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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 王榮德 | |
dc.contributor.author | Yuh Jang | en |
dc.contributor.author | 張彧 | zh_TW |
dc.date.accessioned | 2021-06-13T00:15:26Z | - |
dc.date.available | 2007-08-08 | |
dc.date.copyright | 2007-08-08 | |
dc.date.issued | 2007 | |
dc.date.submitted | 2007-07-27 | |
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/28643 | - |
dc.description.abstract | 研究目的:按摩屬於高度重複及高度施力型工作且採用特定及不適當工作姿勢,此種工作特性讓按摩從業人員屬於罹患肌肉骨骼疾病之高危險群。本研究的目的乃是在探討視覺障礙按摩從業人員肌肉骨骼疾病的盛行率及找出造成按摩從業人員肌肉骨骼疾病的原因。
研究方法:以橫斷式的研究設計,採用實地訪查的方式在2004年期間,針對台北市18歲以上之視覺障礙者,且在按摩院所擔任全職按摩工作者進行問卷調查,調查內容包括:人口學、人體測計與力量資料、肌肉骨骼疼痛及工作姿勢。描述性統計用來描述按摩從業人員的人口學、人體測計及手部力量資料,以及肌肉骨骼疾病的盛行率及嚴重度;用Spearman ρ 相關用來測試變數間的共線性關係;最後,用backward logistic regression的方式來探討影響身體各部位疼痛的危害因子,計算機率(odds ratios, ORs)及95%信賴區間(95% confidence intervals, 95%CIs)。 研究結果:161名按摩從業人員參與本研究,其中42人(26.1%)手部關節有異常腫大及變形現象;71.4%(115人)的受訪者身體至少一個部位有與工作相關之肌肉骨骼疼痛,手指及大拇指疼痛盛行率(50.3%)最高,其次為肩部(31.7%),手腕(28.6%),頸部(25.5%),上臂/肘(23.6%),前臂(20.5%)。神經學檢查結果出現正向反應(positive response)顯示疑似有腕道症候群的有29.8%,de Quervain氏症候群為33.5%,18.6%的受訪者在腕道症候群及de Quervain氏症候群神經學檢查同時呈現正向反應。肩頸疼痛、背部及下肢疼痛對於生活的影響屬輕度失能。 手指腹力≤7公斤或不使用手指腹部及整個手掌來從事按摩的受訪者,手指及大拇指關節可明顯看出有變形及腫大的比例較高(OR=3.4-9.6;95%CI=1.3-44.3)。影響按摩從業人員身體各部位疼痛的因素包括:工作年資、年齡、手指腹力、直接及持續與顧客接觸的時間、工作檯高度,以及工作姿勢。每天與顧客直接接觸的時間≥4小時罹患手指疼痛的機率是<4小時者的3.2倍(95%CI=1.3-8.1)。按摩從業人員的手指腹力≤7公斤罹患前臂或上臂/肘部疼痛的機率是手指腹力>7公斤者的2.9-3.2倍(95%CI=1.5-13.8)。從事按摩>20年者罹患手指及大拇指疼痛的機率是工作4-10年者的4.0-4.5倍(95%CI=1.5-13.8)。從事按摩>20年的工作者要比工作年資4-10年的工作者較容易在腕道症候群及de Quervain氏症候群神經學檢查時出現正向反應(OR=2.9-3.5;95%CI=1.3-9.1)。 從事按摩時有聳肩及駝背現象或肩膀與軀幹間的夾角>60度的話,按摩從業人員罹患手指或頸部疼痛的機率增高(OR=2.6-3.3;95%CI=1.1-9.9)。如果不使用手指的腹部及整個手掌來按摩的話,增加罹患頸部疼痛的機率(OR=12.6;95%CI=2.6-60.9)。從事按摩時頸部無法維持在自然位置的話,罹患下背部疼痛的機率增高(OR=3.1;95%CI=1.3-7.8)。如果按摩時手腕不能儘量維持在自然中立姿勢的話,罹患上背部疼痛的機率會有增高的趨勢(OR=3.3;95%CI=1.1-9.9)。31-45歲的按摩從業人員罹患頸部或上背部疼痛的機率是>45歲的按摩從業人員的2.9-4.6倍(95%CI=1.1-14.9)。使用不適當工作檯的按摩從業人員罹患下背部疼痛的機率是使用適當工作檯按摩從業人員的3.6倍(95%CI=1.4-9.6)。 結論與建議:本研究是第一篇有關按摩從業人員肌肉骨骼疾病盛行率及成因調查研究。本研究結果顯示雖然按摩從業人員在預防及減緩疼痛有豐富的知識,但是因為按摩工作需身體特定部位採用奇怪的姿勢及重複與過度施力,與其他工作者相比,按摩從業人員較容易得到肌肉骨骼疾病。本研究找出部分影響按摩從業人員肌肉骨骼疾病的因素,但是仍然有許多未解的謎題,如:迫切需要進行有關按摩動作之生物力學分析,以增進按摩工作姿勢及動作對於從業人員肌肉骨骼問題影響的了解;進行按摩從業人員之長期追蹤研究,以增進對於引起按摩從業人員之肌肉骨骼疾病危害因子的了解並建立因果關係;另外,進行介入方式及成效研究,以建立降低按摩從業人員罹患肌肉骨骼症狀或疾病的介入方式。 本研究的結果除了對於預防按摩從業人員的肌肉骨骼疾病上確有參考的價值之外,也可以提供視覺障礙者職業輔導評量之用,作為預防視覺障礙按摩從業人員罹患肌肉骨骼疾病及找到適合之工作。「簡易按摩姿勢檢核表」可讓按摩從業人員學習正確的工作姿勢,也可用來發現錯誤按摩姿勢並加以糾正,以避免因按摩姿勢不正確所衍生出來的肌肉骨骼疾病。 | zh_TW |
dc.description.abstract | Objectives. Massage practitioners are at high risk for work-related musculoskeletal disorders (WMSDs) due to constant movement in awkward positions, and repetitive and forceful use of multiple body parts. We investigated the prevalence and risk factors.
