停經後婦女骨質流失與動作障礙症候群之關聯

Relationships among osteopenia, osteoporosis and locomotive syndrome in menoposal women.

葉佳佳(Chia-Chia Yeh)

指導教授 ： 郭藍遠

高雄醫學大學/醫學院/運動醫學系碩士在職專班/碩士(2018年)

摘要

JOA (Japanese Orthopaedic Association) 於2007年提出 Locomotive Syndrome( LS)動作障礙症候群這個概念及Loco-check動作障礙自我檢測表，LS被定義為：由於動作器官病變而導致行動不便的年長者可能需要護理照顧介入的情況。骨質疏鬆症為導致LS的肌肉骨骼疾病之一，由於骨質疏鬆沒有特殊的臨床表徵常直到發生骨折才被注意到，而骨折大多是因為跌倒所致，但骨質流失的情形與跌倒風險的高低之間的關係目前的參考資料並不多，因此，本研究旨在探討骨質密度與Loco-check及動作表現（下肢肌耐力及動靜態平衡）的相關性。
經由門診募集50位50 歲以上女性，DXA檢測骨質密度T值小於-1的骨質流失患者作為受試者，請她們自評Loco-check及進行3種功能性動作測試(FTSTS, TUG, OLST)。實驗結果以SPSS統計軟體進行Shapiro-Wilk及Spearman’s rank correlation coefficient分析。
研究結果發現T score與動作表現中的FTSTS及TUG呈正相關，而Loco-check與所有的動作表現測試皆呈顯著相關，但T score與Loco-check則無呈現相關性。建議未來若患者診斷出骨質疏鬆情形可透過自填loco-check以早期警覺可能出現之失能及跌倒風險，發揮早期篩檢介入早期衛教避免跌倒，以期達到預防勝於治療之臨床目的。

關鍵字

骨質疏鬆 ； 動作障礙症候群 ； 動作表現 ； 跌倒

並列摘要

JOA(Japanese Orthopaedic Association) has proposed the concept of a “Locomotive Syndrome (LS)” and “Loco-check” , a self-check list for locomotive syndrome. LS is defined as the condition of the elders with reduced mobility due to impairment of locomotive organs who are highly likely to required nursing care. Osteoporosis is one of the musculoskeletal disorders which could lead to LS. Until fracture happens, the osteoporosis was rarely noticed because of lack of particular clinical sign. The reason of fractures is often resulted from falling. There is few study about the relationship of bone loss and the risk of falling. Thus, this study aims to investigate the association of the level of bone loss (T score), loco-check and physical performance (muscle endurance of lower extremity and static/dynamic balance).
50 female patients, aged over 50 years old, are screened from the clinic. Their bone mineral density was measured by DXA and T score is less than -1. All the subjects self-completed the Loco-check, then went through 3 tests of physical performance (FTSTS, TUG, OLST). The experimental results were analyzed by SPSS statistical software, by using Shapiral-Wilk test and Spearman’s rank correlation coefficient analysis.
The findings as followed: T score and two of physical performance (FTSTS, TUG) has a positive correlation. Loco-check and all the physical performance tests has a significant correlation. But T score and Loco-check has no correlation in this study. In the future, Loco-check might be used to screening for fall risk and physical dysfunction of the patients who were diagnosed with bone loss in early stage. For preventing fracture from falling, Loco-check would be an ideal tool for people themselves to evaluate their potential risks and make them aware of their physical condition easily . Prevention is better than cure.

並列關鍵字

osteoporosis ； locomotive syndrome ； physical performance ； falling

參考文獻

參考文獻

1. Nakamura, K. (2008). A “super-aged” society and the “locomotive syndrome”. Journal of Orthopaedic Science, 13(1), 1.

doi: 10.1007/s00776-007-1202-6

2. Nakamura, K. (2009). Locomotive syndrome: disability-free life expectancy and locomotive organ health in a “super-aged” society. Journal of Orthopaedic Science, 14(1), 1.

doi: 10.1007/s00776-008-1302-y