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http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/82124完整後設資料紀錄
| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 呂東武(Tung-Wu Lu) | |
| dc.contributor.author | Wei-Chun Lee | en |
| dc.contributor.author | 李偉群 | zh_TW |
| dc.date.accessioned | 2022-11-25T05:36:21Z | - |
| dc.date.available | 2023-10-10 | |
| dc.date.copyright | 2021-10-21 | |
| dc.date.issued | 2021 | |
| dc.date.submitted | 2021-10-15 | |
| dc.identifier.citation | 1. Feeley, I.H., Green, C.J., Rowan, F.E., and Moore, D.P. (2014). International variance in the treatment of developmental dysplasia of the hip. Journal of Children's Orthopaedics 8(5), 381-386. 2. Barlow, T. (1962). 'Early diagnosis and treatment of congenital dislocation of the hip.' The Journal of Bone and Joint Surgery. British volume 44(2): 292-301. 3. Danielsson, L. (2000). Late-diagnosed DDH: A prospective 11-year follow-up of 71 consecutive patients (75 hips). Acta Orthopaedica Scandinavica 71(3), 232-242. 4. Terjesen, T., and Horn, J. (2020). Management of late-detected DDH in children under three years of age: 49 children with follow-up to skeletal maturity. Bone Joint Open 1(4), 55-63. 5. Roposch, A., Ridout, D., Protopapa, E., Nicolaou, N., and Gelfer, Y. (2013). Osteonecrosis Complicating Developmental Dysplasia of the Hip Compromises Subsequent Acetabular Remodeling. Clinical Orthopaedics and Related Research® 471(7), 2318-2326. 6. 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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/82124 | - |
| dc.description.abstract | 發展性髖關節脫臼，常藉由開刀的方式調整髖關節使其能夠有正確的受力方向。但經過手術復位的患者，缺血性壞死是影響兒童步態之關鍵併發症，過去文獻指出缺血性壞死之機率為 10%～ 75%，發生率高且為臨床醫師經常會遭遇到的問題，然而過去診斷與評估術後缺血壞死情形的方式以靜態X 光影像為主， 但這樣的評估方式容易使發展中的兒童過度曝露於輻射的狀態下，會對兒童骨骼發展造成不良的影響，且無法得知功能性動作中關節受力的情形以及有無發生術後發生缺血性壞死對日常行走生物力學及平衡控制的影響。 因此本研究的目的為探討幼兒時期之單側髖關節復位手術後之學齡兒童於行走時，雙下肢運動學、力動學、平衡控制及關節受力之情況以及與健康孩童之差異，以及探討臨床上 X 光呈現缺血性壞死與步態之運動學、力動學變數之間的關係，並追蹤術後長期變化，進而了解潛在造成動作差異的原因為何。預期透過本研究的結果，能夠歸納出兒童髖關節復位手術術後的行走動作特徵、動作策略以及代償的表現。最後預計能找出力動學及運動學中最能偵測出缺血性壞死的因子，未來於臨床上可作為缺血性壞死的預測因子，以提供給臨床醫師更多資訊及治療對策建議。 | zh_TW |
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| dc.description.tableofcontents | 口試委員會審定書……………………………………….……………………………….i Acknowledgements………………………………………………………………………ii 中文摘要…………………………………………………………………………………iii Abstract………………………………………………………………………………….iv Table of Contents……………………………………………………………………….vii List of Figure ……………………………………………………………………………x List of Table …………………………………………………………………………..xii Abbreviations………………….……………………………………………………….xvi Chapter 1. Introduction 1 1.1 Developmental Dislocation of Hip (DDH) 1 1.1.1 Overview 1 1.1.2 Gait Mechanics of DDH patients 2 1.1.3 Limitations of Previous Studies 2 1.2 Avascular necrosis (AVN) 3 1.2.1 Avascular necrosis after DDH surgery 3 1.2.2 Clinical outcome of avascular necrosis after treated DDH 4 1.3 Gait analysis 4 1.4 Balance Control and Dynamic Stability 7 1.5 Aims of this Dissertation 8 Chapter 2. Materials and Methods 10 2.1 Subjects 10 2.1.1 Healthy children subjects 10 2.1.2 DDH subjects 10 2.2 Experimental Setting and Data Collection 11 2.3 Determination of Center of Mass (COM) 15 2.4 Determination