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http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/81058完整後設資料紀錄
| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 王興國(Hsing-Kuo Wang) | |
| dc.contributor.author | Ming-Wei Wang | en |
| dc.contributor.author | 王銘緯 | zh_TW |
| dc.date.accessioned | 2022-11-24T03:28:28Z | - |
| dc.date.available | 2021-09-16 | |
| dc.date.available | 2022-11-24T03:28:28Z | - |
| dc.date.copyright | 2021-09-16 | |
| dc.date.issued | 2021 | |
| dc.date.submitted | 2021-08-24 | |
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Characterization of Damage Process of Rabbit Tendon by Acoustic Emission Technique in Vitro. Journal of the Japanese Society for Experimental Mechanics, 13(Special_Issue), s213-s216. 154. Sarman, H., Atmaca, H., Cakir, O., Muezzinoglu, U. S., Anik, Y., Memisoglu, K., . . . Isik, C. (2015). Assessment of postoperative tendon quality in patients with achilles tendon rupture using diffusion tensor imaging and tendon fiber tracking. The Journal of Foot and Ankle Surgery, 54(5), 782-786. 155. Saunders, R., Astifidis, R., Burke, S. L., CHT, M., Higgins, J., McClinton, M. A. (2015). Hand and upper extremity rehabilitation: a practical guide: Elsevier Healt……… | |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/81058 | - |
| dc.description.abstract | "研究背景：手指屈肌肌腱斷裂修補手術後往往伴隨著肌腱沾黏的副作用產生，導致手部活動度受限與日常生活功能喪失，然而目前臨床上仍缺乏能夠有效量化沾黏嚴重程度的評估工具。超音波斑點追蹤技術目前已被廣泛應用於評估人體軟組織的形變與位移，透過該方法量測術後肌腱之活動能力或可作為評估肌腱沾黏嚴重程度的指標之一。 研究目的：本研究第一部分旨在透過豬隻肌腱體外實驗，以及健康受試者體內實驗以建立超音波斑點追蹤技術之量測再測信度、併行效度以及精度；第二部分旨在透過量測手指屈肌肌腱術後個案之肌腱巨觀與微觀型態、機械性質、活動度以及代謝微循環特徵(macro- and micromorphology, mechanical property, mobility and metabolic microcirculation)等綜合性評估以檢視此類術後個案之肌腱品質，並探討其對於關節活動度受限的影響。 研究設計：本研究為觀察型橫斷實驗。 研究對象：單側掌部第一至第三區域中，第二至第五指兩指以下肌腱斷裂，並經歷手術修補後 6 至 24 個月之個案。 研究方法：第一部分首先使用離體豬隻肌腱進行材料單軸拉伸測試(uniaxial tensile testing)，並以材料拉伸測試儀之位移量作為黃金標準，藉此探討超音波斑點追蹤技術之量測併行效度與精度。另一方面透過分析健康受試者於前、後測時的手指等長收縮肌腱位移量以建立再測信度。第二部分則針對手指屈肌肌腱術後個案進行健側與患側之肌腱品質以及功能性預後表現之評估。肌腱品質之評估項目包括：超音波灰階影像、都卜勒影像、剪力波彈性影像、動態射頻數據，以及紅光雷射光譜儀之微循環量測；功能性預後之評估項目包括：手部關節活動度、肌力以及上肢功能性量表。 統計分析：本研究第一部分將使用Pearson相關性檢定，分析材料拉伸測試儀與超音波斑點追蹤技術之間的併行效度，以及手指等長收縮測試的再測信度，並以平均絕對誤差以及平均相對誤差計算超音波斑點追蹤技術的量測精度。第二部分通過Shapiro-Wilk常態分布檢定的參數會使用成對樣本t檢定(Paired sample t test)比較健患側之間的差異，未符合常態分布之參數則會使用Wilcoxon符號排序檢定(Wilcoxon sign-rank test)進行差異性分析，上述差異性分析之顯著水準皆依據邦佛洛尼校正原則訂為0.008。