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物理治療/Formosan Journal of Physical Therapy

社團法人臺灣物理治療學會 & Ainosco Press,正常發行

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背景與目的:動作功能是評估脊髓性肌肉萎縮症(spinal muscular atrophy, SMA)病程進展與治療成效的重要指標。費城兒童醫院嬰兒神經肌肉疾病測試(Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders, CHOP INTEND)是專門為第一型或無獨坐能力的SMA個案所設計的動作功能評估工具。本研究是要探討臺灣物理治療師在經過線上培訓課程後的CHOP INTEND評估信度。方法:共12位曾接受過CHOP INTEND實體課程訓練的物理治療師參加線上培訓課程,並在課程前後透過線上影片進行CHOP INTEND評分。資料分析使用組內相關係數分析治療師在培訓前後的測試者間信度,並使用斯皮爾曼等級相關係數評量治療師與黃金標準的評估一致性。結果:在培訓前後,治療師均有很高的CHOP INTEND測試者間信度,培訓前組內相關係數(intra-class correlation coefficient, ICC)(1,1)= 0.992,培訓後ICC(1,1)= 0.993-0.999(所有p<0.01)。在培訓前,僅有42%的治療師與黃金標準的評分達到高度相關(r>0.8);但在培訓後,則有77%治療師評分與黃金標準達到高至非常高度相關。結論:對於已經熟悉CHOP INTEND的物理治療師,線上培訓課程有助於維持良好的測試者間信度,並且與資深評估者達到高度的一致性。本研究結果可以提供未來舉辦評估工具培訓課程以及擬定SMA追蹤計畫的參考。

  • Journals

Background and Purpose: Kettlebell training has been reported to increase muscle strength and balance, which are critical for fall prevention. Fall is a serious issue for elders worldwide. It takes time to build strength and balance. However, it is still unknown whether kettlebell is as effective for older adults as for younger adults. Methods: participants (mean age: 61 ± 6 years) were divided into an experimental group and a control group based on their interest in exercise. Both groups received eight weeks of group exercise program led by a physical therapist. The experimental group (n = 18) received a kettlebell training program with three modified moves and progressive intensity. The control group (n = 8) received a whole-body stretch exercise program. Hip and knee extensor strength, Timed Up and Go test (TUG), power, standing balance, and distance for six-minute walk test (6MWD) were measured. The Chinese Nordic Musculoskeletal Questionnaire was compared for body pain. Our study type is quasi-experiments and double-blind control was applied so that the research goal was unknown to both participants and outcome measurer. Mann-Whitney and Wilcoxon signed-rank were used to compare the differences between groups and within groups, respectively. Results: There were no baseline differences between groups. Hip and knee extensor strength, TUG, standing balance, and 6MWD significantly improved in the experiment group. Body fat% significantly lowered in the experimental group. There were no training differences in the control group. The Score for Chinese Nordic Musculoskeletal Questionnaire improved only in the experiment group. Conclusions: Our results showed Kettlebell training improved fall risk predicting parameters, including TUG and lower extremity strength. It was suggested that kettlebell training may prevent falls, and further research is needed to clarify. Kettlebell training with a scientific training program is safe for older adults and body composition improves with training. We conclude that kettlebell training is considered a safe and effective exercise for improving muscle performance, balance, and aerobic fitness.

  • Journals

背景與目的:過短的胸小肌與肩胛骨失能有關,也是造成肩痛的危險因子之一。臨床上常使用伸展來增加胸小肌的長度。過去的統合分析曾指出短期的神經肌肉誘發技術可以增加胸小肌的長度,然而,未有統合分析探討伸展對於肩胛骨運動學的效果為何。因此,本研究主要欲探討胸小肌伸展運動對於舉手過程的肩胛骨運動學和胸小肌長度的效果。方法:使用胸小肌、伸展運動、肩胛骨運動學和肌肉長度作為關鍵字於PubMed、Ovid MEDLINE、CINAHL、Cochrane Library等醫學資料庫搜尋文獻至2022年一月。主要測量參數為舉手時的肩胛骨運動學,次要結果為胸小肌長度與胸小肌指數。各篇的研究結果會依據牽拉前後的平均值與標準差進行統合分析。結果:共有七篇研究中的健康受測者資料納入統合分析,伸展運動並沒有顯著改變舉手活動時肩胛骨向上旋轉、外轉與後傾的角度。胸小肌指數與胸小肌長度在介入後皆有顯著增加。結論:伸展運動能使胸小肌的肌肉長度增加,但是無肩痛者接受胸小肌伸展後肩胛骨運動學並沒有顯著改變。

  • Journals

背景與目的:青少年肥胖率升高已是嚴重健康問題,本研究評估以多專業生活模式調整介入應用於肥胖青少年之療效。方法:一名肥胖青少年,罹患自發性顱內高壓後轉介接受減重療程,療程為期20週、共8次介入。由醫師判斷醫療資訊,臨床心理師以認知行為治療強化動機,營養師教導正確飲食習慣,物理治療師引導增加基本活動量與建立運動習慣,與護理師整合各專業資訊。結果:個案體重、身體質量指數與體脂肪均隨療程下降,骨骼肌肉量增加,血脂值下降至正常範圍。飲食行為改善,日攝取熱量於第四週降至1,350卡,年假期間日攝取熱量仍保持於減重建議值。個案於介入第二週平均日步數已達8,330步,年假期間下降至3,637步,提醒後回復至9,000步以上,因持續進行運動,一分鐘仰臥起坐與立定跳遠表現提升。停止療程後,個案體重仍持續下降。結論:本研究為多專業團隊合作協助肥胖青少年重建生活模式,鞏固正確飲食與運動習慣,供臨床醫療人員參考。