臺灣博碩士論文加值系統

研究目的:探討冰敷對於腰椎薦椎化並下背痛患者的腰椎活動度、腹背肌力和肌耐力表現的影響。研究方法:以24位受試者進行測試，12位腰椎薦椎化並下背痛患者為實驗組，另外12位為年齡、身高、體重相稱的一般健康者為控制組，分別接受腰椎活動度、腹背等長肌力和等長肌耐力等前測。隨後進行腰部20分鐘冰敷，待皮膚回溫後再次進行上述項目後測。本研究採用重複量測雙因子變異數分析(two way ANOVA with reapted measures)進行兩組間與冰敷前後的差異比較。結果與討論:本研究結果顯示，冰敷前實驗組腰椎4個方向活動度皆較一般人來的差，其中前屈曲活動度，兩組達顯著差異；冰敷後，實驗組腰椎活動度皆有所改善，其中前屈曲活動度達顯著差異；背肌肌力和肌耐力表現中，控制組冰敷前後達顯著差異。只有實驗組前屈曲活動度在冰敷前後達顯著，可能與冰敷止痛效果有關；腹背肌肌力/肌耐力表現有改善但皆未達顯著差異，肌肉適能不足，可能需要一段時間規律訓練後，才能夠使增強。結論與建議:腰椎薦椎化並下背痛患者，腰椎活動度和腹背肌肌力、肌耐力皆較一般健康人來的差，冰敷介入有利於腰椎薦椎化患者腰椎活動度和肌肉適能的改善。因此建議冰敷可以暫時部分改善腰椎薦椎化並下背痛患者的腰椎活動度與肌適能，而經由肌力或柔軟度訓練，可能可以更進一步改善腰椎薦椎化患者的下背痛與日常生活功能。

PURPOSE: This research was designed to study on the ice pack application short effect on patients’ lumbar Range of Motion, Trunk muscle strength and muscle endurance. Patients with low back pain were caused by Sacralized L5 were selected by clinical diagnosis. METHOD: 24 subjects were conducted in this study. 12 subjects who have low back pain and were dignosed with Sacralized L5 as experimental group, other 12 healthy subjects who have similar ages, heights, and weights with experimental group as control group. Two groups had lumbar Range of Motion, Trunk muscle strength amd muscle endurance measurements as pretest. All subjects then give 20 minutes ice pack application on lumbar area. When subjects had reported a mederate temperture recovery, a post test would be processed. RESULT&DISCUSSION: Repeated ANOVA measurements revealed experimental group had poor lumbar Range of Motion (flexion/ extension/ lateral bending) before ice pack application. It was significant on lumbar flexion movement. After ice pack application, experimental group lumbar Range of Motion had some improvement, and it was significant different on flexion. On Trunk muscle strength and endurance performance, control group had a significant difference on pretest and post test. The only significant different was in flexion on experimental group, and it might be related to anesthetic effect of ice. Trunk muscle strength and endurance performance had some enhancement but it was not significant. The insufficiency of muscle strength and endurance may need a period of regular muscular training to enhence its quality. CONCLUSION & SUGGESTION: Low back pain patients with Sacralized L5 have poorer lumbar Range of motion , Trunk muscle strength and muscle endurance than healthy people. Ice pack application can temporarily benefit Sacralized L5 patients on lumbar Range of Motion and muscle fitness. By muscular or flexability training, it might decrease the low back pain on Sacralized L5 patients and their active daily living function.

第壹章　緒論 1
第一節　研究背景 1
第二節　研究目的 3
第三節　研究假設 3
第四節　研究範圍 3
第五節　研究限制 4
第六節　名詞解釋及操作性定義 4
第貳章　文獻探討 5
第一節　腰薦椎結構與關節活動度及肌肉作用的關係 5
第二節　腰薦椎轉變椎體(LSTV)之介紹 7
第三節　髂腰韌帶結構之介紹 10
第四節　冷療之治療功效 12
第五節　腰椎薦椎化之結構對活動度、肌力的影響 14
第六節　總結 16
第參章　材料與方法 17
第一節　研究對象 17
第二節　實驗時間與地點 17
第三節　實驗設備與器材 17
第四節　實驗設計 20
第五節　實驗步驟與流程 21
第六節　資料處理與統計分析 30
第肆章　結果 31
第一節　受試者基本資料 31
第二節　腰椎關節活動度 33
第三節　軀幹腹背肌肌力 38
第四節　軀幹腹背肌肌耐力 41
第伍章　討論 44
第一節　腰椎薦椎化對腰椎活動度表現之影響 44
第二節　腰椎薦椎化對腹背肌等長最大肌力與肌耐力表現之比較 45
第三節　冰敷介入後，腰椎薦椎化對腰椎活動度與腹背肌肌力/肌耐力表現之影響 47
第陸章　結論與建議 50
第一節　結論 50
第二節　建議 51
參考文獻 52

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