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研究生:周珮琪
研究生(外文):Pei-Chi,Chou
論文名稱:模擬屈膝站姿對腦性麻痺兒童的姿勢調整影響
論文名稱(外文):Effect of Simulated Crouch Stance on Postural Adjustments in Children with Cerebral Palsy
指導教授:劉文瑜劉文瑜引用關係
指導教授(外文):Wen-Yu,Liu
學位類別:碩士
校院名稱:長庚大學
系所名稱:復健科學研究所
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:2005
畢業學年度:94
語文別:中文
論文頁數:113
中文關鍵詞:屈膝站姿腦性麻痺兒童姿勢調整
外文關鍵詞:Crouch StanceCerebral PalsyPostural Adjustments
相關次數:
  • 被引用被引用:1
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  • 下載下載:39
  • 收藏至我的研究室書目清單書目收藏:6
背景與目的:較差的姿勢調整和屈膝站姿是腦性麻痺兒童的常見問題。雖然肌肉骨骼系統對於姿勢調整的影響,近年來逐漸受到重視,但少有研究探討不同的站立姿勢排列(alignment)對於自發活動時姿勢調整的影響。本研究目的為比較在直立和屈膝站姿下,對於正常和腦性麻痺兒童的自發活動時的姿勢調整的影響。方法: 以重複量測研究設計進行。14名正常和14名腦性麻痺兒童配對年齡與性別參與本實驗,每位兒童分別在直立或利用彈力帶所造成模擬屈膝兩種站姿的姿勢排列,進行伸手向前取物活動,利用EMG比較肌肉活化的型態和力板測量COP的移動做為主要姿勢調整的評估。所蒐集的資料以描述性統計、魏克森符號排序檢定、曼-惠特尼U檢定及重覆量測雙因子變異數分析之統計方式來分析。結果: 在兩種姿勢排列下,兩組姿勢調整的基本特定方向性型態並無明顯差異,但在有些時間和數量變數的差異有達統計顯著意義。討論:本研究的結果建議雖然腦性麻痺兒童和正常發展兒童對於模擬屈膝所造成姿勢排列改變皆不會改變基本特定方向性的姿態調整,但腦性麻痺兒童在模擬屈膝時所使用姿態調整的微調方式可能和正常發展兒童不同。
Background and Purpose: Poor postural adjustments and crouched stance are the common problems in children with cerebral palsy (CP). The influences of musculoskeletal problems to posture control have been valued recently. However, the relationships between different standing alignments and self-initated postural adjustments were not fully examined. The purpose of this study was to compare the postural adjustments in the upright stance to the simulated crouch stance in children with CP and typical development (TD). Methods: A repeated measures design was used. Fourteen children with TD and 14 with CP matching in age and gender participated in this study. Thera-bands that produced the simulated knee flexion by 30 degrees were applied to all children. EMG and center of pressure were recorded during the functional reach tasks in standing as the primary measures. Descriptive analyses、Wilcoxon signed ranks test、Mann-Whitney test and two-way repeated measures ANOVA were used for data analyses. Result: Basic directional-specific postural adjustments were not significantly altered by the simulated crouch position in both groups. However, significantly differences in some temporal and quantivative paramenters were noted after crouched stances. Discussion: Regardless of biomechanical alignments, children in both groups produced similar spatial direction-specific postural adjustments. Compared to children with TD, children with CP may demonstrate temporal and quantivative differences in fine-tune modulation of postural adjustments during the simulated crouch stance.
指導教授推薦書
口試委員會審定書
授權書 iii
致謝 vi
中文摘要 vii
英文摘要 viii
表目錄 xiv
圖目錄 xv
第一章 前言 1
第一節 研究背景與動機 1
第二節 名詞定義 3
第三節 研究問題及研究假設 3
第四節 重要性 4
第五節 研究限制 4
第二章 文獻回顧 6
第一節 腦性麻痺兒童屈膝站姿之定義與可能原因 7
第二節 兒童的肌肉骨骼系統與姿勢調整 10
第一段 姿勢調整的理論架構 10
第二段 正常發展兒童在姿勢反應期姿勢調整 13
第三段 腦性麻痺兒童在姿勢反應期姿勢調整 16
第四段 正常發展兒童的預期性姿勢調整 17
第五段 腦性麻痺兒童的預期性姿勢調整 18
第六段 肌肉骨骼系統與姿勢調整的關係 20
第七段 屈膝站姿對於直立姿勢的影響 22
第三節 站立姿勢調整的評估方法 25
第三章 研究方法 29
第一節 受測者 29
第二節 測量工具 30
第三節 測試流程 31
第四節 資料處理 34
第五節 統計分析 37
第四章 結果 44
第一節 直立與屈膝對在臨床評估上的差異 44
第二節 直立與屈膝對伸手向前動作之影響 44
第三節 直立與屈膝在姿勢評估上的差異 45
第一段 正常發展組兒童的表現 45
第二段 腦性麻痺兒童和正常兒童的比較 47
第五章 討論 67
第一節 神經生理學的考量 68
第一段 屈膝對姿勢調整在空間上變數--基本型態的變化 69
第二段 屈膝對姿勢調整在時間和數量上變數—姿勢活動的調整 71
第二節 實驗方法上的考量 73
第六章 結論 76
參考文獻 77
附錄一 功能性伸手向前測試之重測信度量測 83
附錄二 前趨實驗 87
附錄三 四位半邊痙攣型腦性麻痺和十位下肢痙攣型腦性麻痺分別和其配對正常發展組分開的統計結果 90
附錄四 肌力測試及被動關節角度的選擇及量測方式 103
附錄五 功能性伸手取物測驗方式 104
附錄六 聯合的動作協調形態(Consolidated Motor Coordination Patterns, cMCP) 105
附錄七 臨床與實驗室量測紀錄表 106
附錄八 受測者同意書:家長同意書和兒童同意書 109
附錄九 人體試驗委員會同意書 113
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