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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 胡名霞(Ming-Hsia Hu) | |
dc.contributor.author | Kai-Lin Hung | en |
dc.contributor.author | 洪愷璘 | zh_TW |
dc.date.accessioned | 2021-06-16T17:49:26Z | - |
dc.date.available | 2020-08-13 | |
dc.date.copyright | 2012-09-19 | |
dc.date.issued | 2012 | |
dc.date.submitted | 2012-08-13 | |
dc.identifier.citation | Aras MD, Gokkaya NKO, Comert D, Kaya A, Cakci A: Shoulder pain in hemiplegia. Am J Phys Med Rehab 2004;83:713-719.
Aras MD, Gokkaya NKO, Comert D, Kaya A, Cakci A: Shoulder pain in hemiplegia - results from a national rehabilitation hospital in turkey. Am J Phys Med Rehab 2004;83:713-719. Blennerhassett JM, Gyngell K, Crean R: Reduced active control and passive range at the shoulder increase risk of shoulder pain during inpatient rehabilitation post-stroke: An observational study. J Physiother 2010;56:195-199. Chae J, Mascarenhas D, Yu DT, Kirsteins A, Elovic EP, Flanagan SR, et al.: Poststroke shoulder pain: Its relationship to motor impairment, activity limitation, and quality of life. Arch Phys Med Rehab 2007;88:298-301. Cohen J: A power primer. Psychological Bulletin 1992;112:155-159. Cohen J: Statistical power analysis for the behavioral sciences, ed 2nd, Lawrence Erlbaum Associates., 1998. Dromerick AW, Edwards DF, Kumar A: Hemiplegic shoulder pain syndrome: Frequency and characteristics during inpatient stroke rehabilitation. Arch Phys Med Rehab 2008;89:1589-1593. English C, Hillier S, Stiller K: Incidence and severity of shoulder pain does not increase with the use of circuit class therapy during inpatient stroke rehabilitation: A controlled trial. Aust J Physiother 2008;54:41-46. Gamble GE, Barberan E, Laasch HU, Bowsher D, Tyrrell PJ, K. JA: Poststroke shoulder pain: A prospective study of the association and risk factors in 152 patients from a consecutive cohort of 205 patients presenting with stroke. Eur J Pain 2002;6:467-474. Green J, Young J: A test-retest reliability study of the barthel index, the rivermead mobility index, the nottingham extended activities of daily living scale and the frenchay activities index in stroke patients. Disabil Rehbil 2001;23:670-676. Hadianfard MJ, Hadianfard H: Predictor factors of hemiplegic shoulder pain in a group of stroke patients. Iran Red Crescent Me 2008;10:215-219. Holbrook M, Skilbeck CE: An activities index for use with stroke patients. Age Ageing 1983;12:166-170. Hsueh IP, Lee MM, Hsieh CL: Psychometric characteristics of the barthel activities of daily living index in stroke patients. J Formos Med Assoc 2001;100:526-532. Kong K-H, Woon V-C, Yang S-Y: Prevalence of chronic pain and its impact on health-related quality of life in stroke survivors. Arch Phys Med Rehab 2004;85:35-40. Kumar R, Metter EJ, Mehta AJ, Chew T: Shoulder pain in hemiplegia - the role of exercise. Am J Phys Med Rehab 1990;69:205-208. Langhorne P, Stott DJ, Robertson L, MacDonald J, Jones L, McAlpine C, et al.: Medical complications after stroke: A multicenter