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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 吳英黛(Ying-Tai Wu) | |
dc.contributor.author | Chung-Hsien Tsai | en |
dc.contributor.author | 蔡忠憲 | zh_TW |
dc.date.accessioned | 2021-06-13T00:04:13Z | - |
dc.date.available | 2007-08-08 | |
dc.date.copyright | 2007-08-08 | |
dc.date.issued | 2007 | |
dc.date.submitted | 2007-07-28 | |
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A short-term admission improved brachial-ankle pulse wave velocity in type 2 diabetic patients. Diabetes Res Clin Pract 2005;70:248-52. 64. Yamashina A, Tomiyama H, Takeda K, Tsuda H, Arai T, Hirose K, et al. Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement. Hypertens Res 2002;25:359-64. 65. Yamashina A, Tomiyama H, Arai T, Hirose K, Koji Y, Hirayama Y, et al. Brachial-ankle pulse wave velocity as a marker of atherosclerotic vascular damage and cardiovascular risk. Hypertens Res 2003;26:615-22. 66. Zieman SJ, Melenovsky V, Kass DA. Mechanism, pathophysiology, and therapy of arterial stiffness. Arterioscler Thromb Vasc Biol 2005;25:932-43. 67. 全民健康保險局。全民健康保險醫療統計年報。衛生署;2005。 68. 陳曉宜。步行機訓練對於慢性周邊動脈阻塞疾病患者效果之研究。臺灣大學物理治療學研究所。碩士論文;1999。 | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/28279 | - |
dc.description.abstract | 研究背景及目的:目前文獻少見運動訓練對術後周邊動脈疾患的訓練效果。本研究目的在探討個別化運動訓練對於改善術後周邊動脈疾患的血管功能,以及行走能力與生活品質的效果,並探討三者改變量間的相關性。方法:本研究徵召三十二位仍有症候的周邊動脈疾病術後患者,隨機分配至控制組與接受十二週個別化運動訓練計畫的運動組,所有受試者在研究期間維持原來的生活習慣、飲食習慣與藥物服用,並於收案時與十二週後分別接受一次血管功能、行走能力 (包含行走損傷問卷分數)與血管疾病生活品質問卷的評估。最後運動組十二位、控制組十三位完成測試。統計分析以independent t-test及Chi-square test比較兩組的基本資料,以2 × 2 two-way mixed ANOVA model比較所有參數之組間與組內差異,平均血壓則作為動脈功能參數分析的共同變項。Pearson’s correlation analysis則用以分析血管功能、行走能力及生活品質參數改變量間的相關性。結果:兩組受試者在收入時除舒張壓有顯著差異外,其餘各項參數均無顯著差異。疼痛發生及最大行走時間、行走損傷問卷上下樓梯分數、患側或較嚴重側硬化指數、兩側足趾血流量、血管疾病生活品質活動分數、症狀分數及總分等參數有顯著交互作用,post-hoc發現除患側或較嚴重側硬化指數在控制組內顯著增加外,其餘參數皆在運動組內有顯著變化,後測值組間比較則於患側或較嚴重側足趾血流量及血管疾病生活品質活動分數呈現顯著差異,其餘參數均無。在無顯著交互作用的參數中,行走損傷問卷的症狀與行走速度分數以及血管疾病生活品質情緒分數有顯著整體組內差異。相關性方面,足趾血流改變量與行走能力改變量間、足趾壓力改變量與行走能力改變量間、行走能力改變量與生活品質改變量間有顯著正相關,而脈波速率改變量與行走能力改變量間有顯著負相關。結論:本研究證實個別化運動訓練能顯著改善術後周邊動脈疾患的足趾血流量,行走時間與上下樓梯等行走能力,以及活動、症狀相關的生活品質。 | zh_TW |
dc.description.abstract | Background and purpose: Fewer studies investigated the exercise training effects on patients with peripheral arterial disease (PAD) after vascular intervention. The purposes of this study were to investigate individualized exercise training effects on arterial function, walking ability and quality of life (QoL), and correlations among changes of all variables in these patients. Methods: Thirty-two symptomatic post-vascular intervention subjects were recruited