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研究生:黃柔瑄
研究生(外文):Rou-Syuan Huang
論文名稱:以握力複製精準度評估累積性上肢肌肉骨骼傷害之復健成效
論文名稱(外文):Evaluating Effectiveness of Rehabilitation of Cumulative Musculoskeletal Disorders of the Upper Limb by the Accuracy of Grip Strength Reproduction
指導教授:石裕川石裕川引用關係梁欣光梁欣光引用關係
指導教授(外文):Yu-Chuan ShihSin-Guang Liang
口試委員:石裕川梁欣光紀佳芬鐘綉貞林志隆
口試委員(外文):Yu-Chuan ShihSin-Guang LiangJia-Fen JiSiou-Jhen JhongJhih-Long Lin
口試日期:2014-05-07
學位類別:碩士
校院名稱:國防大學
系所名稱:運籌管理學系
學門:商業及管理學門
學類:行銷與流通學類
論文種類:學術論文
論文出版年:2014
畢業學年度:102
語文別:中文
論文頁數:84
中文關鍵詞:累積性上肢肌肉骨骼傷害握力握力複製精準度
外文關鍵詞:Cumulative Musculoskeletal Disorders of The Upper LimbGrip StrengthThe Accuracy of Grip Strength Reproduction
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本研究旨在探討以握力複製精準度評估累積性上肢肌肉骨骼傷害之復健成效,共招募受測者男性4名及女性5名,受測者自2013年8月至2013年11月復健療程期間進行12次握力測試。本法係採用多因子實驗設計方法,實驗流程以最大意志施力作為分界,將實驗區分為三階段握力試驗。其中自變項包括性別、施力程度暨最大意志施力參考(8種施力組合)及復健療程期間之握力測試次數(12次),依變項為握力複製輸出、握力複製誤差(握力複製精準度不取絕對值)及握力複製變異程度(握力複製精準度取絕對值)。
本研究結果發現,就握力複製來說,當受試者施力程度在20%MVC的握力複製輸出值高估,而80%MVC的握力複製輸出值低估,40及60%MVC的握力複製誤差值則較趨近於零;信度方面,其結果顯示,握力複製輸出及施力程度暨最大意志施力參考具有顯著性相關;另外,不論試驗次數,女性的握力輸出值較男性有高估趨勢,且女性的握力複製誤差較男性趨近於零。在握力複製誤差部分,不同施力程度暨最大意志施力參考彼此間對握力複製誤差有顯著差異,但相同施力程度暨最大意志施力參考則無顯著差異;以握力複製變異程度來說,不論有無參考最大意志施力,當施力程度在20及40%MVC時,男性的握力複製變異程度較女性小;而施力程度在60及80%MVC時,女性的握力複製變異程度較男性小。

The purpose of this study is evaluating effectiveness of rehabilitation of cumulative musculoskeletal disorders of the upper limb by the accuracy of grip strength reproduction. Recruit four males and five females do this experiment . These experimenters have been under this therapy in the period from August to November totally 12 times. This study is using the method -Multi-factorial designs, the progress is using maximum volitional contraction dividing this experiment into three part. In which independent variables include gender, grip exertion Level on refer to maximum volitional contraction(eight kinds of %MVC) and the times when doing grip strength therapy(12 times). The dependent variables are output of grip strength reproduction, the error of grip strength reproduction ( no absolute value of the accuracy of grip strength reproduction)and variation level of grip strength reproduction(the absolute value of the accuracy of grip strength reproduction ).
The result of this study found that when the MVC is 20% the output of grip strength will be overestimate ,however when the MVC is 80% the output will be underestimate, when the MVC is 40% and 60% the margin of error will approach zero. In the point of view of reliability the result turns out that significant correlation coefficients between the error of grip strength reproduction and grip exertion Level on refer to maximum volitional contraction; however no matter how many times of the experiment the output of grip strength in female seems to have the tendency of overestimate than male, also the error of grip strength reproduction in female are getting more closer to zero. In the part of the error of grip strength reproduction have significant difference between different maximum volitional contraction and margin of error, on the other side results show that there is no significant difference between same strength and maximum volitional contraction;On the side of variation level of grip strength reproduction, no matter how the maximum volitional contraction is, when the MVC is between 20 to 40, male gets less variation level of grip strength reproduction than female; however when the maximum volitional contraction is between 60 to 80 the variation level of grip strength reproduction in female is less.

