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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 詹美華(Mei-Hwa Jan) | |
dc.contributor.author | Chih-Chung Hsu | en |
dc.contributor.author | 許至中 | zh_TW |
dc.date.accessioned | 2021-06-15T02:28:46Z | - |
dc.date.available | 2009-09-15 | |
dc.date.copyright | 2009-09-15 | |
dc.date.issued | 2009 | |
dc.date.submitted | 2009-08-17 | |
dc.identifier.citation | 1. Chesworth BM, Culham E, Tata GE, Peat M. Validation of outcome measures in patients with patellofemoral syndrome. J Orthop Sports Phys Ther. 1989;10(8):302-8.
2. DeHaven KE, Lintner DM. Athletic injuries: comparison by age, sport, and gender. Am J Sports Med. 1986 May-Jun;14(3):218-24. 3. Lichota DK. Anterior knee pain: symptom or syndrome? Curr Womens Health Rep. 2003 Feb;3(1):81-6. 4. Fulkerson JP, Arendt EA. Anterior knee pain in females. Clin Orthop Relat Res. 2000 Mar;(372):69-73. 5. Fredericson M, Powers CM. Practical management of patellofemoral pain. Clin J Sport Med. 2002 Jan;12(1):36-8. 6. Witvrouw E, Lysens R, Bellemans J, Cambier D, Cools A, Danneels L, Bourgois J. Which factors predict outcome in the treatment program of anterior knee pain? Scand J Med Sci Sports. 2002 Feb;12(1):40-6. 7. Hamstra-Wright KL, Swanik CB, Ennis TY, Swanik KA. Joint stiffness and pain in individuals with patellofemoral syndrome. J Orthop Sports Phys Ther. 2005 Aug;35(8):495-501. 8. Heino Brechter J, Powers CM. Patellofemoral stress during walking in persons with and without patellofemoral pain. Med Sci Sports Exerc. 2002 Oct;34(10):1582-93. 9. Insall J. Current Concepts Review: patellar pain. J Bone Joint Surg Am. 1982 Jan;64(1):147-52. 10. Witvrouw E, Werner S, Mikkelsen C, Van Tiggelen D, Vanden Berghe L, Cerulli G. Clinical classification of patellofemoral pain syndrome: guidelines for non-operative treatment. Knee Surg Sports Traumatol Arthrosc. 2005 Mar;13(2):122-30. 11. Clark DI, Downing N, Mitchell J, Coulson L, Syzpryt EP, Doherty M. Physiotherapy for anterior knee pain: a randomised controlled trial. Ann Rheum Dis. 2000 Sep;59(9):700-4. 12. Crossley K, Bennell K, Green S, Cowan S, McConnell J. Physical therapy for patellofemoral pain: a randomized, double-blinded, placebo-controlled trial. Am J Sports Med. 2002 Nov-Dec;30(6):857-65. 13. Heintjes E, Berger MY, Bierma-Zeinstra SM, Bernsen RM, Verhaar JA, Koes BW. Exercise therapy for patellofemoral pain syndrome. Cochrane Database Syst Rev. 2003;(4):CD003472. 14. Yip SL, Ng GY. Biofeedback supplementation to physiotherapy exercise programme for rehabilitation of patellofemoral pain syndrome: a randomized controlled pilot study. Clin Rehabil. 2006 Dec;20(12):1050-7. 15. Selfe J, Richards J, Thewlis D, Kilmurray S. The biomechanics of step descent under different treatment modalities used in patellofemoral pain. Gait Posture. 2008 Feb;27(2):258-63. 16. Powers CM. The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective. J Orthop Sports Phys Ther. 2003 Nov;33(11):639-46. 17. Levinger P, Gilleard W. Tibia and rearfoot motion and ground reaction forces in subjects with patellofemoral pain syndrome during walking. Gait Posture. 2007 Jan;25(1):2-8. 18. Powers CM, Chen PY, Reischl SF, Perry J. Comparison of foot pronation and lower extremity rotation in persons with and without patellofemoral pain. Foot Ankle Int. 2002 Jul;23(7):634-40. 19. Ireland ML, Willson JD, Ballantyne BT, Davis IM. Hip strength in females with and without patellofemoral pain. J Orthop Sports Phys Ther. 2003 Nov;33(11):671-6. 