脊髓肌肉萎縮症患者的肌力、動作功能與健康相關生活品質的相關性

The relationships among muscle strength,motor function and health-related quality of life in individuals with spinal muscular atrophy

謝佩恩(Pei-En Hsieh)

指導教授 ： 王慧儀

高雄醫學大學/健康科學院/物理治療學系碩士班/碩士(2017年)

摘要

背景與目的：本研究目的為了解脊髓肌肉萎縮症（SMA）患者的健康相關生活品質（HRQOL）情況，並探討其與肌肉力量和動作功能的相關性。方法：本研究採用橫斷性研究設計。收案條件為臨床診斷為SMA第二型或第三型患者且年齡為18歲以上。評估方式及測量工具包括徒手肌力測試法（MMT）、MicroFET4測力器、修正式漢默史密斯功能性動作量表（MHMSE- extend），及台灣版36項短版健康問卷（SF-36），包含生理健康向度和心理健康向度兩大部分。結果：分析結果顯示整體肌力得分與動作功能得分間有顯著高度相關（r = 0.91; p <0.001）。HRQOL中的生理健康向度之得分，分別與以下的測量參數有顯著正相關，包括：上肢伸肌群之肌力得分（r=0.46, p=0.01）、在生活中使用之移行輔具或能獨自行走（r=0.39, p=0.03）、整體肌力得分（r=0.36, p=0.04），及動作功能得分(r=0.37, p=0.04）；而在HRQOL中的心理健康向度得分方面，則與以下兩參數有顯著的負相關，包括與上肢伸肌群之肌力得分（r=-0.44, p=0.01)，及整體肌力得分（r=-0.34, p=0.05）。此外，從迴歸統計分析結果顯示「上肢伸肌群之肌力」解釋了生理健康向度及心理健康向度中的變異。結論：本研究顯示SMA患者之肌力與其動作功能之間有高度相關，但患者的肌力喪失程度及身體動作功能之限制似乎不會全然地影響其健康相關生活品質，尤其對心理健康層面上。

關鍵字

脊髓肌肉萎縮症 ； 肌肉力量 ； 動作功能 ； 健康相關生活品質

並列摘要

Objective: To determine the level of health-related quality of life (HRQOL)in individuals with spinal muscular atrophy (SMA), and to examine its relation to muscle strength and motor function. Methods: This is a cross-sectional study. The recruited adult subjects that were 18 years or older were diagnosed as SMA type 2 and 3. The measurements included muscle strength assessment using the method of Manual Muscle Test (MMT) and a hand dynamometer MicroFET4, the Modified Hammersmith Functional Motor Scale- extend (MHMSE-extend), and the 36-Item Short Form Health Survey (SF-36) [consist of physical component score (PCS) and mental component score (MCS)]. Results: Total muscle strength was significantly positively correlated to motor function (r = 0.91; p < 0.001). PCS was positively correlated to the variables, including extensors muscle strength of upper extremity (r=0.46, p=0.01), mobility devices used in daily living (r=0.39, p=0.03), total muscle strength (r=0.36, p=0.04) and motor function(r=0.37, p=0.04). MCS were negatively correlated to extensors muscle strength of upper extremity(r=-0.44, p=0.01) and total muscle strength (r=-0.34, p=0.05). About regression analysis, upper extremity extensors muscle strength explained of the variance in PCS and MCS. Conclusions: Muscle strength of the subjects with SMA type 2 and 3 was strongly correlated to their motor function. Nevertheless, the level of HRQOL seems not related to their motor functional status, especially the mental component of HRQOL.

並列關鍵字

Spinal Muscular Atrophy ； Muscle Strength ； Motor Function ； Health-Related Quality Of Life

參考文獻

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