目錄
誌謝 i
摘要 ii
Abstract iii
目錄 v
表目錄 viii
圖目錄 ix
第一章 緒論 1
1.1 研究背景與動機 1
1.2 研究目的 2
1.3 研究範圍與限制 2
1.4 研究流程 3
第二章 文獻探討 4
2.1 累積性肌肉骨骼傷害之定義及國內外概況 5
2.1.1 職業傷害定義 5
2.1.2 累積性肌肉骨骼傷病定義 6
2.1.3 國內外肌肉骨骼傷害之概況 6
2.2 累積性上肢肌肉骨骼常見病理機制 9
2.3 累積性上肢肌肉骨骼傷害與握力 11
2.3.1 握力 13
2.3.2 握力複製 15
2.4 物理治療介入復健療程 17
2.4.1 肌肉骨骼傷害復健成效之時間 17
2.4.2 物理治療儀器於復健上之應用 18
2.5 小結 19
第三章 研究方法 21
3.1 受試者 21
3.2 實驗儀器設備 21
3.3 實驗流程及資料擷取 23
3.3.1 受試者遴選 25
3.3.2 實驗階段 27
3.4 實驗設計 33
3.4.1 自變項 (Independent Variables) 34
3.4.2 依變項 (Dependent Variables) 35
3.5 統計分析 36
第四章 實驗結果 37
4.1 受試者之敘述統計資料 37
4.2 握力複製輸出之準度及信度 41
4.3 握力複製誤差 42
4.4 握力複製變異程度 45
第五章 結論與建議 49
5.1 結論 49
5.2 建議 50
參考文獻 51
附錄A 58
附錄B 59
附錄C 65
附錄D 66
附錄E 67
附錄F 69
附錄G 70
附錄H 72
附錄I 73
附錄J 74

表目錄
表2.1 民國100年國民醫療保健支出 8
表2.2 常見的累積性上肢傷害 10
表2.3 上肢肌肉骨骼傷害與握力之相關研究 12
表2.4 握力在各種臨床之應用領域 14
表2.5 握力複製精準度之相關文獻 16
表2.6 復健之物理治療方法 19
表3.1 跨距式握力計與荷重計規格表 22
表3.2 應變資料擷取系統規格表 23
表3.3 簡短肌肉骨骼傷害評估問卷(SMFA) 25
表3.4 工作等級分類 26
表3.5 人體計測量測項目定義 27
表3.6 實驗流程註解 28
表4.1 受試者基本資料表 37
表4.2 受試者工作資料表 39
表4.3 受試者肌肉骨骼傷害問卷調查表 40
表4.4 握力複製輸出之敘述性統計表 41
表4.5 握力複製輸出與施力程度暨最大意志施力參考之相關分析 42
表4.6 握力複製誤差之ANOVA結果 43
表4.7 握力複製誤差之敘述性統計 43
表4.8 握力複製變異程度之ANOVA結果 46
表4.9 握力複製變異程度之敘述性統計 46


圖目錄
圖1.1 研究流程圖 4
圖3.1 實驗流程圖 24
圖3.2 實驗組合流程範例圖 28
圖3.3 手持握力計坐姿圖 29
圖3.4 握力計之間距圖 30
圖3.5 握力計歸零畫面圖 30
圖3.6 握力複製第一階段量測圖 31
圖3.7 握力複製資料擷取圖 32
圖3.8 本研究之實驗設計圖 33
圖4.1 施力程度暨最大意志施力參考對握力複製誤差之影響 44
圖4.2 性別與試驗次數對握力複製誤差之影響 44
圖4.3施力程度暨最大意志施力參考對握力複製變異程度之影響 47


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