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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 章良渭(Liang-Wey Chang) | |
dc.contributor.author | Pei-Yu Wu | en |
dc.contributor.author | 吳佩育 | zh_TW |
dc.date.accessioned | 2021-05-20T20:10:37Z | - |
dc.date.available | 2012-08-03 | |
dc.date.available | 2021-05-20T20:10:37Z | - |
dc.date.copyright | 2009-08-03 | |
dc.date.issued | 2009 | |
dc.date.submitted | 2009-07-29 | |
dc.identifier.citation | 1. World Health Organization. Stroke: 1989. Recommendations on stroke prevention, diagnosis, and therapy: Report of the WHO Task Force on Stroke and other Cerebrovascular Disorders 1989; 20: 1407.
2. Haydar Gök, Ayse Küçükdeveci, Haydar Altinkaynak, Günes Yavuzer, Süreyya Ergin. Effects of ankle-foot orthoses on hemiparetic gait Clin Rehabil 2003 17: 137-139. 3. Lehmann JF, Esselman PC, Ko MJ, Smith JC, deLateur BJ, Dralle AJ. Plastic ankle-foot orthoses: evaluation of function. Arch Phys Med Rehabil. 1983 Sep; 64(9):402-7. 4. ToeOFF AFO® Clinical Manual, Camp Scandinavia, June 2001. 5. O’Sullivan SB, Schmitz TJ. Physical rehabilitation: Assessment and Treatment. Fourth Edition, 2001 6. S.Olney, C.Richards. Hemiparetic gait following stroke. Part I: Characteristics. Gait & Posture, Volume 4, Issue 2, Pages 136-148 7. Nakamura R, Handa T, Watanabe S, Morohashi I. Walking cycle after stroke. Tohoku J Exp Med. 1988 Mar; 154(3):241-4. 8. AL Hsu, PF Tang, MH Jan. Analysis of impairments influencing gait velocity and asymmetry of hemiplegic patients after mild to moderate stroke, Archives of Physical Medicine and Rehabilitation, Volume 84, Issue 8, Pages 1185-1193 9. Ray G Burdett, Diane Borello-France, Cathleen Blatchly, Cynthia Potter. Gait Comparison of Subjects with Hemiplegia Walking unbraced, with Ankle-Foot Orthosis, and with Air-Stirrup® Brace. PHYS THER Vol. 68, No. 8, August 1988, pp. 1197-1203 10. CM Kim, JJ Eng. Magnitude and pattern of 3D kinematic and kinetic gait profiles in persons with stroke: relationship to walking speed. Gait & Posture, Volume 20, Issue 2, Pages 140-146. 11. Bowker P, Condie DN, Bader DL, Pratt DJ, Wallace WA. Biomechanical basis of orthotic management (1993). 12. Lehmann JF, Ko MJ, deLateur BJ. Double-stopped AFO in flaccid peroneal and tibial paralysis: evaluation of function. Arch Phys Med Rehabil 1980; 61: 536-541. 13. Lehmann JF, Condon SM, deLateur BJ, Smith JC. AFO: Effect on gait abnormality in tibial nerve paralysis. Arch Phys Med Rehabil 1985; 66: 212-218. 