐姿前伸之關係,所以本研究希望了解中風患者執行坐姿前伸和坐姿站起間是否有相關性。
研究方法:本研究共收集三十三位中風患者,分為可獨立站起組及無法獨立站起組,利用電子位移計量測單手及雙手坐姿前伸的距離,用碼表記錄坐姿站起完成的時間,並且利用電腦軟體分析動作時軀幹角度的變化。
統計分析:以獨立t測試比較可獨立站起組與無法獨立站起組之間坐姿前伸長度的差異,及兩組之間執行坐姿站起時軀幹前傾角度的差異。以皮爾森相關係數檢驗可獨立站起組其坐姿前伸的長度與坐姿站起完成時間的關係,及該組執行坐姿站起時軀幹前傾角度與坐姿站起完成時間的關係,所有測試的□值設定在0.05。
結果:坐姿下單手及雙手前伸的距離在可獨立站起組(41.6± 4.4公分,37. 5± 6.3公分)與無法獨立站起組間(32.0± 7.4公分,29.5± 9.1公分)有顯著差異(p<0.001)。可獨立站起組的單手和雙手前伸距離長短和坐姿站起時間的快慢並沒有統計上的相關(r= -0.106,0.202,p= 0.0647, 0.38)。坐姿站起時的軀幹前傾角度,可獨立站起組為67.5± 11.7°,無法獨立站起組為66.6± 7.4°兩組並沒有統計上的差異(p=0.837)。可獨立站起組的軀幹前傾角度和坐姿站起的時間呈現中等程度的負相關(r= -0.525),具有統計意義(p= 0.044)。
討論:坐姿站起動作執行的成功與否和坐姿前伸的距離有關。可獨立站起組坐姿前伸距離較遠,所以,在執行坐姿站起時,坐姿前伸應該是一個重要的準備動作。坐姿前伸動作的完成除了需要有好的上肢功能外,也需要下肢動作控制能力與軀幹控制能力的幫忙,如此才能使坐姿前伸距離拉長。在執行坐姿站起時,軀幹前傾角度越大者,完成坐姿站起活動的時間會越短。
結論:坐姿前伸是中風病患在執行坐姿站起活動時一項重要的預備工作,如果病患不能有效的執行坐姿前伸,就無法有效的將軀幹重心前移到下肢,所以在執行坐姿站起時就容易失敗。此結論可以提供一些臨床治療師在執行功能性動作訓練治療上的參考,對於中風後無法自行由坐姿站起的病患,臨床治療師可以先給予一些有關坐姿前伸的訓練,加強病患坐姿前伸與軀幹前傾的能力,如此一來可以加強病患由坐姿站起的預備動作,使得獨立由坐姿站起活動更容易達成。
關鍵詞:坐姿站起,坐姿前伸,軀幹前傾,中風
Relationships between forward reach and the sit-to-stand activity in patients with stroke
Abstract
Background and Purpose: Sit to stand is one of the most important activities of daily living. It requires coordination, balance, mobility, and strength. The ability of reach while in sitting is also important for an independent living. Trunk forward and loading body weight to the feet, both are key components for reaching a distant object. Both are also important components in the early phase of the sit-to-stand activity. The purpose of this study is to investigate the relationships between the reaching activity in sitting and the ability of sit-to-stand in patients with stroke.
Study design: A cross-sectional, exploratory study was carried out in a medical center. Subjects: Thirty-three patients with hemiparesis resulting from cerebral vascular disease participated in the study.
Measurements: The forward reach distance in sitting was measured by a displacement transducer. With regard to the sit-to-stand activity, a ‘fail’ was marked if the patients cannot complete the activity. Once the patient can succeed in the activity, the time needed to complete the sit-to-stand was recorded by a stopwatch. The trunk movement was recorded by video camera during the reaching and sit-to-stand activities, and was analysis by kinview 2.0 to determine trunk forward angle.
Statistical analysis: The independent t-test was used to compare the differences in the forward reach distance and trunk flexion angle between subjects who failed and subjects who succeeded in the sit-to-stand activity. Further, the Pearson correlation was used to examine the relationships between the forward reach distance and the time needed to complete the sit-to-stand activity and between trunk flexion angle and the time needed to complete the sit-to-stand activity. The □ lever was set at 0.05.
Results: There were significant difference in reaching distance between subjects who failed and subjects who succeeded in the sit-to-stand activity. But there were no correlation between reaching distance and the time needed for the sit-to-stand activity. There was no significant difference in trunk flexion angle between the two groups during the sit-to-stand activity. Significant correlation was found between trunk flexion angle and the time needed to complete the sit-to-stand activity.
Discussion/ Conclusion: The forward reach activity was an important component for preparing the sit-to-stand activity. When performing the sit to stand activity, the more trunk flexion forward, the shorter the time needed to complete the task. The results of our study can provide information to clinicians. The patients can practice forward reach in sitting for preparing a sit-to-stand activity. Trunk forward, which is the key component for sit-to-stand, can also practice during the reaching activity.
Key word: sit to stand, forward reach, trunk forward, stroke
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