and randomly assigned into control group and exercise group whom received 12-week individualized exercise program. All subjects were asked to maintain their life style, diet, and medicine during study period and had arterial function, walking ability (including grades of Walking Impairment Questionnaire (WIQ)), and Vascular Quality of Life questionnaire (VascuQoL) measured at baseline and 12 weeks after. Twelve subjects in exercise group and 13 in control group completed the study. Independent t-test and Chi-square test were performed to compare the baseline data between groups. A 2 × 2 two-way mixed ANOVA model was performed to compare the between- and within-group differences in all variables. Mean arterial pressure was used as the covariate in analyzing the effects on variables of arterial function. Pearson correlation analysis was used to investigate the correlations among the changes in arterial function, walking ability and QoL. Results: There were no significant differences in baseline data between groups except diastolic blood pressure. Significant interactions were noted in variables of reflection index (RI) of more affected side, toe fluxs of two sides, initial claudication and maximal walking time, stairs grades of WIQ, acivity and symptom and sum grades of VascuQoL. Post-hocs showed significant within-control-group change in RI of more affected side, within-exercise-group changes in other variables with significant interaction, and between-group post-test differences in toe flux of more affected side and acivity grades of VascuQoL. Other variables with significant interaction showed no between-group post-test differences. For those without significant interactions, symptom and speed grades of WIQ and emotion grades of VascuQoL showed only significant within-group main differences. For correlations, positive relationships were noted between changes of toe flux and walking ability, toe pressure and walking ability, as well as walking ability and QoL. Negative relationship was noted between changes of brachial-ankle pulse wave velocity and walking ability. Conclusion: Individualized exercise training could significantly improve toe fluxs, walking time and ability of up/down stairs, as well as activity- and symptom-associated QoL in PAD patients post-vascular intervention. | en |
dc.description.provenance | Made available in DSpace on 2021-06-13T00:04:13Z (GMT). No. of bitstreams: 1 ntu-96-R94428005-1.pdf: 2930562 bytes, checksum: 368421c5d3ab4e3b23c1c68e0d8f02cd (MD5) Previous issue date: 2007 | en |
dc.description.tableofcontents | 口試委員會審定書 i
