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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 林居正(Jiu-Jenq Lin) | |
| dc.contributor.author | Deng Siang Ting | en |
| dc.contributor.author | 陳登翔 | zh_TW |
| dc.date.accessioned | 2022-11-24T03:06:17Z | - |
| dc.date.available | 2022-01-26 | |
| dc.date.available | 2022-11-24T03:06:17Z | - |
| dc.date.copyright | 2022-01-26 | |
| dc.date.issued | 2022 | |
| dc.date.submitted | 2022-01-05 | |
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Kalra N, Seitz AL, Boardman ND, 3rd, Michener LA. Effect of posture on acromiohumeral distance with arm elevation in subjects with and without rotator cuff disease using ultrasonography. J Orthop Sports Phys Ther. 2010;40(10):633-640. 76. Michener LA, Subasi Yesilyaprak SS, Seitz AL, Timmons MK, Walsworth MK. Supraspinatus tendon and subacromial space parameters measured on ultrasonographic imaging in subacromial impingement syndrome. Knee Surg Sports Traumatol Arthrosc. 2015;23(2):363-369. 77. Ludewig PM, Hoff MS, Osowski EE, Meschke SA, Rundquist PJ. Relative balance of serratus anterior and upper trapezius muscle activity during push-up exercises. Am J Sports Med. 2004;32(2):484-493. 78. Kendall FP, McCreary EK, Kendall HO. Muscles, testing and function: testing and function: Lippincott Williams and Wilkins; 1983. 79. Leschinger T, Wallraff C, Muller D, Hackenbroch M, Bovenschulte H, Siewe J. 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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/80419 | - |
| dc.description.abstract | 研究背景：喙突下夾擠相較於肩峰下夾擠而言，在臨床上較不普遍。根據文獻回顧，喙突下夾擠被認為是造成肩膀前側疼痛的可能原因之一。在進行肩夾擠症候群臨床測試時，肩胛下肌可能於喙突下被夾擠。因此，針對喙突下夾擠與肩峰下夾擠之鑑別診斷，有助於制定治療策略。此外，喙肱韌帶在解剖構造上附著於喙突外側，被認為於喙突下夾擠可能扮演者重要的角色。喙肱韌帶的形態學特性可能是造成肩峰下夾擠之因子，而其可能會影響喙肱距離以及肩胛骨運動學。 研究目的：此研究的目的包括（1）使用超音波影像，探討肩夾擠症候群病患喙肱韌帶厚度與喙肱距離之相關性，（2）探討有無合併肩胛下肌損傷之肩夾擠症候群病患，於喙肱韌帶厚度與喙肱距離之差異，（3）探討有無合併肩胛下肌損傷之肩夾擠症候群病患，於肩胛骨運動學與肌肉活化之差異。 研究設計：本研究為橫斷式研究。 研究對象：本研究招募40位肩夾擠症候群病患。依照臨床肩胛下肌測試的結果，進一步將病患分為合併肩胛下肌損傷（SSCL）與無肩胛下肌損傷（SIS）兩組。 研究方法：受試者進行肩胛下肌、二頭肌隧道特殊測試以及超音波影像收集，並於手臂上抬時，使用運動追蹤與肌電圖，測量肩胛骨運動學與相關肌肉活化情形。測量參數包含：喙肱韌帶厚度，在不同肩膀旋轉姿勢下的喙肱距離，以及於手臂上抬時之肩胛骨運動學與相關肌肉活化程度。 統計分析：使用SPSS 25.0進行統計分析，顯著水準設為p值小於0.05。分析喙肱韌帶厚度與喙肱距離之相關性。使用獨立樣本t檢定分析超音波影像測量參數之組間差異。使用變異數分析比較兩組在手臂上抬時之肩胛骨運動學與相關肌肉活化之差異。 結果：在SSCL組之患側中，呈現內轉肌力比少於80%，內轉姿勢下的喙肱距離（CHDIR：9.4mm，CHRIRFA：8.8mm）呈顯著減少，其喙肱韌帶厚度、肩胛下肌肌腱厚度與肩胛下肌於喙肱距離佔比皆呈顯著增加。在SIS組之患側中，喙肱韌帶與喙肱距離（CHDNR：r=0.455，CHDIR：r=0.483）呈中度正相關。兩組於肩胛骨運動學與相關肌肉活化皆無顯著差異。 結論：喙肱韌帶增厚與喙肱距離增加之不一致變化機制可能為造成肩夾擠症候群病患肩胛下肌損傷的因素。臨床上評估肩夾擠症候群病患之喙肱韌帶，喙肱距離與內轉肌力比可能為預防肩胛下肌後續損傷的方法。可能之治療策略建議包括減少肩胛下肌肌腱厚度與肌力訓練。兩組受試者於手臂上抬時之肩胛骨運動學與相關肌肉活化皆呈現相似結果。 | zh_TW |
| dc.description.provenance | Made available in DSpace on 2022-11-24T03:06:17Z (GMT). No. of bitstreams: 1 U0001-0401202210441400.pdf: 16769926 bytes, checksum: a9f6a0e618e6c0f629a512b94ca4c69d (MD5) Previous issue date: 2022 | en |
| dc.description.tableofcontents | 口試委員審定書 i 致謝 ii 摘要 iv Abstract vi Chapter 1 – Nature of the study 1 1.1 Background 1 1.2 Statement of Problems 2 1.3 Purpose of the study 3 1.4 Hypotheses 3 Chapter 2 – Literature Review 5 2.1 Epidemiology of Subscapularis Tear 5 2.2 Shoulder Impingement Syndrome (SIS) 5 2.3 Subcoracoid Impingement and Coracohumeral Distance (CHD) 6 2.4 Subscapularis and Long Head of Biceps Tendon (LHBT) Pathologies 8 2.5 Coracohumeral Ligament (CHL) 9 2.6 Scapular kinematics and muscular activity in SIS 12 2.7 Clinical Application of Ultrasonography (USG) in SIS and LHBT Instability 13 Chapter 3 – Methods 15 3.1 Design 15 3.1.1 Sample size estimate 15 3.1.2 Inclusion criteria 15 3.1.3 Exclusion criteria 16 3.2 Instrumentation 16 3.2.1 Ultrasonography (USG) 16 3.2.2 Three-dimensional scapular kinematics 17 3.2.3 Surface electromyography (sEMG) 17 3.2.4 Tensiometer 18 3.3 Procedures 19 3.4 Outcome Measures 26 3.4.1 USG 26 3.4.2 Three-dimensional scapular kinematics 27 3.4.3 Scapular muscles activities 27 3.5 Statistical analysis 28 Chapter 4 – Results 29 4.1 Clinical Measurements 29 4.2 USG Measurements 29 4.3 Correlation with CHL Thickness 30 4.4 Scapular Kinematics and Associated Muscular Activation 31 Chapter 5 – Discussion 33 Chapter 6 – Conclusions 38 References 39 Table 1: Demographic data of the subjects 52 Table 2: Clinical Measurement 53 Table 3: Primary USG Measurement 54 Table 4: Secondary USG Measurement 55 Table 5: Correlation between coracohumeral ligament thickness and coracohumeral distance. 