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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 章良渭 | |
| dc.contributor.author | Lun-Ho Yuan | en |
| dc.contributor.author | 袁倫和 | zh_TW |
| dc.date.accessioned | 2021-06-13T17:05:00Z | - |
| dc.date.available | 2005-02-02 | |
| dc.date.copyright | 2005-02-02 | |
| dc.date.issued | 2005 | |
| dc.date.submitted | 2005-01-27 | |
| dc.identifier.citation | Balmaseda, M. T., Koozekanani S. H., et al. (1988). Ground reaction forces, center of pressure, and duration of stance with and without an ankle-foot orthosis. Arch Phys Med Rehabil 69(12): 1009-12.
Beckerman, H., Becher J., et al. (1996). Walking ability of stroke patients: efficacy of tibial nerve blocking and a polypropylene ankle-foot orthosis. Arch Phys Med Rehabil 77(11): 1144-51. Burdett, R. G., Borello-France D., et al. (1988). Gait comparison of subjects with hemiplegia walking unbraced, with ankle-foot orthosis, and with Air-Stirrup brace. Phys Ther 68(8): 1197-203. Chen, C. L., Yeung K. T., et al. (1999). Anterior ankle-foot orthosis effects on postural stability in hemiplegic patients. Arch Phys Med Rehabil 80(12): 1587-92. Crenna, P. (1998). Spasticity and 'spastic' gait in children with cerebral palsy. Neurosci Biobehav Rev 22(4): 571-8. Crenna P, Frigo C, Palmieri R, Fedrizzi E. (1992). Pathophysiological profile of gait in children with cerebral palsy. Med Sport Sci 36: 186~98. Cynthia C. Norkin, D. (1996). Measurement of joint motion : a guide to goniometry. Philadelphia, F.A. Davis Co. David A. Winter (1991). Technique for interpretation of electromyography for concentric and contractions in gait. J. of Electromyography and Kinesiology 1(4): 263~269. Diamond, M. F., Ottenbacher K. J. (1990). Effect of a tone-inhibiting dynamic ankle-foot orthosis on stride characteristics of an adult with hemiparesis. Phys Ther 70(7): 423-30. Edward F. Delagi, John Iazzetti, Daniel Morrison, Anatomical Guide for the Electromyographer : The Limb and Trunk. New York. Gillen G. (1998). Stroke Rehabilitation: A function-Based Approach. New York, Mosby-Year Book, Inc. Gok, H., Kucukdeveci A., et al. (2003). Effects of ankle-foot orthoses on hemiparetic gait. Clin Rehabil 17(2): 137-9. Hachisuka, K., Ogata H., et al. (1998). Clinical evaluations of dorsiflexion assist controlled by spring ankle-foot orthosis for hemiplegic patients. J Uoeh 20(1): 1-9. Herman R. (1968). Alterations in dynamic and static properties of the stretch reflex in patients with spastic hemiplegia. Arch Phys Med Rehabil 25: 199~204. Hesse, S., Luecke D., et al. (1996). Gait function in spastic hemiparetic patients walking barefoot, with firm shoes, and with ankle-foot orthosis. Int J Rehabil Res 19(2): 133-41. Iwata, M., Kondo I., et al. (2003). An ankle-foot orthosis with inhibitor bar: effect on hemiplegic gait. Arch Phys Med Rehabil 84(6): 924-7. Knutsson E. (1980). Dynamic motor capacity in spastic paresis and its relation to prime mover dysfunction, spastic reflexes and antagonist coactivation. Scand J Rehabil Med 12(93~106). Lamontagne, A., Malouin F., et al. (2001). Locomotor-specific measure of spasticity of plantarflexor muscles after stroke. Arch Phys Med Rehabil 82(12): 1696-704. Lamontagne, A., Malouin F., et al. (2002). Mechanisms of disturbed motor control in ankle weakness during gait after stroke. Gait Posture 15(3): 244-55. Lamontagne, A., Richards C. L., et al. (2000). Coactivation during gait as an adaptive behavior after stroke. J Electromyogr