小兒麻痺患者骨盆傾斜與脊椎側彎之關聯性

Relationship of Pelvic Obliquity and Scollosis in Post-Poliomyelitis Patients

周文傳(Wen-Po Chow)

《中華民國物理治療學會雜誌》 13卷 (1988/09) Pp. 14-20

https://doi.org/10.29616/JPTAROC.198809.0003

摘要

自民國七十一年八月至七十二年十二月私立振興復健醫學中心小兒麻痺症患者有骨盆傾斜者203人，弱側下肢骨盆上傾者103人，骨盆下斜者100人，經分析發現骨盆上傾者驅幹肌肉衰弱(70% fair、30% trace/poor、0% good)與脊椎側彎(77%)的比例甚高，而且兩者在程度上互有關聯性，與上傾角度也有正相關，強側下肢肌力也頗衰弱，95%坐姿重心落在強側臀部。骨盆下斜者軀幹肌力較為強壯，只有6%有輕微的脊椎側彎，強側下肢肌力強壯者多，82%坐姿重心落在弱側下肢的臀部，因而判斷骨盆上傾者主因脊髓灰白質炎波及軀幹肌肉，而骨盆下斜者主因下肢麻痺所帶來的繼發性畸型。

並列摘要

From August 1982 through December 1983, 203 patients of post-poliomyelitis with pelvic obliquity in Cheng Hsin Rehabilitation Center were studied. Patients could be classified into two groups based on the muscle power of the lower extremites: the pelvis on weak-side tilted up (n=103) and that tilted down (n=100). It was observed that the trunk muscles were much weaker for the tilted-up group (70% fair, 30% trace/poor, 0% good), scoliosis was very common (77%), muscle power and severity of scoliosis correlated with each other and generally agreed with pelvic obliquity angle, the muscle power of the stronger leg was quite weak, 95% of the patients shifted the center of gravity toward the stronger buttock when they were sitting. On the other hand, the trunk muscle power of the tilted-down group was stronger, only 6% had scoliosis and most of them were mild with a smaller obliquity angle. The muscle power of the stronger leg was stronger than the tilted-up group; when sitting, 82% of the patients shifted the center of gravity toward the weaker buttock. These findings suggested that the principle mechanism of pelvic tilting upward on the weak-side was due to trunk muscle paralysis. While the downward tilting of the pelvis was secondary to the paralysis of the ipsilateral leg.

並列關鍵字

Poliomyelitis ； Scoliosis