老年化對平地及斜坡行走的平衡控制及下肢關節間協調性之影響

Abstract

病灶位於脊椎的疾病中，最常見的是脊椎關節退化。脊椎關節退化在初期常常沒有症狀，或不容易發覺。生物力學對脊椎研究的其中一個切入點是動作分析，目前的研究進度對影響斜坡行走的因素尚未釐清。所以本研究分為兩個部分，第一部分是以動作分析技術，來對於健康年輕及健康年長兩組受試者作分析，以釐清平地及斜坡行走時的全身控制策略，由此探討老年化對的下肢關節協調性和平衡控制的影響。第二部分是以動作分析技術，來對於腰椎退化年長者及健康年長者兩組受試者作分析，以釐清平地行走時的全身控制策略，由此探討腰椎脊椎關節退化患者的下肢關節協調性和平衡控制，希望對預防評估與治療計畫有幫助。第一部分召募15位健康年長者及15位健康年輕人共兩組受試者，第二部分招募11位腰椎退化年長者及11位健康年長者共兩組受試者，運動學資料部分是採用三維動作分析系統，地面反作用力是使用三塊測力板量測，關節運動學、力動學與全身動態平衡參數皆納入統計分析，統計方法採用獨立樣本t檢定、皮爾森積動差相關係數、變異數分析及共變異數分析，結論是老年化的確會造成平地及斜坡行走時的全身控制策略，脊椎退化也的確會影響年長者平地行走時的下肢關節協調性和平衡控制。

Among the disease that affect human spine, the most common encounter was Spondylosis . Spondylosis is a silent killer which means the initial symptoms were not apparent nor easy to discover. One perspective of research in biomechanics is motion analysis, the current research frontier about slope walking is still in the beginnings. Therefore, this study was divided into two parts. The first part was aimed to use the technique of motion analysis to analyze aging effects on whole-body-strategy during slope walking, and to shed light on of balance control and lower limb inter-joint coordination. The second part was aimed to use the technique of motion analysis to analyze spondylotic effects on whole-body-strategy during of level walking. The second part would be helpful for the clinical assessment and treatment plan for lumbar spondylotic patients. Fifteen healthy old people and fifteen healthy people were included as test subjects into two groups in the first part. Eleven healthy elderly and eleven spondylotic patients were divided into two groups in part two. Kinematic data were collected by three-dimensional, ground reaction force was measured by three force plates. In terms of the kinematics, kinetics of the joints and dynamic balance was enumerated and statistically examined. Statistical method included independent t-test, Pearson’s correlation coefficient, ANOVA and ANCOVA. The conclusion was aging and spondylosis would affected whole-body-strategy during level walking and aging would affect whole-body-strategy during slope walking, and to shed light on of balance control and lower limb inter-joint coordination.