誌謝 ii 中文摘要 iii 英文摘要 v 第一章、前言 1 第一節、研究背景 1 第二節、研究目的 3 第三節、研究的重要性 3 第四節、受試者順應性 4 第五節、使用名詞之操作型定義 4 第二章:文獻回顧 6 第一節、動脈硬化的危險因子 6 第二節、動脈硬化的形成 7 第三節、周邊動脈血管與血流功能的測量 10 第四節、行走損傷問卷 16 第五節、生活品質問卷 18 第六節、運動對於動脈硬度與血液灌流狀態的影響 20 第七節、運動訓練改善動脈硬化的可能機轉 21 第三章、方法與實驗步驟 23 第一節、研究設計 23 第二節、受試者 23 第三節、研究變項 23 第四節、實驗程序 24 第五節、儀器與問卷評估 25 第六節、運動介入方式 28 第七節、統計方法 28 第四章、結果 30 第一節、受試者基本資料 30 第二節、訓練十二週後的參數改變 31 第三節、訓練前後參數改變之相關性 35 第五章、討論 36 第一節、運動訓練對行走能力的影響 36 第二節、運動訓練與血脂及血糖控制的關係 37 第三節、運動訓練對血管功能參數的影響 39 第四節、運動訓練對生活品質的影響 41 第五節、探討各項參數改變量的相關性 42 第六節、研究限制 43 第六章、結論 44 參考文獻 45 圖表目錄 表1. 非侵入性動脈硬化測量參數整理 56 表2. 影響各血管功能參數測量之可能因素 59 表3. 肱踝脈波速率測量之信度與效度研究 60 表4. 肱踝脈波速率測量之反應性研究 61 表5. 指容積脈波之信度與效度研究 62 表6. 指容積脈波之反應性研究 63 表7. 皮膚灌流狀態測量之信度與效度研究 64 表8. 皮膚灌流狀態測量之反應性研究 65 表9. 行走損傷問卷二十二題標準版之信度與效度研究 66 表10. 行走損傷問卷二十二題標準版之反應性研究 67 表11. 血管疾病生活品質問卷之信度與效度研究 68 表12. 血管疾病生活品質問卷之反應性研究 69 表13. 受試者基本資料 70 表14. 所有參數之變異數來源分析表 71 表15. 血液檢測、飲食、活動於十二週前後測試的比較 77 表16. 血管功能測試於十二週前後測試的比較 78 表17. 行走能力評估於十二週前後測試的比較 79 表18. 生活品質評估於十二週前後測試的比較 80 表19. 所有測試變項之簡單相關性分析 81 圖1. 周邊動脈硬化或阻塞之國際功能、失能與健康分類模型圖 84 圖2. 動脈硬化理論與假說示意圖 85 圖3. 動脈硬化形成示意圖 86 圖4. 肱踝脈波速率測試儀器簡圖 87 圖5. 指容積脈波測試儀器簡圖 88 圖6. 皮膚灌流量與灌流收縮壓測試儀器簡圖 89 圖7. 收案時之脈波速率儀器設定 90 圖8. 收案時之指容積脈波儀器設定 91 圖9. 收案時之都卜勒血流計儀器設定 92 圖10. 實驗流程圖 93 圖11. 受試者收案流程圖 94 圖12. 兩組受試者疼痛發生時間交互作用圖 95 圖13. 兩組受試者最大行走時間交互作用圖 96 圖14. 兩組受試者行走損傷問卷上下樓梯分數交互作用圖 97 圖15. 兩組受試者患側或較嚴重側足趾血流量交互作用圖 98 圖16. 兩組受試者另側足趾血流量交互作用圖 99 圖17. 兩組受試者患側或較嚴重側硬化指數交互作用圖 100 圖18. 兩組受試者血管疾病生活品質問卷活動分數交互作用圖 101 圖19. 兩組受試者血管疾病生活品質問卷症狀分數交互作用圖 102 圖20. 兩組受試者血管疾病生活品質問卷總分交互作用圖 103 圖21. 指容積脈波圖形比較 104 附件目錄 附件一、受試者同意書 105 附件二、受試者資料表 112 附件三、運動紀錄表 117 附件四、行走損傷問卷二十二題標準版 120 附件五、血管生活品質問卷 123 附件六、衛教單張 127 附件七、七日活動回顧問卷 129 附件八、飲食習慣問卷 132 附件九、各式問卷分數計算之公式 134 附件十、國立臺灣大學醫學院附設醫院研究倫理委員會同意函 136 | |
dc.language.iso | zh-TW | |
dc.title | 個別化運動訓練對周邊動脈疾病術後患者在動脈功能與行走能力及生活品質上的效果 | zh_TW |
dc.title | Effects of individualized exercise training on arterial function, walking ability and quality of life in patients with peripheral arterial disease post surgery | en |
dc.type | Thesis | |
dc.date.schoolyear | 95-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 王水深,王亭貴,邵耀華,高憲立 | |
dc.subject.keyword | 周邊動脈疾病術後,血管功能,行走能力,生活品質,個別化運動訓練, | zh_TW |
dc.subject.keyword | Peripheral arterial disease post vascular intervention,Arterial function,Walking ability,Quality of life,Individualized exercise training, | en |
dc.relation.page | 137 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2007-07-30 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 物理治療學研究所 | zh_TW |
顯示於系所單位: | 物理治療學系所 |
文件中的檔案:
檔案 | 大小 | 格式 | |
---|---|---|---|
ntu-96-1.pdf 目前未授權公開取用 | 2.86 MB | Adobe PDF |
系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。