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研究生:杜婉瑜
研究生(外文):Wan-Yu Du
論文名稱:比較肌電訊號回饋與影像回饋訓練法於肩峰下夾擠族群之效果:隨機控制實驗
論文名稱(外文):Comparison of the effect of EMG biofeedback and video feedback in patients with subacromial impingement syndrome: a randomized control trial
指導教授:林居正林居正引用關係
口試日期:2017-07-28
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:物理治療學研究所
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:2017
畢業學年度:105
語文別:英文
論文頁數:109
中文關鍵詞:肩峰下夾擠症候群肌電生理回饋影像回饋隨機控制實驗肌肉表現肩胛骨動作
外文關鍵詞:Subacromial impingement syndromeEMG biofeedbackVideo feedbackRandomized control trialMuscle performanceScapular kinematics
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Background: Subacromial impingement syndrome (SIS) is associated with scapular dyskinesis, imbalanced scapular muscle activity. It is crucial to focus on scapular control during the initial stage of rehabilitation. Evidence showed that feedback can be beneficial to this population. However, it is unknown whether real-time electromyography (EMG) biofeedback or video feedback is optimal for improving scapular kinematics and muscle activity during functional tasks. Objective: There were 3 objectives for the present study: (1) to compare the effects between EMG and video feedback sessions on absolute muscle activity (UT, LT, SA), muscle balance ratios (UT/LT, UT/SA) and scapula kinematics (anterior/posterior tilt, external/ internal rotation, upward rotation) in SIS subjects during functional tasks ;(2) to compare the effects of feedback on absolute muscle activity, muscle balance ratios and scapula kinematics in SIS subjects during functional tasks; (3) to compare the effects of feedback training on shoulder girdle proprioception in SIS participants. Design: Patients with SIS and scapular dyskinesis (prominmence of medial border) was recruited in this study. Participants was randomized into EMG biofeedback group or video feedback group. Each patient learned to control their scapula through feedback session during arm elevation/ lowering in the scapula plane and placing a light load on a shoulder height desk. Three-dimensional electromagnetic motion analysis system and electromyography muscle activity was used to record scapular kinematics, absolute muscle activation and muscular balance ratios during tasks before and after feedback training. Main outcome measures: Scapula kinematics (internal/ external rotation, anterior/ posterior tilt, upward rotation), absolute muscle activity (UT, LT, SA) and muscle balance ratios (UT/LT, UT/ SA) were main outcomes of the study. Results: In comparisons of video group and EMG biofeedback group, EMG biofeedback group had significant increase in increased LT muscle activity and decrease in UT/LT. Both groups had decreased UT muscle activity, UT/LT, UT/SA and scapular internal rotation, increased LT muscle activity after feedback training. In contrast, subjects did not improve in shoulder girdle proprioception in either video group or EMG biofeedback group. Conclusion: It is suggested that EMG biofeedback application on SIS patients could maximize the learning effect on both muscle control and scapular correction.
口試委員審定書 i
致謝 ii
Abstract viii
List of tables xiii
List of figures xv
Nature of the study 1
Background 1
Statement of problems 4
Purposes of the study 5
Hypotheses 6
Literature review 8
Subacromial impingement syndrome (SIS) 8
SIS and shoulder function 10
Scapular dyskinesis in SIS patients 12
Altered scapular muscle activation in SIS patients 14
Benefits of feedback 16
Application of real-time electromyography feedback 17
Application of real-time video feedback 19
Methods 20
Design 20
Subjects 20
Inclusion criteria 20
Exclusion criteria 21
Instrumentation 22
Procedures 24
Outcome measures 30
Statistical analysis 33
Results 35
Basic data 35
Scapular plane arm elevation and lowering 35
Reaching 39
Shoulder girdle proprioception 42
Discussion 43
Conclusions 52
References 53
Tables 63
Figures 82
Appendix 102
Appendix 1: Flexilevel Scale of Shoulder Function-Self reported 102
Appendix 2: Permission of Institutional Review Board and Consent 106
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