握力(Handgrip Strength,HGS)是指特定條件下單手緊握握力器產生的力量總和,其力量主要由前臂外侧肌群和手内在肌群的共同收缩活動而產生,一般以公斤為單位顯示。本研究的第一部分目的在於由機械式握力測定計,利用抓握動作測定到單一最大抓握力量。結果,得到在客觀條件下所測得之即時握力值,經評估以性別及慣用手分類下,其年齡、體重、身高的分佈值R^2 (0.21、0.39、0.17)及P值(P<0.001)皆達到一致的顯著水準,在相關性分析中,相關係數(-0.459、0.421、0.631)跟P值皆呈現高度複相關且達到顯著水準。這也表示,不管是年齡、身高、體重皆與握力產生影響,且有不錯的預測價值。這種趨勢與國外文獻所報告之文獻並無顯著不同,這些都是建構常模的重點之一。第二部分,針對特定族群”食道癌患者”,以手握力是作為一個指標,以評估病人術後的生理狀態。其結果,在受試者ROC曲線分析中,可發現其發病率至少為25公斤還有22公斤的死亡率。因此,可將定義握力25公斤為一基準,若握力超過25公斤,死亡率有72.41﹪與84.37﹪的併發症機率;握力低於22公斤,死亡率則有75﹪和79.25﹪併發症。在食道癌研究中,握力分析有不錯預測的結果,也有必要將握力測定,做為即將接受食道癌治療與重建患者臨床評價工具。此研究的第三部份在將握力測定作為適合的臨床工具下,以鑒於方便資料蒐集,建構一套可攜帶的數位式電子儀器,其施測與計分方式均由電腦程式執行,可提供客觀的測驗資料。由本實驗所得到的結果,可支持臨床治療對於手握力大小扮演相對重要的角色。並利用此結果提供醫療人員在臨床照護及治療之基礎,且幫助術後患者免於惡化的可能性。
This research aims to develop thenorm of adult hand-grip strength in Taiwan. Its role of clinical applications were investigated in the study. Hand-grip strength (HGS) is the maximal force that generated by holding the grip dynamometer with greatest effort in the hand under standard position. The force is generated by thecombination of both forearm and hand muscles. The results are read in either kg or pounds. HGS reflects the strength of forearm and hand muscle. We evaluated the grip strength difference in patients grouped according to each clinical variables, incling gender, handedness, the distribution values R2(0.21、0.39、0.17) of age, weight, and height and assessed if it reachedstastistical significant level. In the second part, the HGS was viewed as an indicator to eveluate the physiological state of patients with esophageal cancer after surgery. The results of ROC curve analysis showed that the complication rate will increaed if the HGS less than 25 kg. The mortality rate will increased of the HGS less than 22kg. Therefore, 25 kg of HGS was defined as a cut-of-value. The mortality is 72.41% and the complication rate is 84.37% if the HGS is less than 25kg. The mortality is 75% and the complication rate is 79.25% if the HGS is less than 22kg.In the third part of this research, HGS determination was treated as a clinical tool for the appropriate. The portable digital electronic devices was constructed and applied to HGS measurement. The measurement and scoring method were implemented by computer program and the data were recorded objectively.The results of experiments showed that the HGS plays an important role in .clinical evaluation. The results provide a basis of clinical care and treatment for medical staff. Additionally, it may has role in preoperative evaluation and may relate to postoperative complication and mortality rate.