14. Franco Molteni. Control of Foot-Drop. A technical appraisal of the effectiveness of the ToeOFF AFO® appliance. (2001) 15. Lehmann JF. Push-off and propulsion of the body in normal and abnormal gait: correction by AFO. Clinical Orthopaedics and Related Research 1993; 288: 97-108. 16. Lamontagne A, Malouin F, Richards CL. Contribution of passive stiffness to ankle plantarflexor moment during gait after stroke. Arch Phys Med Rehabil March 2000(March); 81: 351-358. 17. David A. Winter. Biomechanics and motor control of human movement. 1990, Third Edition. 18. Rettig O,Wolf S, Doederlein L. Kinetics of a carbon spring Af-orthosis and its influence on the kinetics of gait. Gait & Posture 2003; 18 (Suppl.2):94 [Abstract]. 19. Bartonek A, Eriksson M, Gutierrez-Farewik EM. A carbon fiber spring orthosis for children with plantarflexor weakness. Gait & Posture 2007, Volume 25, Pages 652-656. 20. Danielsson A, Sunnerhagen KS. Energy expenditure in stroke subjects walking with a carbon composite ankle foot orthosis. J Rehabil Med 2004; 36: 165–168. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/9140 | - |
dc.description.abstract | 背景及目的:現今腦中風患者術後之復健工作,常常使用各種不同的功能性「踝足矯具」(Ankle-Foot Orthosis, AFO)作為步態訓練及功能維持的工具,目前已有許多研究指出這類的矯具對於控制病人踝足部擺位(alignment)以及改善步態功能方面有很大的幫助;一般來說,大部份有踝足部問題的中風病人會得到醫師處方以客製化固定踝關節式踝足矯具(solid ankle AFO, SAFO);而近來則有一種半成品類型的踝足矯具,ToeOFF AFO,可供病人做選擇。除了製造的材料有很大的不同之外,它所具有的裁切線形式(trimline)和SAFO也有很大的差異。因此,本研究假設ToeOFF AFO的特殊裁切線,可能較SAFO提供了更好的運動空間及功能,進而幫助中風病人的行走步態;故本研究將針對腦中風患者穿戴兩種踝足矯具:ToeOFF AFO以及SAFO下進行步態分析,以期藉由研究了解其功能及對腦中風患者步態改善的功效,並了解何種裁切線形式的踝足矯具對於中風病人歩態改善最有幫助。
方法: 本研究募集九位偏癱型腦中風患者,在下述三種情況下來回行走進行步態分析:(1)只穿著運動鞋,(2)雙腳著運動鞋並在患側穿著ToeOFF AFO,(3)雙腳著運動鞋並在患側穿著SAFO。步態分析各項資料及參數由OPTOTRAK動作分析系統以及AMTI測力板取得;並利用BodyGemTM calorimeter量取耗氧量各項參數。 結果:本研究結果顯示,(1) ToeOFF AFO 符合研究假設所提出的改善步態表現之行走速度、步頻、步長、提高推進力、加強與地面接觸的平順度、降低能量消耗等;(2)在有垂足問題的兩位受試者的機械能傳遞分析中顯示,ToeOFF AFO雖然提供受試者在踝關節處產生相較於只穿運動鞋以及著SAFO情況下較大的能量,但經由能量傳遞分析結果得知,此一能量並未完全有效地傳遞於個體向前推進;(3) SAFO 對於時間空間步態參數的改善較為顯著。 結論:對於腦中風病人來說,使用適當的AFO以提供對缺損之功能的補充是復健工作上非常重要的課題。不同症狀的病人對於AFO的選擇會有不同,有的病人需要提供穩定性,有的病人需要藉由AFO以提供較好的推進力。本研究的結果顯示,ToeOFF AFO雖改變受試者的步態表現並且可提供受試者較高的能量,但其改變步態的方式無法給予參與研究的腦中風患者足夠的穩定性及適應; SAFO能夠提供患者較好的穩定性,因此對於步態改善的效果較為顯著。 關鍵詞:腦中風、步態分析、踝足部矯具、耗能分析 | zh_TW |
dc.description.abstract | Objective: The aim of this study was to investigate the effectiveness of the ToeOFF AFO in hemiplegic gait in CVA patients with ankle paralysis problem, and compared it with the conventional custom-made solid ankle AFO. The comparison would include biomechanical performance in spatio-temporal parameters, joint kinematics, and joint kinetic as well as the ankle-foot roll-over shape, asymmetry ratio, and push-off power in terminal stance.