20. Tyler TF, Nicholas SJ, Mullaney MJ, McHugh MP. The role of hip muscle function in the treatment of patellofemoral pain syndrome. Am J Sports Med. 2006 Apr;34(4):630-6. 21. Robinson RL, Nee RJ. Analysis of hip strength in females seeking physical therapy treatment for unilateral patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2007 May;37(5):232-8. 22. Bolgla LA, Malone TR, Umberger BR, Uhl TL. Hip strength and hip and knee kinematics during stair descent in females with and without patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2008 Jan;38(1):12-8. Epub 2007 Nov 21. 23. Mizuno Y, Kumagai M, Mattessich SM, Elias JJ, Ramrattan N, Cosgarea AJ, Chao EY. Q-angle influences tibiofemoral and patellofemoral kinematics. J Orthop Res. 2001 Sep;19(5):834-40. 24. Salsich GB, Perman WH. Patellofemoral joint contact area is influenced by tibiofemoral rotation alignment in individuals who have patellofemoral pain. J Orthop Sports Phys Ther. 2007 Sep;37(9):521-8. 25. Mascal CL, Landel R, Powers C. Management of patellofemoral pain targeting hip, pelvis, and trunk muscle function: 2 case reports. J Orthop Sports Phys Ther. 2003 Nov;33(11):647-60. 26. Cuthbert SC, Goodheart GJ Jr. On the reliability and validity of manual muscle testing: a literature review. Chiropr Osteopat. 2007 Mar 6;15:4. 27. Bohannon RW. Reference values for extremity muscle strength obtained by hand-held dynamometry from adults aged 20 to 79 years. Arch Phys Med Rehabil. 1997 Jan;78(1):26-32. 28. Wang CY, Olson SL, Protas EJ. Test-retest strength reliability: hand-held dynamometry in community-dwelling elderly fallers. Arch Phys Med Rehabil. 2002 Jun;83(6):811-5. 29. Roy MA, Doherty TJ. Reliability of hand-held dynamometry in assessment of knee extensor strength after hip fracture. Am J Phys Med Rehabil. 2004 Nov;83(11):813-8. 30. Merlini L, Mazzone ES, Solari A, Morandi L. Reliability of hand-held dynamometry in spinal muscular atrophy. Muscle Nerve. 2002 Jul;26(1):64-70. 31. Wessel J, Kaup C, Fan J, Ehalt R, Ellsworth J, Speer C, Tenove P, Dombrosky A. Isometric strength measurements in children with arthritis: reliability and relation to function. Arthritis Care Res. 1999 Aug;12(4):238-46. 32. Bohannon RW. Measuring knee extensor muscle strength. Am J Phys Med Rehabil. 2001 Jan;80(1):13-8. Links 33. Gagnon D, Nadeau S, Gravel D, Robert J, Bélanger D, Hilsenrath M. Reliability and validity of static knee strength measurements obtained with a chair-fixed dynamometer in subjects with hip or knee arthroplasty. Arch Phys Med Rehabil. 2005 Oct;86(10):1998-2008. 34. Martin HJ, Yule V, Syddall HE, Dennison EM, Cooper C, Aihie Sayer A. Is hand-held dynamometry useful for the measurement of quadriceps strength in older people? A comparison with the gold standard Bodex dynamometry. Gerontology. 2006;52(3):154-9. 35. Jordan K, Dziedzic K, Jones PW, Ong BN, Dawes PT. The reliability of the three-dimensional FASTRAK measurement system in measuring cervical spine and shoulder range of motion in healthy subjects. Rheumatology (Oxford). 2000 Apr;39(4):382-8. 36. Laprade JA, Culham EG. A self-administered pain severity scale for patellofemoral pain syndrome. Clin Rehabil. 2002 Nov;16(7):780-8. 37. Kujala UM, Jaakkola LH, Koskinen SK, Taimela S, Hurme M, Nelimarkka O. Arthroscopy. 1993;9(2):159-63. Scoring of patellofemoral disorders. 38. Watson CJ, Propps M, Ratner J, Zeigler DL, Horton P, Smith SS. Reliability and responsiveness of the lower extremity functional scale and the anterior knee pain scale in patients with anterior knee pain. J Orthop Sports Phys Ther. 2005 Mar;35(3):136-46. 