study. Stroke 2000;31:1223-1229. Lindgren I, Jonsson AC, Norrving B, Lindgren A: Shoulder pain after stroke - a prospective population-based study. Stroke 2007;38:343-348. Lindsay P, Bayley M, Hellings C, Hill M, Woodbury E, Phillips S: Selected topics in stroke management. Shoulder pain assessment and treatment. In: Canadian best practice recommendations for stroke care. CMAJ 2008;2:E70-72. Lo SF, Chen SY, Lin HC, Jim YF, Meng NH, Kao MJ: Arthrographic and clinical findings in patients with hemiplegic shoulder pain. Arch Phys Med Rehab 2003;84:1786-1791. Portney LG, Watkins MP: Foundations of clinical research: Applications to practice, ed 3rd, Julie Levin Alexander, 2009. Ratnasabapathy Y, Broad J, Baskett J, Pledger M, Marshall J, Bonita R: Shoulder pain in people with a stroke: A population-based study. Clin Rehabil 2003;17:304-311. Roosink M, Buitenweg JR, Renzenbrink GJ, Geurts ACH, IJzerman MJ: Altered cortical somatosensory processing in chronic stroke: A relationship with post-stroke shoulder pain. Neurorehabilitation 2011;28:331-344. Roosink M, Renzenbrink GJ, Buitenweg JR, Van Dongen RT, Geurts AC, IJzerman MJ: Persistent shoulder pain in the first 6 months after stroke: Results of a prospective cohort study. Arch Phys Med Rehab 2011;92:1139-1145. Roosink M, Renzenbrink GJ, Buitenweg JR, Van Dongen RT, Geurts AC, MJ IJ: Persistent shoulder pain in the first 6 months after stroke: Results of a prospective cohort study. Arch Phys Med Rehabil 2011;92:1139-1145. Roy C, Sands MR, Hill LD, Harrison A, Marshall S: The effect of shoulder pain on outcome of acute hemiplegia. Clin Rehabil 1995;9:21-27. Roy CW, Sands MR, Hill LD: Shoulder pain in acutely admitted hemiplegics. Clin Rehabil 1994;8:334-340. Widar M, Ahlstrom G: Disability after a stroke and the influence of long-term pain on everyday life. Scand J of Caring Sci 2002;16:302-310. Yu DT: Shoulder pain and other musculoskeletal complications; in Stein J, Harvey RL, Macko FG, Winstein CJ, Zorowitz RD (eds): Stroke recovery and stroke rehabilitation. New York, Demos Medical Publishing, 2009, pp 437-451. Zeferino SI, Aycock DM: Poststroke shoulder pain: Inevitable or preventable? Rehabilitation Nursing 2010;35:147-151. 薛 漪平, 謝 清麟: 中風患者芙蘭切活動量表效度之再驗證:大台北地區研究. 台灣醫學 1997;6:696-702. 謝 清麟: 芙蘭切活動量表之信度及效度驗證. 慈濟醫學 1997;9:123-130. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/64476 | - |
dc.description.abstract | 患側肩部疼痛為中風後最常見的併發症之一,這不僅影響病人的生活品質,也阻礙了患側肢體的活動與上肢復健,病人的功能表現因此受到影響。過去文獻調查中風病人肩部疼痛的研究缺乏長期、密集追蹤、人數充足的特點,各研究調查發生率與盛行率的時間點不一,難以有全面完整的了解。此外與患側肩部疼痛相關的早期預測因子眾多,目前尚未有定論。而患側肩部疼痛的出現,可能對於病人的動作、日常活動及生活品質有負面的影響,減少後期中風病人恢復的程度。