Design: Experimental gait analysis; Repeated measure ANOVA analysis. Participants: Nine CVA hemiplegia patients (5 males, 4 females) participated in this study. Five subjects were left and four were right involved. Setting: Rehabilitation Engineering Research Center with instrumented gait laboratory. Interventions: Three conditions: shoes only (SHOE), shoes with solid ankle AFO (SAFO), and the same shoes with ToeOFF AFO (TOEOFF). Main outcome measures: Significance in spatio-temporal parameters, gait performance, asymmetry ratio, and ankle-foot roll-over shape. Results: The major finding of this study included: (1) the ToeOFF AFO was found to be consistent of the hypotheses, which improved the walking speed, cadence step length, temporal symmetry, ankle power generation, foot contact patterns, and energy cost; (2) in subjects of drop foot group, the power flow analysis showed that part of the greater power generation with the ToeOFF AFO was partially transferred to trunk as support; (3) the SAFO provided more stability resulted in improving the spatio-temporal parameters more. Conclusion: For CVA patients, walk with an adequate AFO to compensate the deficit functions is a very important issue in rehabilitation work. Dissimilar configurations of AFOs provide different effectiveness for certain condition of patients. The results of this study supported that the SAFO provided better stability, and the ToeOFF AFO provided better power generation. The generated power could make use for propulsion in more stable patients. Accordingly, these findings in the present study provided as a reference to choose an adequate AFO by considering what’s the majority of the patients need? The propulsion power or the stability is. Key words: Stroke, Gait analysis, Ankle-foot orthosis, Energy consumption | en |
dc.description.provenance | Made available in DSpace on 2021-05-20T20:10:37Z (GMT). No. of bitstreams: 1 ntu-98-R94548053-1.pdf: 742389 bytes, checksum: fd7d97b85b3cce19544065f4e3eb46b8 (MD5) Previous issue date: 2009 | en |
dc.description.tableofcontents | 致謝 I
摘要 II Abstract IV Contents VI Figure contents VIII Table contents IX Chapter 1 Introduction - 1 - 1.1 Background - 1 - 1.2 Research motivation - 2 - 1.3 Literature reviews - 3 - 1.3.1 Hemiplegic CVA gait deviations and patterns - 3 - 1.3.2 Recent development of advanced AFO’s and orthotic interventions………………………………………………………………- 9 - 1.3.3 Initial contact and smoothness of the gait - 11 - 1.3.4 Push-off power in terminal stance phase of the gait - 12 - 1.3.5 Ankle-foot roll-over shape - 13 - 1.3.6 Energy consumption on pathological gait of hemiplegic CVA patients - 13 - 1.4 Objectives and hypotheses - 14 - Chapter 2 Materials and Methods - 16 - 2.1 Subjects - 16 - 2.2 Materials - 17 - 2.3 Procedure - 21 - 2.4 Data analysis - 24 - 2.5 Statistical analysis - 28 - Chapter 3 Results - 29 - 3.1 Clinical assessment - 29 - 3.2 Gait performance - 32 - 3.2.1 Spatio-temporal parameters - 32 - 3.2.2 Joint kinematics and kinetics - 35 - 3.2.3 Ankle-foot roll-over shape - 39 - 3.2.3 Energy expenditure - 41 - Chapter 4 Discussion - 42 - 4.1 Effectiveness of the ToeOFF AFO on gait for CVA subjects - 42 - 4.2 Comparison of the ToeOFF AFO and Solid ankle AFO - 43 - 4.3 The Drop foot group - 46 - Chapter 5 Conclusion - 55 - References - 57 - Appendix A - 60 - Appendix B - 63 - | |
dc.language.iso | en | |
dc.title | ToeOFF®踝足矯具在改善腦中風病患歩態上之果效 | zh_TW |
dc.title | The effectiveness of the ToeOFF® AFO in hemiplegic gait for CVA patients with flaccid ankle paralysis | en |
dc.type | Thesis | |
dc.date.schoolyear | 97-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 王亭貴,湯佩芳 | |
dc.subject.keyword | 腦中風,步態分析,踝足部矯具,耗能分析, | zh_TW |
dc.subject.keyword | Stroke,Gait analysis,Ankle-foot orthosis,Energy consumption, | en |
dc.relation.page | 65 | |
dc.rights.note | 同意授權(全球公開) | |
dc.date.accepted | 2009-07-29 | |
dc.contributor.author-college | 工學院 | zh_TW |
dc.contributor.author-dept | 醫學工程學研究所 | zh_TW |
顯示於系所單位: | 醫學工程學研究所 |
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