Kinesiol 10(6): 407-15. Lehmann, J. F., Condon S. M., et al. (1987). Gait abnormalities in hemiplegia: their correction by ankle-foot orthoses. Arch Phys Med Rehabil 68(11): 763-71. Lehmann, J. F., Esselman P. C. , et al. (1983). Plastic ankle-foot orthoses: evaluation of function. Arch Phys Med Rehabil 64(9): 402-7. Lehmann JF, DeLateur BJ, Hinderer S, Traynor C. (1989). Spasticity: quantitative measurements as a basis for assessing effectiveness of therapeutic intervention. Arch Phys Med Rehabil 70: 6~15. Nordin M, Victor H. (2001). Basic Biomechanics of the Musculoskeletal System. Baltimore. Neilson PD, Andrews CJ (1973). Comparison of the tonic stretch reflex in athetotic patients during rest and voluntary activity. Neurosurg Psychiatry 36: 547~54. Powers RK, Rymer WZ. (1988). Quantitative relations between hypertonia and stretch reflex threshold in spastic hemiparesis. Ann Neurol 23: 115~124. Feldmann, R.G. (1990). In Spasticity: Disordered Motor Control. Chicago, Year Book Medical Publisher. Susan B. O'Sullivan, et al. (1994). Physical Rehabilitation Assessment and Treatment. New York. Von Schroeder, H. P., Coutts R. D., et al. (1995). Gait parameters following stroke: a practical assessment. J Rehabil Res Dev 32(1): 25-31. White, S. C., Yack H. J., et al. (1989). A three-dimensional musculoskeletal model for gait analysis. Anatomical variability estimates. J Biomech 22(8-9): 885-93. Wong, A. M., Tang F. T., et al. (1992). Clinical trial of a low-temperature plastic anterior ankle foot orthosis. Am J Phys Med Rehabil 71(1): 41-3. | |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/39153 | - |
| dc.description.abstract | 摘要:
固定式踝足部矯具用於偏癱病患已有三十年的歷史,鉸接式蹠曲限制踝足部矯具被認為在處理偏癱病患行走時的背曲軟癱具有良好的效果。然而中風病患穿著鉸接式蹠曲限制踝足部矯具在降低痙攣的機轉及效果並不是十分清楚。 本研究收集十四位中風病患,在下列三種情況行走六公尺以便記錄關節角度變化與肌電圖: (1)只穿著球鞋, (2)雙腳著球鞋並在患側穿著零度背曲(踝關節正中位置)之鉸接式蹠曲限制踝足部矯具, (3)雙腳著球鞋並在患側穿著五度背曲之鉸接式蹠曲限制踝足部矯具。 根據 Crenna (1992) 以及 Lamontagne (2001) 的研究,對於痙攣的量化(痙攣指數)使用肌電反應對肌肉伸長速度作回歸分析,肌肉伸長速度的資料由步態分析系統(Vicon 250,Oxford,UK)取得,而肌電資料由表面電極取得(Gould Instrument System Inc,USA) 結果顯示 (1)健側及患側間的痙攣指數具有顯著差異(p<0.001), (2)患側穿著五度背曲之鉸接式蹠曲限制踝足部矯具相對於不穿著的情況下,其痙攣指數有明顯上升(p<0.01),但是病患穿著零度背曲之鉸接式蹠曲限制踝足部矯具在痙攣指數上並無顯著差異(p>0.05), (3) 零度及五度背曲之鉸接式蹠曲限制踝足部矯具對於載重反應時期(loading response)的時間有明顯改善(p<0.001),但是五度背曲之鉸接式蹠曲限制踝足部矯具對於擺盪前期時期(Pre-swing)的時間有顯著的減少。本研究的結論是正中位置(neutral position)之鉸接式蹠曲限制踝足部矯具相對於五度背曲之鉸接式蹠曲限制踝足部矯具在改善中風並患步態更具改善效果。 | zh_TW |
| dc.description.abstract | Abstract
Conventional rigid ankle-foot orthosis (AFO) has been used in hemiplegic subjects to improve gait function for almost thirty years. However, hinged plantarflexion-stop ankle-foot orthoses (PSAFO) are suggested to be effective for patients with hemiparesis and weak ankle dorsiflexion to stabilize the ankle in the sagittle and coronal plane during ambulation. However, the changes of ankle spasticity in stroke patients during ambulation with PSAFO is not very clear. Totally 14 CVA patients participated in this study. They would walk about 6 meters in three conditions: (1) wearing only sports shoes. (2) wearing sports shoes with zero-degree PSAFO (with neutral ankle) on the paretic side. (3) wearing sports shoes with five-degree dorsiflexion PSAFO on the paretic side. We measured the spasticity index proposed by Crenna (1992) and Lamontagne (2001) with muscle length-EMG activity relationship to quantify the spasticity during walking. The gait cycles were recorded by the motion analysis system (Vicon 250, Oxford, UK). The EMG activities were recorded by surface