39. McClinton S, Donatell G, Weir J, Heiderscheit B. Influence of step height on quadriceps onset timing and activation during stair ascent in individuals with patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2007 May;37(5):239-44. 40. Yen TY. The treatment effects of additional hip abductor and external rotator strength training to leg press exercise in patients with patellofemoral pain syndrome. Master thesis. 2008. 41. Witvrouw E, Lysens R, Bellemans J, et al. Open versus closed kinetic chain exercises for patellofemoral pain. Am J Sports Med 2000; 28(5): 687-94. 42. Van der Esch M, Steultjens M, Harlaar J, Wolterbeek N, Knol D, Dekker J. Varus-valgus motion and functional ability in patients with knee osteoarthritis. Ann Rheum Dis. 2008 Apr;67(4):471-7. Epub 2007 Jun 29. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/43791 | - |
dc.description.abstract | 背景:髕股關節疼痛症候群為一臨床常見之膝關節疾病,過去針對此病症的保守治療幾可有效的降低疼痛並改善日常生活功能表現。然而不幸的是,至今仍無一有效的治療方式能讓他們完全根治,導致患者不定期便會出現反覆性疼痛。至此,學者開始懷疑是否問題癥結並非髕股關節本身。近年有文獻指出,相較於正常人,此類患者的髖外展肌群及髖外轉肌群存有肌力缺失問題,但髖部的肌力缺失是否會影響患者下肢運動學改變進而產生疼痛,目前仍是缺乏正面文獻;另外在髖部肌力與下肢運動學之變化,是否會影響髕股關節疼痛症候群患者日常功能表現仍缺乏研究佐證。因此,本研究欲比較並探討髕股關節疼痛症候群患者與健康成年人其髖部肌肉力量、下肢運動學以及日常生活功能之間其相關性。
研究目的:比較患有髕股關節疼痛症候群之女性患者及一般健康成年女性之髖部肌力值(髖外展肌、髖外轉肌、髖伸直肌)與下肢運動學(髖關節冠狀切面、髖關節水平切面)之差異;並進一步了解髖部肌力與下肢運動學兩者之相關性;最後探討髖部肌力與下肢運動學之變化是否可以用來預測患者其日常功能表現。 研究方法:徵召20位髕股關節疼痛症候群女性患者,及20位相符條件之健康成年女性。兩組各接受系列性評估,包括用手持式徒手肌力測試儀去量測髖部肌力、用電磁運動追蹤系統去量測執行功能性上/下階梯時之下肢運動學變化、用前膝疼痛量表及單層樓上/下樓梯測試來量測受試者其功能性生活表現程度。 結果:髕股關節疼痛症候群患者較控制組有顯著較差的髖外轉肌及髖伸直肌力(P< .05),髖外展肌肌力亦有較低的趨勢(P= .06)。患者在執行功能性上、下階梯測試時會分別出現較控制組顯著的髖關節內收、及內轉(P< .01)。患者也需花費較控制組長的時間來完成單層樓上、下樓梯的活動測試(P< .01)。在相關性方面,髖關節肌肉力量與運動學參數之間並無顯著相關(P> .05);量表分數與髖關節肌肉力量及下肢運動學參數之間也無統計顯著相關(P> .05)。然而,髖伸直肌肌力與單層樓上、下樓梯測試所花費的時間有顯著相關(r= - .34~ - .39, P< .03);執行功能性上樓梯測試時髖內收角度與單層樓上樓梯時間有顯著相關(r= .53, P< .001);而執行功能性下樓梯測試時髖內轉角度與單層樓下樓梯時間有顯著相關(r= .43, P= .005)。至於多重變相迴歸分析結果如下:上樓梯時間 = 5.99 – 0.04*(髖伸直肌肌力) + 0.25*(上樓梯髖內收角度);而下樓梯時間 = 3.25 – 0.04*(髖伸直肌肌力) + 0.18*(下樓梯髖內轉角度)。 結論:年輕的髕股關節疼痛症候群女性患者有較低的髖外轉及髖伸直肌力,並且分別在執行功能性上下階測試時會有較大的髖內收及髖內轉情形。髖伸直肌肌力及髖內收、內轉角度與患者執行日常功能性上、下樓梯的活動表現有相關。 | zh_TW |
dc.description.abstract | Background
Patellofemoral pain is a common knee disorder. Conservative treatment could decrease pain and improve function efficiently. However, none of them could totally cure patients. The researcher focus then shift toward the hip joint from patellofemoral joint. Evidence showed decreased hip abductor and external rotator strength existed in patients with patellofemoral pain, however, we have no idea if the deficit of hip muscle strength would influence the lower-extremity kinematics and result in pain. Furthermore, there is no study focus on the relationship between hip muscle strength and kinematics, and the functional activity.The purpose of this study was to investigate the association of hip strength, lower extremity kinematics, and the functional activity among female with and without patellofemoral pain. Purpose To compare the hip strength (hip abductor, external rotator, and extensor) and lower extremity kinematics (frontal and transverse plane of hip joint) between female with and without patellofemoral pain, and to investigate the relationship between hip strength and lower extremity kinematics to see if these parameters could predict the functional activity. Methods Twenty female subjects with patellofemoral pain, and 20 matched healthy controls participated. All subjects underwent muscle strength testing of hip muscles by hand-held dynamometer, and lower extremity kinematics testing during functional ascend and descend stairs by Fastrak. The functional activity was measured by anterior knee pain scale and ascend/descend stairs. Results