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http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/21320完整後設資料紀錄
| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 徐瑋勵(Wei-Li Hsu) | |
| dc.contributor.author | Wei-Jin Wong | en |
| dc.contributor.author | 黃薇瑾 | zh_TW |
| dc.date.accessioned | 2021-06-08T03:31:02Z | - |
| dc.date.copyright | 2019-08-27 | |
| dc.date.issued | 2019 | |
| dc.date.submitted | 2019-08-13 | |
| dc.identifier.citation | 1.Ravindra VM, Senglaub SS, Rattani A, et al. Degenerative lumbar spine disease: estimating global incidence and worldwide volume. Global Spine J. 2018;8(8):784-794.
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Spine (Phila Pa 1976). 2000;25(8):989-994. 44.Koenders N, Rushton A, Verra ML, Willems PC, Hoogeboom TJ, Staal JB. Pain and disability after first-time spinal fusion for lumbar degenerative disorders: a systematic review and meta-analysis. Eur Spine J. 2018. 45.Zaina F, Tomkins-Lane C, Carragee E, Negrini S. Surgical versus non-surgical treatment for lumbar spinal stenosis. Cochrane Database Syst Rev. 2016(1):CD010264. 46.Stokes OM, Cole AA, Breakwell LM, Lloyd AJ, Leonard CM, Grevitt M. Do we have the right PROMs for measuring outcomes in lumbar spinal surgery? Eur Spine J. 2017;26(3):816-824. 47.Dietz N, Sharma M, Alhourani A, et al. Variability in the utility of predictive models in predicting patient-reported outcomes following spine surgery for degenerative conditions: a systematic review. Neurosurg Focus. 2018;45(5):E10. 48.Khor S, Lavallee D, Cizik AM, et al. Development and validation of a prediction model for pain and functional outcomes after lumbar spine surgery. JAMA Surg. 2018;153(7):634-642. 49.McGirt MJ, Sivaganesan A, Asher AL, Devin CJ. Prediction model for outcome after low-back surgery: individualized likelihood of complication, hospital readmission, return to work, and 12-month improvement in functional disability. Neurosurg Focus. 2015;39(6):E13. 50.Archer KR, Seebach CL, Mathis SL, Riley LH, 3rd, Wegener ST. Early postoperative fear of movement predicts pain, disability, and physical health six months after spinal surgery for degenerative conditions. Spine J. 2014;14(5):759-767. 51.Wang TY, Pao JL, Yang RS, Jang JS, Hsu WL. The adaptive changes in muscle coordination following lumbar spinal fusion. Hum Mov Sci. 2015;40:284-297. 52.Sipko T, Chantsoulis M, Kuczynski M. Postural control in patients with lumbar disc herniation in the early postoperative period. Eur Spine J. 2010;19(3):409-414. 53.Truszczynska A, Drzal-Grabiec J, Trzaskoma Z, Rachwal M, Rapala K, Gorniak K. Static balance after surgical decompression of lumbar spinal canal stenosis. J Back Musculoskelet Rehabil. 2015;28(4):865-871. 54.Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med. 2001;8(12):1153-1157. 