目前調查台灣本土患側肩部疼痛流行病學的研究較少,無法掌握人數比例及變化趨勢。本實驗欲探討中風一年內患側肩部疼痛狀態的人數比例與變化趨勢,以及中風後兩周、一個月時的動作、平衡、感覺、肩關節活動度與年齡是否可以預測患側肩部疼痛一年內的變化趨勢。此外,本實驗探討中風病人發病後六個月及一年時,不同患側肩部疼痛程度與病人在上肢動作、日常生活活動、自覺的上肢功能生活品質、性格生活品質、以及情緒生活品質的相關性。 本研究的樣本採用台灣中風後生活品質研究資料庫的資料,其為一前瞻性研究所收取的資料,收取進入台大醫院1999年12月至2001年11月中風的個案。本研究紀錄個案中風後二周、一個月、三個月、六個月及一年時狀況,包含年齡、傅格—梅爾評量表之患側肩部疼痛、動作、平衡、感覺、肩關節活動角度。 本研究最初徵召了310位個案,最後完整追蹤人數為192人。基本資料記錄了性別、首次中風與否、中風類型與患側,三組間皆沒有統計上差異。依據傅格—梅爾肩部關節疼痛分數,一年內肩部疼痛狀態可分為持續疼痛、疼痛變動、沒有疼痛。人數比例高至低為疼痛變動(113人, 佔58.9%)、持續疼痛(61人, 佔31.8%)、沒有疼痛(18人, 佔9.4%)。中風初期特徵結果顯示,年齡在三類不同患側肩部疼痛變化病人間無統計上顯著差異;傅格—梅爾上肢動作、下肢動作、平衡、感覺方面,沒有疼痛病人顯著優於持續疼痛病人與疼痛變動病人(p<0.001),疼痛變動與持續疼痛病人間沒有差異;傅格—梅爾肩關節活動更是三者之間皆有差異,沒有疼痛病人優於疼痛變動病人,再優於持續疼痛病人(p≧0.002)。中風後期肩部疼痛嚴重程度與病人的上肢動作、日常生活活動、上肢功能生活品質,有輕度到中度相關(r=0.377-0.494, p≦0.002),影響較大,而情緒及性格生活品質與肩部疼痛嚴重程度沒有顯著相關。本研究顯示台灣大台北地區有超過90%的中風病人在發病一年內有患側肩部疼痛,其中就屬發病後三個月至一年有較高的盛行率。曾有患側肩部疼痛的病人年齡較高,初期時動作、平衡、感覺、肩關節活動度也較差;此外中風後期病人的日常活動與生活品質也受到肩部疼痛的負面影響。 未來研究可朝向探討患側肩部疼痛的病理機轉,以及臨床介入與家屬照顧對中風病人肩部可能造成的傷害,有助於醫療人員選擇對應且有效的患側肩部疼痛預防方法與治療方式,亦能減少患側肩部疼痛的發生。 | zh_TW |
dc.description.abstract | Hemiplegic shoulder pain is one of the most common complications after stroke. To the patient, it influences the quality of life and impedes the recovery of upper extremity function during rehabilitation. Previous studies on hemiplegic shoulder pain were mostly short period with few participants. On the other hand, hemiplegic shoulder pain may also influence the recovery of stroke patients’ motor, activities, and quality of life.
There is lacking of epidemiology studies for hemiplegic shoulder pain in Taiwan. We have limited information of the number and percentage of hemiplegic shoulder pain patients. The first purpose of this study is to find the trend of hemiplegic shoulder pain development and its percentage of patients. Second, we want to find out the differences of early characteristics between different pain development patients, such as age, motor, balance etc. The last one, we want to figure out whether the pain severity is related to motor of upper extremities, activities, and quality of life in upper limb function, personality of mood. The study sample was recruited from the Registry of the Quality of Life after Stroke Study in Taiwan, a prospective data bank. Data were recorded at 2 weeks, 1 month, 3 months, 6 months, and 1 year after stroke. Basic data, status of hemiplegic shoulder pain, motor, balance, sensation, shoulder range of motion in Fugl-Meyer assessment scale were recorded. Three-hundred-and-ten patients were recruited at the beginning and 192 had completed the follow ups. Hemiplegic shoulder pain was defined by Fugl-Meyer shoulder joint pain subscore. The development of hemiplegic shoulder pain can be categorized into three statuses: persistent pain, transitional pain, and no pain. Basic data between three groups including gender, first stroke or not, stroke type, hemiside were no significantly different. Numbers and percentage of patients of pain development were 113 patients (58.9%) in transitional pain group, 61 patients (31.8%) in persistent pain group, 18 patients (9.4%) in no pain group. Statistical analysis revealed that age was not significantly different between three groups. Fugl-Meyer upper extremity, lower extremity, balance, sensation in no pain group were significantly higher than patients in the transitional pain status and persistent pain status group (p<0.001). Fugl-Meyer shoulder joint motion was largest in the no pain group, then the transitional