of Center of Pressue (COP) 19 Chapter 3. Kinematic and Kinetic Change During Gait in Children with Treated Unilateral DDH 20 3.1 Subjects 20 3.2 Data Analysis 21 3.3 Results 22 3.3.1 Spatial-temporal variables 22 3.3.2 Pelvic and joint kinematics 22 3.3.3 Joint Moments 29 3.4 Discussion 34 3.5 Conclusions 35 Chapter 4. Kinematic and Kinetic Change during Gait in Children with Treated Unilateral DDH with Avasular Necrosis 36 4.1 Subjects 36 4.2 Data Analysis 37 4.3 Results 37 4.3.1 Spatial-temporal variables 37 4.3.2 Pelvic and joint Kinematics 39 4.3.3 Joint Moments 48 4.4 Discussion 54 4.5 Conclusions 55 Chapter 5. Bilateral Asymmetry in Balance Control During Gait in Children with Treated Unilateral Developmental Dysplasia of the Hip 56 5.1 Subjects 57 5.2 Data Analysis 58 5.3 Results 59 5.3.1 Spatial-temporal variables 60 5.3.2 COM-COP Inclination Angle (IA) and Rate of Change in IA 62 5.4 Discussion 67 5.5 Conclusions 70 Chapter 6. Avascular Necrosis of the Hip Compromises Gait Balance Control in Juveniles with Treated Unilateral Developmental Dysplasia in Toddlerhood 71 6.1 Subjects 71 6.1.1 Healthy young subjects 71 6.1.2 Avascular necrosis subjects 72 6.2 Data Analysis 72 6.3 Results 74 6.3.1 Spatial-temporal variables 74 6.3.2 COM-COP Inclination Angle (IA) and Rate of Change in IA 76 6.4 Discussion 81 6.5 Conclusions 83 Chapter 7. Loading Rate of Ground Reaction Force vs. Hip Morphology 84 7.1 Subjects 84 7.1.1 Healthy subjects 84 7.1.2 DDH subjects 85 7.2 Data Analysis 85 7.3 Results 87 7.4 Discussion 96 7.5 Conclusions 101 Chapter 8. Conclusions and Suggestions 103 8.1 Conclusions 103 8.2 Suggestions and Further Studies 105 8.2.1 Clinical Applications 105 8.2.2 Future Studies 106 Bibliography 107 | |
| dc.language.iso | en | |
| dc.subject | 股骨頭缺血性壞死 | zh_TW |
| dc.subject | 步態與功能性動作分析 | zh_TW |
| dc.subject | 兒童發展性髖關節脫位 | zh_TW |
| dc.subject | 平衡控制 | zh_TW |
| dc.subject | 關節受力 | zh_TW |
| dc.subject | loading rates | en |
| dc.subject | developmental dislocation of the hip (DDH) | en |
| dc.subject | avascular necrosis (AVN) | en |
| dc.subject | three dimension motion analysis | en |
| dc.subject | balance control | en |
| dc.title | 兒童發展性髖關節脫臼復位術後步態、平衡控制及關節受力之研究 | zh_TW |
| dc.title | "A Study on Gait, Balance Control, and Joint Loading in Children after Surgical Reduction for Developmental Hip Dysplasia" | en |
| dc.date.schoolyear | 109-2 | |
| dc.description.degree | 博士 | |
| dc.contributor.author-orcid | 0000-0002-1929-6222 | |
| dc.contributor.oralexamcommittee | 陳祥和(Hsin-Tsai Liu),陳文斌(Chih-Yang Tseng),王廷明,釋高上 | |
| dc.subject.keyword | 兒童發展性髖關節脫位,股骨頭缺血性壞死,步態與功能性動作分析,平衡控制,關節受力, | zh_TW |
| dc.subject.keyword | developmental dislocation of the hip (DDH),avascular necrosis (AVN),three dimension motion analysis,balance control,loading rates, | en |
| dc.relation.page | 116 | |
| dc.identifier.doi | 10.6342/NTU202103702 | |
| dc.rights.note | 同意授權(限校園內公開) | |
| dc.date.accepted | 2021-10-18 | |
| dc.contributor.author-college | 工學院 | zh_TW |
| dc.contributor.author-dept | 醫學工程學研究所 | zh_TW |
| dc.date.embargo-lift | 2023-10-10 | - |
| 顯示於系所單位： | 醫學工程學研究所 | |
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