56 Table 6: Correlation between coracohumeral ligament thickness and occupation ratio 57 Table 7: Correlation between coracohumeral ligament thickness and tendon thickness 58 Table 8: Scapular Kinematics during Arm Elevation in the 2 groups 59 Table 9: Activation Percentage of MVIC of Scapular Associated Muscular during Arm Elevation 60 Table 10: Activation Ratio during Arm Elevation 62 Figure Legends 63 Figure 1: Flowchart of the experiment 67 Figure 2: The illustration of measurement of subscapularis special tests 68 Figure 3: The illustration of measurement of bicipital tunnel special test 69 Figure 4: The illustration of measurement of coracohumeral ligament (CHL) 70 Figure 5: The illustration of measurement of coracohumeral distance (CHD) 71 Figure 6: The illustration of measurement of long head of biceps tendon (LHBT) stability 72 Figure 7: The illustration of measurements of demographic data by using USG 73 Figure 8: The illustration of sensors of FASTRAK placement 74 Figure 9: The illustration of electrodes of EMG placement 75 Figure 10: The illustration of measurement of MVIC 76 Figure 11: Correlation between CHL thickness and CHD on affected side of SIS 77 Figure 12: Correlation between CHL thickness and CHD on affected side of SSCL 78 Figure 13: Correlation between CHL thickness and CHD on non-affected side of SIS 79 Figure 14: Correlation between CHL thickness and CHD on non-affected side of SSCL 80 Figure 15: Correlation between CHL thickness and occupation ratio on affected side 81 Figure 16: Correlation between CHL thickness and tendon thickness of SIS 82 Figure 17: Correlation between CHL thickness and tendon thickness of SSCL 83 Figure 18: External Rotation/Internal Rotation of Scapular during Arm Elevation 84 Figure 19: Anterior Tip/Posterior Tip of Scapular during Arm Elevation 85 Figure 20: Upward Rotation/Downward Rotation of Scapular during Arm Elevation 86 Figure 21: Activation Percentage of MVIC of UT during Arm Elevation 87 Figure 22: Activation Percentage of MVIC of SA during Arm Elevation 88 Figure 23: Activation Percentage of MVIC of LHB during Arm Elevation 89 Figure 24: Activation Percentage of MVIC of LT during Arm Elevation 90 Appendix 91 Appendix 1: Permission of Institutional Review Board and Consent 91 | |
| dc.language.iso | en | |
| dc.subject | 肩夾擠症候群 | zh_TW |
| dc.subject | 肩胛下肌 | zh_TW |
| dc.subject | 喙肱距離 | zh_TW |
| dc.subject | 喙肱韌帶 | zh_TW |
| dc.subject | 喙突下夾擠 | zh_TW |
| dc.subject | Shoulder impingement syndrome | en |
| dc.subject | Coracohumeral distance | en |
| dc.subject | Subcoracoid impingement | en |
| dc.subject | Coracohumeral ligament | en |
| dc.subject | Subscapularis | en |
| dc.title | 肩胛下肌損傷於肩夾擠症候群患者之影響:超音波影像與肩胛骨運動學研究 | zh_TW |
| dc.title | The Influences of Subscapularis Lesion on Ultrasonography and Scapular Kinematics in Patients with Shoulder Impingement Syndrome | en |
| dc.date.schoolyear | 110-1 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 王亭貴(Hsin-Tsai Liu),林光華(Chih-Yang Tseng),楊靜蘭 | |
| dc.subject.keyword | 肩夾擠症候群,喙突下夾擠,喙肱韌帶,喙肱距離,肩胛下肌, | zh_TW |
| dc.subject.keyword | Shoulder impingement syndrome,Subcoracoid impingement,Coracohumeral ligament,Coracohumeral distance,Subscapularis, | en |
| dc.relation.page | 97 | |
| dc.identifier.doi | 10.6342/NTU202200004 | |
| dc.rights.note | 同意授權(限校園內公開) | |
| dc.date.accepted | 2022-01-06 | |
| 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 | |
文件中的檔案：
| 檔案 | 大小 | 格式 | |
|---|---|---|---|
| U0001-0401202210441400.pdf 授權僅限NTU校內IP使用（校園外請利用VPN校外連線服務） | 16.38 MB | Adobe PDF |
系統中的文件，除了特別指名其著作權條款之外，均受到著作權保護，並且保留所有的權利。