electrodes (Gould Instrument Systems Inc., USA). Results of present studies were: (1) the spasticity index between sound sides and paretic sides were significantly different at all conditions with and without PSAFO (p<0.001). (2) The spasticity index of the paretic side with five-degree AFO was significantly greater than that without AFO (p<0.01), and the spasticity index of zero-degree AFO was not significantly different from that without PSAFO (p>0.05). (3) PSAFO in zero and five-degree dorsiflexion could improve the loading response, but the pre-swing phase with five-degree PSAFO was significantly reduced. The major conclusion is that zero-degree AFO is a good prescription for stroke patients to enhance the walking ability. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-13T17:05:00Z (GMT). No. of bitstreams: 1 ntu-94-R91548031-1.pdf: 1732802 bytes, checksum: ab962789ffd80696bfb42ccf42030a55 (MD5) Previous issue date: 2005 | en |
| dc.description.tableofcontents | Contents
Chapter 1. Introduction I 1.1 Project Motivation I 1.2 Literature Review 2 1.2.1 Gait Pattern in CVA 2 1.2.2 Studies of AFO and Other Othoses in CVA 5 1.2.3 Biomechanics of AFO 9 1.2.4 Measurements of spasticity 10 1.3 Hypotheses and Objectives 13 Chapter 2. Materials and Methods 14 2.1 Subjects 14 2.2 Study Design 16 2.3 Experimental Protocols 16 2.4 AFO Fabrication procedures 16 2.4.1 Molding Procedures 16 2.4.2 Cast Modification 19 2.4.3 Fabrication 20 2.4.4 Fitting 23 2.5 Equipments 24 2.6 Experimental procedures 24 2.7 Spasticity Measurements 28 2.8 Data Analysis 30 Chapter 3. Results 31 3.1 Demographic data 31 3.2 Lengthening velocity and EMG responses during stance phase 31 3.2.1 Lengthening velocity and EMG responses during stance phase without PSAFO 32 3.2.2 Lengthening velocity and EMG responses during stance phase with Zero- degree PSAFO 35 3.2.3 Lengthening velocity and EMG responses during stance phase with Five- degree PSAFO 37 3.3 Comparison of spasticity index during stance phase with and without PSAFO 39 3.4 EMG firing pattern during stance phase with and without PSAFO 41 3.5 Comparison of kinematic data during stance phase 45 Chapter 4. Discussion 48 4.1 Abnormal gait pattern in hemiplegic patients 48 4.2 Effect of PSAFO on spasticity 48 4.3 Effect of PSAFO on EMG firing pattern 49 4.4 Effect of PSAFO on gait cycle 50 4.5 Mechanism of PSAFO on Spasticity 51 4.6 Proposed clinical application 54 4.7 Limitation of study 54 4.8 Future works 55 Chapter 5. Conclusion 56 | |
| dc.language.iso | en | |
| dc.subject | 步態 | zh_TW |
| dc.subject | 踝足部矯具 | zh_TW |
| dc.subject | 痙攣 | zh_TW |
| dc.subject | 中風 | zh_TW |
| dc.subject | Gait | en |
| dc.subject | Spasticity | en |
| dc.subject | Ankle-foot orthosis | en |
| dc.subject | Stroke | en |
| dc.title | 中風病患穿著鉸接式蹠曲限制踝足部矯具行走之
內側腓腸肌痙攣分析 | zh_TW |
| dc.title | Analysis of spasticity on medial gastrocnemius in stroke individuals wearing articulated ankle-foot orthoses with plantarflexion-stop during ambulation | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 93-1 | |
| dc.description.degree | 碩士 | |
| dc.contributor.coadvisor | 林光華 | |
| dc.contributor.oralexamcommittee | 林銘川 | |
| dc.subject.keyword | 踝足部矯具,痙攣,中風,步態, | zh_TW |
| dc.subject.keyword | Stroke,Gait,Ankle-foot orthosis,Spasticity, | en |
| dc.relation.page | 60 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2005-01-28 | |
| 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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