Methods. We randomly selected 161 visually impaired practitioners, who were >18 years old and full-time massage practitioners in the massage centers during 2004. Demographics, musculoskeletal symptoms, and working postures were collected. Analyses included descriptive statistics to describe the year and point prevalence rates and severity; Spearman ρ correlation statistics to test the collinearity among variables, and adjusted ORs and 95% CIs calculated with multivariate backward logistic regression analyses to explore the risk factors of WMSDs among massage practitioners. Results. Results indicated that 26.1% had swelling and/or deformity in fingers and/or thumbs, and 71.4% had at least one WMSD in 12 months. Prevalence rates were finger or thumb, 50.3%; shoulder, 31.7%; wrist, 28.6%; neck, 25.5%; arm/elbow, 23.6%; and forearm, 20.5%. Risk factors included work duration, hours per day in direct contacts with clients, pulp pinch, age, height of the working table, and working posture. Working duration >20 years had an adjusted OR for finger or thumb 4.0-4.5 with 95%CI 1.5-13.8, client contact >4 hours/day (adjusted OR for finger=3.2, 95%CI=1.3-8.1), and ≤7-kg pulp-pinch strength (adjusted OR for upper extremity=2.9-3.2, 95%CI=1.2-8.3). Adjusted ORs for lower-back symptoms were 3.1 (95%CI=1.3-7.8) and 3.6 (95%CI=1.4-9.6), respectively, for lack of neutral neck posture and for inappropriate working-table height. Working duration >20 years had an adjusted OR for Carpal Tunnel Syndrome or de Quervain’s syndrome 2.9-3.5 with 95% CI 1.3-9.1. Adjusted ORs for swelling and/or deformity in fingers and/or thumbs were 3.4 (95%CI=1.3-8.6) and 9.6 (95%CI=2.1-44.3), respectively, for ≤7-kg pulp-pinch strength and for not using whole hand or palm to perform massage. Conclusions/Recommendations. To our limited knowledge, this study is the first in the world to determine the prevalence and risk factors of WMSDs in massage practitioners who are visually impaired. Although massage practitioners are knowledgeable in the prevention and relief pain, they are susceptible to WMSDs because of their awkward positions and repetitive and forceful motion in all body regions. It indicates the necessity of a more comprehensive biomechanical analysis for the dynamic movements in massage. Moreover, longitudinal studies enrolling professionals when they begin their massage practice are recommended to improve our understanding of the risk factors and predictors of WMSDs and to establish their cause-and-effect relationships. Further research is needed to develop intervention methods to reduce the risk of WMSDs in massage practice. In addition to prevent WMSDs in massage practice, results in this study could be also used in vocational evaluation for job placement of people with visual impairment. Working Posture Questionnaire could be used in checking and correcting the working postures of the massage practitioners to prevent WMSDs. | en |
dc.description.provenance | Made available in DSpace on 2021-06-13T00:15:26Z (GMT). No. of bitstreams: 1 ntu-96-F89841005-1.pdf: 1871525 bytes, checksum: 4a91c2283b83c99476cbb8075b29f09f (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 目錄...……………………………………………………… vii 圖目錄.……………………………………………………… ix 表目錄..……………………………………………………… x 第一章 前言………………………………………………… 1 第二章 文獻回顧…………………………………………… 3 第一節 按摩.………………………………………… 3 第二節 按摩容易引起肌肉骨骼疾病知原因………… 6 第三節 按摩從業人員肌肉骨骼疾病之盛行率……… 10 第四節 總結…………………………………………… 12 第三章 研究目的…………………………………………… 13 第四章 研究方法…………………………………………… 14 第一節 研究對象…………………………………… 14 第二節 研究步驟…………………………………… 15 第三節 研究工具…………………………………… 16 第四節 資料分析…………………………………… 22 第五章 結果………………………………………………… 23 第一節 基本資料…………………………………………… 23 第二節 工作姿勢…………………………………………… 25 第三節 疼痛狀況…………………………………………… 26 第四節 影響按摩從業人員肌肉骨骼疼痛之因素………… 29 第六章 討論………………………………………………… 38 第一節 按摩與肌肉骨骼疾病……………………………… 38 第二節 影響按摩從業人員肌肉骨骼疾病之因素………… 42 第七章 結論與建議………………………………………… 53 參考文獻……………………………………………………… 57 附錄一、按摩從業人員肌肉骨骼症狀及成因調查表……… 62 附錄二、快速上肢評量表…………………………………… 84 附錄三、就讀期間所發表之論文…………………………… 87 | |
dc.language.iso | zh-TW | |
dc.title | 按摩從業人員肌肉骨骼疾病盛行率及成因調查 | zh_TW |
dc.title | A study of the risk factors and prevalence of the musculoskeletal disorders in massage practitioners | en |
dc.type | Thesis | |
dc.date.schoolyear | 95-2 | |
dc.description.degree | 博士 | |
dc.contributor.oralexamcommittee | 黃耀輝,紀佳芬,王顏和,謝清麟 | |
dc.subject.keyword | 肌肉骨骼疾病,危害因子,盛行率,工作姿勢,按摩從業人員, | zh_TW |
dc.subject.keyword | musculoskeletal disorder,risk factor,prevalence,working posture,massage, | en |
dc.relation.page | 86 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2007-07-27 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 職業醫學與工業衛生研究所 | zh_TW |
顯示於系所單位: | 職業醫學與工業衛生研究所 |
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