Female subjects with patellofemoral pain showed significantly decreased hip external rotator and extensor strength (P< .05), and lower hip abductor strength (P= .06) compared to the matched control group. They also demonstrated more hip adduction and internal rotation during functional ascend and descend stairs (P< .01) compared to the matched control. The functional activity performance was significantly different between patients and controls (P< .01). There was no relationship between hip strength and lower extremity kinematics (P> .05), and between hip strength, lower extremity kinematics, and anterior knee pain scale (P> .05). However, hip extensor strength was significantly associated with functional activity (r= - .34~ - .39, P< .03). The hip adduction angle during up stairs was correlated with ascend stairs performance (r= .53, P< .001), while the hip internal rotation angle during descend stairs was correlated with descend stairs performance (r= .43, P= .005). Multiple regressions showed ascend stairs time= 5.99 – 0.04* hip extensor strength + 0.25* hip adduction angle; descend stairs time= 3.25 – 0.04* hip extensor strength + 0.18* hip internal rotation angle. Conclusion Young female subjects with patellofemoral pain demonstrated decreased hip external rotator and extensor strength, and showed greater hip adduction and internal rotation during functional ascend and descend stairs compared to the healthy controls. Hip extensor strength, hip adduction and internal rotation angle were associated with ascend / descend stairs of functional activity. | en |
dc.description.provenance | Made available in DSpace on 2021-06-15T02:28:46Z (GMT). No. of bitstreams: 1 ntu-98-R96428006-1.pdf: 5033521 bytes, checksum: 6d02ddc3a05ddfd0ba66fa36db3fd72a (MD5) Previous issue date: 2009 | en |
dc.description.tableofcontents | 口試委員會審定書-I
致謝-II 中文摘要-III 英文摘要-V 目錄-i 表目錄.-iii 圖目錄-vi 附件目錄-v 第一章、前言 第一節、 研究背景與動機-1 第二節、 研究目的-3 第三節、 研究問題-4 第四節、 實驗假說-5 第二章、文獻回顧 第一節、 髕股關節疼痛與下肢運動學之關聯性-7 第二節、 髕股關節疼痛症候群常用之評估工具-9 第三節、 髕股關節疼痛症候群常用之評估量表-11 第三章、研究方法 第一節、 實驗設計-14 第二節、 樣本數估計-14 第三節、 研究受試者及收案流程-14 第四節、 研究使用變項定義-17 第五節、 研究使用設備及工具-17 第六節、 評估項目-18 第七節、 統計分析-24 第四章、研究結果 第一節、 收案流程及受測者基本資料-26 第二節、 量測參數之組間比較-26 第五章、討論 第一節、 髖部肌肉群肌力值之表現-29 第二節、 髖部運動學之表現-30 第三節、 髖部肌力值、髖部運動學以及功能性活動表現之相關-32 第四節、 研究限制-34 第五節、 臨床應用-34 第六章、總結-34 參考文獻-35 表目錄 表一、 受試者基本資料-40 表二、 髖關節肌肉力量之表現-41 表三、下肢運動學之表現-42 表四、評估量表之表現-43 表五、功能性動作之表現-44 表六、髖關節肌肉力量與下肢運動學參數之相關性-45 表七、評估量表與髖關節肌肉力量及下肢運動學參數之相關性-46 表八、功能性活動與髖關節肌肉力量及下肢運動學參數之相關性-47 圖目錄 圖一、 手持式徒手肌力測試儀-48 圖二、 外接式驅幹固定用具-49 圖三、 FASTRAK電磁運動追蹤系統-50 圖四、 計時碼錶-51 圖五、 髖外展肌之肌力測試-52 圖六、 髖外轉肌之肌力測試-53 圖七、髖伸直肌之肌力測試-54 圖八、微型電磁場接受器固定-55 圖九、足部定位-56 圖十、功能性下階梯測試-57 圖十一、功能性上階梯測試-58 圖十二、單層樓上/下樓梯測試-59 圖十三、實驗收案流程圖-60 附件目錄 附件一、自填式髕股關節疼痛症候群疼痛嚴重度量表-61 附件二、前膝疼痛量表-62 附件三、足部姿勢評估量表-63 附件四、受試者基本資料記錄單-64 附件五、 台灣大學醫學院臨床試驗受試者說明及同意書-65 | |
dc.language.iso | zh-TW | |
dc.title | 髕股關節疼痛症候群女性患者與健康成年女性在髖部肌肉力量、下肢運動學以及日常生活功能之相關性探討 | zh_TW |
dc.title | The Associations of Hip Strength, Lower Extremity Kinematics and Functional Activity among Female Adults With and Without Patellofemoral Pain Syndrome | en |
dc.type | Thesis | |
dc.date.schoolyear | 97-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 徐阿田(Ar-Tyan Hsu),林居正(Jiu-Jenq Lin),林永福(Yung-Fu Lin) | |
dc.subject.keyword | 髕股關節疼痛症候群,髖關節肌肉,下肢運動學, | zh_TW |
dc.subject.keyword | Patellofemoral pain syndrome,Hip muscle,Lower extremity kinematics, | en |
dc.relation.page | 69 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2009-08-17 | |
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 |
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