55.Vlaeyen JW, Kole-Snijders AM, Boeren RG, van Eek H. Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain. 1995;62(3):363-372. 56.Qaseem A, Wilt TJ, McLean RM, Forciea MA, Clinical Guidelines Committee of the American College of P. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514-530. 57.Mannion AF, Junge A, Fairbank JC, Dvorak J, Grob D. Development of a German version of the Oswestry Disability Index. Part 1: cross-cultural adaptation, reliability, and validity. Eur Spine J. 2006;15(1):55-65. 58.Miekisiak G, Kollataj M, Dobrogowski J, et al. Validation and cross-cultural adaptation of the Polish version of the Oswestry Disability Index. Spine (Phila Pa 1976). 2013;38(4):E237-243. 59.Copay AG, Glassman SD, Subach BR, Berven S, Schuler TC, Carreon LY. Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and pain scales. Spine J. 2008;8(6):968-974. 60.Leinonen V, Määttä S, Taimela S, et al. Impaired lumbar movement perception in association with postural stability and motor- and somatosensory-evoked potentials in lumbar spinal stenosis. Spine (Phila Pa 1976). 2002;27(9):975-983. 61.Sipko T, Chantsoulis M, Kuczyński M. Postural control in patients with lumbar disc herniation in the early postoperative period. European Spine Journal. 2010;19(3):409-414. 62.Hsu WL. Adaptive postural control for joint immobilization during multitask performance. 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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/21320 | - |
| dc.description.abstract | 背景： 退化性腰椎病變患者常伴隨疼痛、日常功能受限及平衡能力受損。過去研究發現，患者於腰椎融合術前的個人特性與術後的日常功能進步程度有關。然而，患者於腰椎融合術前的平衡表現對術後的功能性表現進步程度的影響仍未知。
研究目的：探討退化性腰椎病變患者於腰椎融合術前的平衡表現與術後12個月的功能性表現進步程度之間的關係，並建立一腰椎融合術後功能性活動表現之預測模型。 研究設計：前瞻性世代研究 研究方法：本研究在2014至2019年於一醫學中心招募了100位退化性腰椎病變患者。此研究收集了所有受試者術前與術後的基本身體資料、問卷調查(疼痛視覺類比量表 Visual Analog Scale、歐氏失能量表 Oswestry Disability Index) 及平衡表現。平衡測試為在受試者開眼和閉眼的情況下，於力板上雙腳與肩同寬站立和雙足併攏站立維持35秒，並記錄站立時的足底壓力中心之位移。本研究使用邏輯斯迴歸分析，功能性表現的進步為依變數，術前平衡表現與患者特性為預測因子。術後的歐氏失能量表分數相比術前的分數下降超過12.8分定義為功能性表現的進步。 研究結果：本研究100名患者中，有77名患者的功能性表現於術後12個月進步。於單變項迴歸分析中，術前平衡表現中的雙腳與肩同寬站立與閉眼測試的結果較差（勝算比[Odds ratio, OR] = 0.92, P = 0.012）與術後功能性表現的進步較少相關。於多變項迴歸分析中，術後有較差的功能性表現進步之預測因子為：術前平衡表現較差、術前歐氏失能量表分數較低、年齡較大、身高體重指數較高和症狀持續時間較長，且此模型的曲線下方的面積為0.90。性別、身高、體重、術前疼痛程度及在開眼雙腳與肩同寬和張眼/閉眼雙腳合併的平衡表現與術後功能性表現的進步無關。 結論：退化性腰椎病變患者於腰椎融合術前，若有較差的平衡表現，可預測術後會有較差的功能性表現改變。本研究建立了一可預測腰椎融合術後功能性表現進步之預測模型，且可提供臨床手術決策與患者對於手術療效的期望之重要指標。 | zh_TW |
| dc.description.abstract | Background: Degenerative lumbar spine disease (DLSD) is often accompanied by pain, functional impairment, and balance impairment. Preoperative patient characteristics have been associated with functional improvement after lumbar fusion. However, the effect of preoperative balance performance on functional improvement after lumbar surgery was unclear.