此外，本實驗預計針對「肌腱活動度」與「關節活動度」進行相關性分析。若兩參數之間呈現線性關係，資料無明顯離群值且兩者皆符合常態分佈，則該兩參數之間便會使用Pearson相關性檢定(Pearson correlation)進行相關性測試；反之，則使用Spearman相關性檢定(Spearman correlation)進行相關性測試，顯著水準皆設定為0.05。 結果：第一部分：材料拉伸測試儀與超音波斑點追蹤技術之豬隻肌腱(N=4)順時位移量併行效度與最大位移量併行效度分別為r= 0.992 (p<0.001)以及r= 0.989 (p<0.001)，呈現高度正相關。精度的部份，順時位移量之平均絕對以及相對誤差分別為0.15±0.06毫米以及5.20±2.20%，最大位移量之平均絕對以及相對誤差分別為0.05±0.09毫米以及1.65±2.83%。手指等長收縮測試(N=8)結果顯示，手指等長收縮肌力以及肌腱位移量的再測信度分別為r=0.83 (p<0.001)以及r=0.89 (p<0.001)，呈現中度至高度正相關。第二部分：手指屈肌肌腱術後患者之手指(N=10)肌腱厚度(p=0.008)、截面積(p=0.005)、形變位移量(p=0.002)以及超音波功率都卜勒訊號(p=0.003)等參數於健患側之間皆表現出顯著差異，而功能性預後的部分僅在主動關節活動度的部分於健患側之間表現出顯著差異(p=0.002)。相關性分析的部分，健側之肌腱形變位移量與主動關節活動度之間表現出顯著高度相關(r=0.742, p=0.014)，然而該情況並未於患側發現。 結論：本研究第一部分結果證實了超音波斑點追蹤技術於量測肌腱橫向形變位移量的信度、效度以及精準度，第二部分則將該方法應用於手指屈肌肌腱術後患者身上，初步建立此類個案之術後「肌腱品質」的概念，未來期望能將該工具應用於評估術後肌腱的恢復程度以及預後進展上，並進一步提升個案之功能性預後。" | zh_TW |
| dc.description.provenance | Made available in DSpace on 2022-11-24T03:28:28Z (GMT). No. of bitstreams: 1 U0001-2208202122234900.pdf: 7008070 bytes, checksum: 647b509e97de3726739c9d559e892034 (MD5) Previous issue date: 2021 | en |
| dc.description.tableofcontents | 口試委員審定書……………………………………………………………...………….i 誌謝………………………………………………………………………….…..………ii 中文摘要………………………………………………………………………...……...iii 英文摘要………………………………………………………………………..………vi 第一章 前言…………………………………………………..……………………….1 第一節 研究背景…………………………………………………..…………….1 第二節 研究目的……………………………………………………..………….3 第二章 文獻回顧…………………………………………………..………………….4 第一節 手部屈指肌腱之解剖構造與功能…………………..………………….4 第二節 手指屈肌肌腱斷裂之手術修補與早期運動介入…..………………...12 第三節 手指屈肌肌腱受損後的癒合進程與沾黏形成機轉..………………...16 第四節 手指屈肌肌腱修補術後之功能性預後與個案自評量表……..……...19 第五節 術後肌腱之微循環特徵與量測方法………………..………………...21 第六節 超音波肌腱形態學與微觀結構量測………………..………………...23 第七節 超音波剪力波彈性成像……………………………………..………...26 第八節 超音波斑點追蹤技術………………………………………..………...27 第三章 研究方法…………………………………………………..………………...36 第一節 超音波斑點追蹤技術之信度、效度與精度………………………….36 一、 實驗背景…………………………………………………………..…...36 二、 實驗假說…………………………………………………………..…...36 三、 實驗方法…………………………………………………………..…...37 四、 數據分析…………………………………………………………..…...41 五、 統計分析…………………………………………………………..…...45 第二節 手指屈肌肌腱斷裂修補術後個案之應用………………………….....48 一、 理論架構…………………………………………………………..…...48 二、 實驗假說…………………………………………………………..…...49 三、 參數與操作型定義………………………………………………..…...50 四、 研究對象…………………………………………………………..…...52 五、 研究方法…………………………………………………………..…...52 六、 數據分析…………………………………………………………..…...54 七、 統計分析…………………………………………………………..…...56 第四章 實驗結果…………………………………………………..