- 學位論文
冷凍肩之肩胛胸廓與盂肱關節活動評量
ASSESSMENT of SCAPULOTHORACIC and GLENOHUMERAL MOTION in FROZEN SHOULDER
摘要
我們利用3D電磁場軌跡追蹤儀來描述和測量此一特殊的運動模式並比較之，以了解冷凍肩患者患側手與健側手之間的差異。國外文獻中雖有不少肩關節相關的活動測量，僅少數對冷凍肩個案患側與健側進行比對，此實驗的目的是為了要觀察冷凍肩的病人在不同受限角度下患側和健側之肩關節活動形態的差異程度與其對應的變化情形。 本實驗共收受十四位志願者，我們的收案標準包含：經骨科醫師門診檢查為肩關節活動受限並診斷為冷凍肩者為納入條件，而排除條件為曾經因外傷或手術等外在因素而非原發性冷凍肩所導致的肩關節受限者將排除在外。利用3D電磁場軌跡追蹤儀與即時動作分析(Motion monitor)來測量肩關節在肩胛平面與前舉平面下，肩胛骨與肱骨之間的相對活動。 實驗結果顯示，在冷凍肩的個案中我們觀察到，比較健患側的差異上可發現，肩胛平面上舉時患側肩胛骨的活動相對的提早，移動的幅度也較健側為大。而在前舉的活動中則無明顯不同。觀察肩胛肱骨節律也可發現不論在肩胛平面或是前舉平面上舉時，在30°~60°開始健側節律的平均值均大於患側的平均值。比較健側與患側肩在上舉時肱骨外轉的變化量，在前舉至30°~60°開始肩患側才有顯著的差異出現。當比較患側肱骨外展0°、45°與90°時肱骨外轉與內轉的比值，發現0°、45°的值較小，90°的值相對較大，意味著這各個角度下功能受限的程度不同。希望藉著這個研究，能提供臨床復健上評估與治療的參考。
並列摘要
There have been a number of studies on the measurement of shoulder movements. Few studies, however, focus on frozen shoulder movements. The aim of this study is to observe the shoulder joint movements of frozen-shoulder patients under different restricted angles and to compare the differences between affected shoulder joints and unaffected shoulder joints of frozen-shoulder patients. There are fourteen participants in this study. The participants include the patients who have limited unilateral shoulder range of motion (ROM) and are diagnosed for frozen shoulder by doctors, and exclude those with limited shoulder ROM due to accidents, surgery or secondary frozen shoulder. We measure the shoulder joint motion in scapula plane and forward flexion plane by the 3D tracking device and motion monitor. The study shows that when the arm is elevated in scapula plane, the scapula upward happens earlier and is larger in affected side than in unaffected side. The average rhythm of unaffected side is higher than affected side from 30° ~ 60° in both planes. We compared the ratio of external rotation to internal rotation in 0°, 45° and 90° in the affected side in abduction plane. The ratio in 0° and 45° is smaller than in 90°. It means that the limits of functional abilities are different in different angles. We hope this study can provide a reference for clinical assessment and treatment in rehabilitation.