- 學位論文
輕微結構性長短腿症狀的生物力學：輕微結構性長短腿甚至可能造成人體肌肉骨骼結構功能失常嗎？
Mild Anatomical Leg Length Discrepancy and Musculoskeletal Pathomechanics: Could even the mild anatomical leg length discrepancy cause the structural and functional disorder of the human musculoskeletal system?
摘要
目的：探討輕微結構性長短腿的症狀力學，包含骨盆扭轉與梨狀肌失能等因素。 設計：前瞻性研究，採用配對T檢定統計分析 實驗場域：台灣大學身心障礙者輔具工程研究中心，復健工程與步態實驗室 受測者：年輕的輕微長短腿患者，排除各種肌肉骨骼疾病主要量測參數：長短腿、相對的腳掌偏移量△Ef、骨盆扭轉角度Pt、髖關節的內收 (hip adduction) 活動角度以及內轉(internal rotation)活動角度ROMadd與ROMinf，外側的地面反作用衝力If、作用在髖關節上的內旋鉛直力矩衝量Im 結果：所有的參數在長腿側與短腿側的表現都有顯著的不同。Pt在短腿側皆為負值，但在長腿側皆為正值，ROMadd和ROMinf在短腿側的數值顯著小於長腿側。 If和Im在短腿側的數值顯著大於長腿側。所有的參數除了△If均與LLD有顯著的相關性。 結論：即使是輕微長短腿也會導致骨盆扭轉，這可能導致短腿側的梨狀肌緊蹦與限制髖關節的被動關節活動度，此外在步態上，也會影響外側的地面反作用力和垂直力矩。 關鍵詞：長短腿、骨盆扭轉、骶髂關節障礙、梨狀肌、步態分析
並列摘要
Objective: The aim of this research is to study the musculoskeletal pathomechanics of anatomical leg length discrepancy (LLD) in relation to pelvic torsion and piriformis muscle malfunction. Design: Prospective experiment, paired t-test. Setting: Rehabilitation Engineering Research Center at National Taiwan University with instrumented gait laboratory. Participants: Young mild LLD subjects without musculoskeletal disease Main outcome measures: Leg length Discrepancy, relative foot sole excursion △If, Pelvic inclinometer output Pt, ROM of hip adduction and internal rotation ROMadd and ROMinf, lateral direction ground reaction force If, internally rotation vertical moment acting on the hip Im Results: All the parameters showed significant difference between the longer limb and the shorter limb. Pt were negative for the shorter leg but positive for the counterlimb, ROMadd and ROMinf of the shorter limb were smaller than of the longer limb. If and Im of the shorter limb were larger than of the longer limb. All the parameter was correlated to the LLD except △If. Conclusion: Even mild LLD could lead pelvic torsion, which might cause the piriformis muscle tightness and limit the static ROM of hip of the shorter limb; in addition, affect the gait with lateral direction ground reaction force and vertical moment. Keywords: LLD, pelvic torsion, sacroiliac joint dysfunction, piriformis muscle, gait analysis.