pain group, and leastly, the persistent pain group (p≧0.002).There were fair to moderate correlation between pain severity and motor of upper extremity, daily activities, upper limb quality of life (r=0.377-0.494, p≦0.002). There was no significant correlation between pain severity and mood and personalityquality of life. The current result is a first report onhemiplegic shoulder pain using the Fugl-Meyer pain subscore in Taiwan. Shoulder range of motion, sensation, balance and motor abilities might influence the development of pain and further research is needed. | en |
dc.description.provenance | Made available in DSpace on 2021-06-16T17:49:26Z (GMT). No. of bitstreams: 1 ntu-101-R99428005-1.pdf: 2424276 bytes, checksum: b700c3283622f48725c11949b050344d (MD5) Previous issue date: 2012 | en |
dc.description.tableofcontents | 中文摘要 I
英文摘要 III 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、 研究問題與假說 3 第四節、 研究的重要性 5 第二章、 文獻回顧 7 第一節、 患側肩部疼痛流行病學資料 7 第二節、 中風病人患側肩部疼痛之相關與預測因子 8 第三節、 患側肩部疼痛之中風病人的動作功能與生活品質 9 第四節、 評估量表與工具介紹 10 第三章、 研究方法 13 第一節、 研究設計 13 第二節、 受試者 13 第三節、 資料收取與評估方式 14 第四節、 資料處理與統計分析 16 第四章、 結果 18 第一節、 受試者資料 18 第二節、 實驗結果 18 第五章、 討論 21 第一節、 中風病人肩部疼痛狀態 21 第二節、 患側肩部疼痛病人的早期特徵 23 第三節、 患側肩部疼痛嚴重程度與日常活動、生活品質之關聯性 23 第四節、 研究限制 24 第五節、 臨床應用及未來研究方向 25 第六章、 結論 26 參考文獻 27 表目錄 表1. 三類不同疼痛變化趨勢受試者基本資料………………….....…..31 表2. 一年內不同疼痛狀態變化者二周時之身體功能特徵………...…33 表3. 一年內不同疼痛狀態變化者一個月時之身體功能特徵……...…34 表4. 中風六個月、一年不同疼痛程度個案人數比例…………….....…35 表5. 中風六個月與一年疼痛程度與上肢動作、日常生活活動、生活品質之相關性…………………………………………...……………36 圖目錄 圖1. 研究流程圖......................................................................................37 圖2. 理論架構...........................................................................................38 圖3. 中風一年內患側肩部疼痛變化情形人數比例…...........................39 圖4. 疼痛變動個案中各時間點疼痛與沒有疼痛所占人數比例...........40 圖5. 所有個案各時間點有肩部疼痛與沒有肩部疼痛所占人數比例...41 圖6. 六個月患側肩部疼痛嚴重度人數比例...........................................42 圖7. 一年患側肩部疼痛嚴重度人數比例...............................................43 附 錄 附錄一、傅格—梅爾評估量表 上肢動作..............................................44 附錄二、傅格—梅爾評估量表 下肢動作..............................................47 附錄三、芙蘭切活動量............................................................................49 附錄四、中風病人生活品質量表............................................................52 | |
dc.language.iso | zh-TW | |
dc.title | 中風患者肩部三種疼痛狀態及對動作、日常活動與生活品質的影響:一年長期追蹤調查研究 | zh_TW |
dc.title | Hemiplegic Shoulder Pain Status and Its Influence on Motor, Daily Activities, and Quality of Life: A One Year Longitudinal Study | en |
dc.type | Thesis | |
dc.date.schoolyear | 100-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 謝清麟(Ching-Lin Hsieh),林居正(Jiu-Jenq Lin) | |
dc.subject.keyword | 患側肩部疼痛,疼痛狀態,初期特徵,疼痛程度,生活品質,關聯, | zh_TW |
dc.subject.keyword | Hemiplegic shoulder pain,Pain status,Early Characteristics,Pain severity,Quality of life,Correlation, | en |
dc.relation.page | 54 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2012-08-14 | |
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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