透過您的圖書館登入
IP:174.129.190.10
  • 學位論文

腿前式踝足矯具在中風患者平衡及移動能力之效果

Effects of the anterior ankle-foot orthosis on balance and mobility in stroke patients.

指導教授 : 陳瓊玲

摘要


研究目的:本研究旨在探討中風患者穿戴腿前式踝足矯具(AAFO)對靜態平衡、動態平衡及移動能力的效果。 研究方法:24位中風患者參與研究,使用SMART平衡儀之感覺組織測驗評量靜態平衡能力,穩定限制測驗及規律重心轉移測驗評量動態平衡能力,計時起走及計時上下樓梯測量移動能力。使用配對t檢定比較穿戴與不穿戴AAFO在上述測驗項目差異情形。 研究結果:穿戴AAFO以感覺組織測驗評量之站立穩定度及站立對稱性無顯著差異。穩定限制測驗中,穿戴AAFO重心轉移至患側前方(p=.000)及患側(p=.002)之最大移動範圍顯著增加,往患側(p=.003)及患側後方(p=.000)重心轉移後之最大患側承重比率顯著增加。規律重心轉移測驗中,穿戴AAFO於左右快速重心轉移跟上理想速度差距顯著降低(p=.01)。左右慢速(p=.002)、快速(p=.001)及前後慢速(p=.000)、快速(p=.000)重心轉移穩定性顯著改善。穿戴AAFO顯著改善計時上下樓梯之速度(p=.000)。 結論與建議:本研究發現中風患者穿戴腿前式踝足矯具能夠改善患側方向穩定限制範圍與承重、左右來回具節奏性重心轉移之跟上速度、前後與左右來回重心轉移之穩定性及上下樓梯之移動能力。參與者亦普遍表示穿戴AAFO能增加安全性。因此,建議中風患者可穿戴AAFO來執行重心轉移及上下樓梯之活動以增進其功能表現、穩定性及安全性。

並列摘要


Objective:The objective of this study was to examine the effects of the anterior ankle-foot orthosis(AAFO) on static and dynamic balance, and mobility in stroke patients. Methods:Twenty-four stroke subjects completed the study. Subjects were measured with and without an AAFO, the sequence of which was randomized. The static and dynamic balance abilities were measured by the Sensory Organization Test (SOT), Limit of Stability (LOS) and Rhythmic Weight Shift (RWS) of the SMART Balance Master. Mobility was measured using the Timed Up and Go test and the Timed up and down stairs test. Paired t test was used to determine the difference of balance and mobility performances measured with and without the AAFO. Results: The results showed that the stance stability and symmetry in the Sensory Organization Test did not improve when the subjects wearing an AAFO. There were significant improvements in (1) the maximal distance during LOS weight-shifting toward the affected-forward(p=.000) and the affected side(p=.002), (2) the maximal affected weight-bearing percentage after LOS toward the affected side(p=.003) and the affected-backward side(p=.000), (3) the gap to keep up with the ideal speed for the fast speed of lateral weight-shifting(p=.01), (4) stability for the slow (p=.002, p=.000)and fast (p=.001, p=.000) speed of lateral and forward-backward weight-shifting respectively, and (5) the Timed up and down stairs tests(p=.000). Conclusion and Suggestion:This study found that the stroke subjects wearing an AAFO could improve the distance of the limit of stability toward the affected side and the weight bearing of the affected side, the keep up with the ideal speed of lateral rhythmic weight-shifting, the stability of lateral and forward-backward rhythmic weight-shifting, and go up and down stairs. Furthermore, the subjects reported that the confidence in safety was increased by using the AAFO. Therefore, we suggest that when performing the weight shifting activities and go up and down stairs, the stroke patients can wear the AAFO to improve the functional performance and safety.

參考文獻


張玄松、陳貞夙、龍希文、楊樑怡、鄧復旦、倪壽民(2007)。踝足裝具對於中風患者站立平衡能力與行走表現的影響:比較前置型與後置型踝足裝具的效益。 台灣職能治療研究與實務,3(2),94-109。
陳瓊玲、楊國德、吳鑫漢與江炳焱 (民87)。前葉式踝足矯具對偏癱步態之效應。中華復健醫誌,26(3),119-127.
Chou, S. W., Wang, A. M., Leong, C. P., Hong, W. S., Tang, F. T., and Lin, T. H. (2003). Postural control during sit-to stand and gait in stroke patients. American Journal of Physical Medicine and Rehabilitation, 85(7), 1095-1101.
王斐誼、鄭方瑜、連怡婷、王瑞瑤、楊雅如 (2011)。踝足裝具對於中風患者步態和功能性活動的效果:系統性回顧與統合分析。中華民國物理治療協會雜誌,36(4),274-284。
Abe, H., Michimata, A., Sugawara, K., Sugaya, N., and Izumi, S. I. (2009). Improving gait stability in stroke hemiplegic patients with a plastic ankle-foot orthosis. Tohoku Journal of Experimenral Medicine, 218, 193-199.

延伸閱讀