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研究生:羅楚玲
研究生(外文):Chu-Ling Lo
論文名稱:除壓貼紮相對於傳統物理治療對手肘外上髁炎患者之附加治療效果
論文名稱(外文):The additional effects of unloading taping to conventional treatment for subjects with latera epicondylitis
指導教授:陳文英陳文英引用關係王子娟王子娟引用關係
指導教授(外文):Wen-Yin ChenTzyy-Jiuan Wnag
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:英文
論文頁數:112
中文關鍵詞:手肘外上髁炎貼紮
外文關鍵詞:lateral epicondylitistaping
相關次數:
  • 被引用被引用:1
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  • 下載下載:65
  • 收藏至我的研究室書目清單書目收藏:0
摘要
研究背景:外上髁炎是手肘常見的一種肌肉骨骼系統問題,在一般族群中其盛行率約為百分之一到百分之十五,手肘外上髁炎主要會影響患者之疼痛系統以及肌肉系統和動作系統的功能與表現;而「貼紮」是一種常被物理治療師使用的治療方式,主要用於處理因肌肉骨系統所產生之疼痛,其中「除壓貼紮法」被認為是一種可減輕疼痛、增加肌肉力量的治療方式;然而目前並無相關研究文獻能證實除壓貼紮對於手肘外上髁炎之治療效果。本篇研究的目的是要評估除壓貼紮配合上傳統物理治療是否對於手肘外上髁炎之患者有附加的治療效果。本研究有27位患有單側手肘外上髁炎的受測者(18位男性,9位女性)參與本研究,這27位受測者被隨機分配至治療組與比較組;治療組共有13位患者(9位男性以及4位女性,平均年齡為37.9±9.9歲),接受的治療項目包括傳統物理治療(間斷式超音波、治療性運動)以及除壓貼紮;比較組有14位患者(9位男性以及5位女性,平均年齡為42.6±13歲),接受的治療只有傳統物理治療(間斷式超音波、治療性運動)以及安慰劑式貼紮,所有受測者的年齡、身高、體重、身體質量指數、症狀持續時間、工作或活動狀態、患側手以及慣用手均會列入基本資料記錄;兩組均會接受為期一週三次的治療,第一次治療前測試為本研究之前測,完成一週治療後接受後測,測試項目包括無痛握力測試、壓痛覺閾值測試、手臂自我評量表以及綜合改善量表。兩組受測者之基本資料以卡方檢定、t檢定分析,其他量測除綜合改善量表外以二因子重複測試多變量變異數分析(two way repeated measures MANOVAs),綜合改善量表結果以卡方檢定分析,本研究結果分析採意向治療分析(intention to treat)。結果:經一週治療後治療組與比較組之無痛握力測試均有顯著進步(p<0.05),治療組之進步量為45%,比較組之進步量為21%,但兩組並無組間差異。在壓痛覺閾值測試方面,經一週治療後治療組有28%的進步量而比較組的進步量只有9%,雖然治療組之進步較比較組多,但兩組之進步量均未達統計學上的顯著性進步量。在手臂自我評量表方面,兩組受測者不論在總分、疼痛以及功能方面經一 週治療後均有顯著的進步(p<0.05),且兩組的結果有顯著的交互作用(interactions),但兩組間並無統計學上的顯著差異;而在綜合改善量表上,治療組顯著的有較多比例的受測者自評有較佳的整體進步量(p<0.05)。結論:本篇研究的結果指出對手肘外上髁炎的患者而言,除壓貼紮配合上傳統物理治療比上只接受傳統物理治療在手臂自我評量表和綜合改善量表上有較好的效果,因此依本研究的結果可建議對於手肘外上髁炎的治療而言除壓貼紮是一種有附加效果的輔助療法。
Abstract
Background. Lateral epicondylitis (LE) is a common musculoskeletal problem in the elbow with a prevalence ranged from 1 to 15% among general population. Pain system dysfunction, muscle and motor dysfunction are the main deficits. Taping is one of the adjunctive treatments commonly used by physical therapists for managing musculoskeletal pain. Unloading taping has been claimed to reduce pain and improve strength. However, no research has been conducted to support its effects. Purpose. This study aimed to assess the additional effects of unloading taping to conventional physical therapy in treating subjects with LE. Methods. Twenty-seven subjects (18 males, 9 females) were recruited and randomly assigned to either a treatment or a comparison group. The treatment group (9 males, 4 females; mean age 37.9±9.9 years) received ulsed ultrasound, therapeutic exercise, and unloading taping. The comparison group (9 males, 5 females; mean age 42.6±13.0 years) received pulsed ultrasound, therapeutic exercise, and placebo taping. The intervention for both groups was provided three times a week for one week. Outcome measurements. Outcome measurements consisted of pain-free grip strength (PFGS), pressure pain threshold (PPT), patient-rated forearm evaluation questionnaire (PRFEQ) and the global change rating scale. Outcome measures were evaluated before and after the one-week intervention for both the treatment and the comparison groups. Statistical Analysis. Two-way repeated measures MANOVAs were used to analyze the group by time interaction and the group and time main effects in PFGS, PPT and PRFEQ. The global rating scale was analyzed by using a Chi-square test. Intention-to-treat analysis was also used. Results. The PFGS significantly improved (increased 45%, p<0.05) after one-week intervention in the treatment group although the comparison group also demonstrated 21% improvement. The PPT also revealed 28% and 9% improvement in the treatment group and the comparison group, respectively, although the between-group difference was not significant. Significantly improvements were found in both groups on the functional disability domain (PRFEQ), including the pain subscore and the functional subscore in after one-week treatment (p<0.05). A significant better improvement was found in the treatment group for the global rating scale than the comparison group (p<0.05). Conclusion. The results of this study indicated that unloading taping did have some additional effects on functional disability and patient’s self-perceived general improvement to conventional therapy for managing LE. The data suggested that unloading taping is a useful adjunctive treatment in treating subjects with LE.
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