Objective: To determine the association between the preoperative balance performance of patients with DLSD and the functional improvement 12 months postoperatively and to develop a prediction tool for functional improvement. Design: Prospective cohort study Methods: Patients with DLSD (n = 100) were prospectively enrolled between 2014 and 2019 in a medical center. Balance performance assessment and patient-reported outcomes were completed by all patients before lumbar fusion surgery and 12 months postoperatively. Each participant performed 4 standing tasks: natural stance with eyes open (EO) and eyes closed (EC), and Romberg stance with eyes open (RSEO) and eyes closed (RSEC). Logistic regression analysis was conducted with functional improvement as the outcome, and with preoperative balance performance and patient characteristics as predictors. Functional improvement was defined as a reduction in the Oswestry Disability Index (ODI) score of 12.8 or more between before and after surgery. Results: Seventy-seven patients showed improvement in functional performance 12 months postoperatively. On univariate analysis, poor preoperative balance performance in natural stance under eyes closed (odds ratio [OR] = 0.92, P = 0.012) was associated with less optimal functional improvement postoperatively. On multivariate analysis, predictors of less optimal outcome included poor preoperative balance performance, low preoperative ODI score, old age, high body mass index, and long symptom duration, with an area under curve of 0.90 for the model. Sex, height, weight, preoperative pain level, and preoperative balance performance under EO, RSEO, and RSEC showed no association with functional improvement postoperatively. Conclusion: Poor preoperative balance performance may predict a lower likelihood of functional improvement after lumbar fusion for DLSD. This study developed a prediction model for postoperative functional improvement, which may provide useful information for surgical decision-making and perioperative expectations. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-08T03:31:02Z (GMT). No. of bitstreams: 1 ntu-108-R06428014-1.pdf: 3548430 bytes, checksum: 31d456234e875d1ffebce150d886c8ed (MD5) Previous issue date: 2019 | en |
| dc.description.tableofcontents | 謝辭 ii
中文摘要 iii ABSTRACT v CONTENTS vii INDEX OF FIGURE ix INDEX OF TABLE x CHAPTER 1 INTRODUCTION 1 CHAPTER 2 LITERATURE REVIEW 3 2.1 Degenerative Lumbar Spine Disease (DLSD) 3 2.1.1. Epidemiology 3 2.1.2. Pathophysiology 4 2.1.3. Interventions for DLSD 5 2.2 Postural Control System Underlying Upright Position 6 2.3 Balance Performance in Patients with DLSD 8 2.4 Lumbar Surgical Outcomes for Patients with DLSD 9 2.4.1. Pain Intensity 9 2.4.2. Functional Performance 10 2.4.3. Balance Performance 11 2.5 Research Questions 14 2.6 Study Objectives 14 2.7 Hypotheses 15 CHAPTER 3 METHODOLOGY 16 3.1 Study Design 16 3.2 Study Procedure 16 3.3 Participants 17 3.4 Data Collection and Data Analysis 18 3.4.1 Patient-Reported Outcomes 18 3.4.2 Balance Performance Assessment 20 3.5 Statistical Analysis 21 CHAPTER 4 RESULTS 23 4.1 Demographic Data 23 4.2 Univariate Logistic Regression Analysis 23 4.3 Multivariate Logistic Regression Model Development 25 CHAPTER 5 DISCUSSION 27 CHAPTER 6 CONCLUSION 33 REFERENCES 34 APPENDIX 1. Clinical Trial/ Research Approval 56 APPENDIX 2. Consent Form from NTUH 57 APPENDIX 3. Visual Analog Scale 64 APPENDIX 4. Oswestry Disability Index 65 | |
| dc.language.iso | zh-TW | |
| dc.title | 腰椎融合術後功能性表現之臨床預測模型 | zh_TW |
| dc.title | Clinical Prediction Model for Functional Performance Following Lumbar Fusion Surgery | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 107-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 王淑芬(Shwu-Fen Wang),賴達明(Dar-Ming Lai),張雅如(Ya-Ju Chang),程蘊菁(Yen-Ching Karen Chen) | |
| dc.subject.keyword | 平衡表現,足底壓力中心,退化性腰椎病變,腰椎融合術,功能性測試量表,病人報告結果, | zh_TW |
| dc.subject.keyword | Balance performance,Center of pressure,Degenerative lumbar spine disease,Lumbar fusion surgery,Oswestry Disability Index,Patient-reported outcome, | en |
| dc.relation.page | 67 | |
| dc.identifier.doi | 10.6342/NTU201903051 | |
| dc.rights.note | 未授權 | |
| dc.date.accepted | 2019-08-14 | |
| 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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