………………...58 第一節 超音波斑點追蹤技術之信度、效度與精度………………………….58 一、 豬隻肌腱材料單軸拉伸測試………………………………………….58 二、 健康受試者之手指等長收縮測試…………………………………….58 三、 效度…………………………………………………………..………...58 四、 精度…………………………………………………………..………...59 五、 信度…………………………………………………………..………...59 第二節 手指屈肌肌腱斷裂修補術後個案之應用…………………………….59 一、 人口統計與常態檢定結果…………………………………………….59 二、 手指屈肌肌腱術後患者之肌腱品質………………………………….60 三、 手指屈肌肌腱術後患者之功能性預後……………………………….60 四、 肌腱形變位移量與主、被動關節活動度之相關性………………….61 第五章 討論………………………………………………………………………….62 第一節 方法學的驗證…………………………………………………..……...62 一、 豬隻肌腱材料單軸拉伸測試………………………………………….62 二、 健康受試者之手指等長收縮測試…………………………………….65 三、 超音波斑點追蹤演算法……………………………………………….66 第二節 手指屈肌肌腱術後個案之探討……………………………………….70 一、 術後肌腱品質………………………………………………………….70 二、 功能性預後…………………………………………………………….76 第六章 結論…………………………………………………………..……………...78 參考文獻……………………………………………………………………………….79 附錄一 本研究結果表格…………………………………………………..………...96 附錄二 受試者自評量表…………………………………………………..……….107 附錄三 受試者同意書…………………………………………………..……….…111 附錄四 研究倫理委員會臨床試驗研究許可書…………………………………...121 | |
| dc.language.iso | zh-TW | |
| dc.subject | 手指屈肌肌腱修補 | zh_TW |
| dc.subject | 超音波斑點追蹤技術 | zh_TW |
| dc.subject | 功能性預後 | zh_TW |
| dc.subject | 肌腱品質 | zh_TW |
| dc.subject | 沾黏 | zh_TW |
| dc.subject | functional outcomes | en |
| dc.subject | tendon quality | en |
| dc.subject | adhesion | en |
| dc.subject | finger flexor tendon repair | en |
| dc.subject | Ultrasonic speckle tracking | en |
| dc.title | 使用超音波斑點追蹤技術評估手指屈肌肌腱修補手術後個案之肌腱位移量：綜合探討術後肌腱品質與功能性預後之相關性 | zh_TW |
| dc.title | Speckle-Tracking Sonographic Assessment of Tendon Excursion in Patients after Finger Flexor Tendon Repair: Comprehensively Explore the Correlation between Tendon Quality and Functional Outcome | en |
| dc.date.schoolyear | 109-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 李維寧(Hsin-Tsai Liu),張志豪(Chih-Yang Tseng),趙遠宏 | |
| dc.subject.keyword | 超音波斑點追蹤技術,手指屈肌肌腱修補,功能性預後,肌腱品質,沾黏, | zh_TW |
| dc.subject.keyword | Ultrasonic speckle tracking,finger flexor tendon repair,functional outcomes,tendon quality,adhesion, | en |
| dc.relation.page | 122 | |
| dc.identifier.doi | 10.6342/NTU202102600 | |
| dc.rights.note | 同意授權(限校園內公開) | |
| dc.date.accepted | 2021-08-24 | |
| 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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| U0001-2208202122234900.pdf 授權僅限NTU校內IP使用（校園外請利用VPN校外連線服務） | 6.84 MB | Adobe PDF |
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