全身振動訓練對退化性膝關節炎患者健康狀況與靜態平衡能力的影響

The Effect of Whole Body Vibration Training on Health Status and Static Balance in Patient with Knee Osteoarthritis

張世昕(Chang,Shrhsin)

指導教授 ： 李淑芳

國立中正大學/教育學院/運動與休閒教育研究所/碩士(2012年)

摘要

退化性膝關節炎(Knee OA)是老年人口中常見的慢性疾病。疾病症狀導致患者較低意願從事身體活動，而使其症狀惡化。此外，Knee OA患者的平衡能力也較一般老年人衰弱，因此會有較高的跌倒風險。近年來針對慢性病患族群有效的全身振動訓練介入已十分廣泛，因其具便利性、有效性及安全性特徵，所以針對退化性膝關節病患設計全身振動訓練處方是必須的。本研究目的在探討八週全身振動訓練對退化性膝關節炎患者靜態平衡能力、WOMAC及日常生活能力的影響。本研究以40位行動能力正常，經醫師透過膝關節X光片診斷，符合Kellgren與Lawrence（1957）量表1至2等級的患者為受試對象。目前皆於中部某醫院從事規律復健活動，但平常無運動習慣。徵求同意後進行前測（WOMAC量表評分，BBS評估與CTSIB測試），之後再隨機分配成實驗組20人（56.80±3.16歲）及控制組20人（57.20±3.38）。實驗組使用漸增負荷原則( progressive loading principle )的方式，採用固定的頻率( 20Hz )、次數（6－9次）與振動時間隨訓練時間增加，進行每週2次，每次約10分鐘，持續進行八週的訓練內容，而控制組僅維持平常的日常生活。八週後在進行後測，內容與前測相同。兩組受試者在實驗期間皆建議不得參與其他運動訓練課程。本研究以描述性統計分析受試者基本資料及測驗所得數據及利用獨立樣本t檢定兩組受試者資料的同質性。利用獨立樣本t檢定測驗實驗組與控制組的前後測差異；利用前測為共變量，進行BBS、WOMAC及CTSIB後測分數的ANCOVA差異檢定。結果發現實驗組及控制組在BBS的動作表現上有顯著差異（p＜.05）；WOMAC部分，實驗組與控制組在疼痛感（p＜.05）、僵硬感（p＜.05）、身體活動（p＜.05）及總分（p＜.05）的部分皆有顯著差異；CTSIB感覺統合臨床測試部分，實驗組與控制組在基礎（p＜.05），取消本體感覺（p＜.05）及取消視覺與本體感覺（p＜.05）的搖晃指數有顯著差異。全身振動訓練是一項省時的訓練方式，能夠有效改善退化性膝關節炎患者因疾病造成的疼痛感、僵硬感，同時也能夠增進其靜態平衡能力，降低跌倒風險。

關鍵字：退化性膝關節炎、靜態平衡能力、跌倒風險、全身振動訓練。

關鍵字

退化性膝關節炎 ； 靜態平衡能力 ； 跌倒風險 ； 全身振動訓練

並列摘要

Knee osteoarthritis is a common chronic disease in older population. Researchers have shown that knee OA patients have lower motivation to engage in physical activities due to symptoms, which will worsen their physical condition. The balance ability of knee OA patients is less stable than healthy older adults, so they have high risk of falling. Recently, whole body vibration training (WBVT) is widely used and showed effectively in patients with chronic disease. WBVT is considered as a convenience, effective and safe tool; as a result, it has potentials as a training prescription for patients with knee OA. In this study, we determined the effects of 8 weeks WBVT on static balance performance, WOMAC and the performance of daily living in knee OA patients. Forty knee OA patients, whose severity were mild to moderate, but they have normal capacity. All participants were randomly assigned to whole body vibration group (WBV, n=20) or control group (CON, n=20). WBV group trained two times per week for 8 weeks. According to the progressive loading principle, the fixed frequency (20Hz) and number of training time (6-9 times) were increased per week. The CON group were not receive any training. All participants were suggesting not to do any exercise during 8 weeks. Descriptive analysis analyzed two groups of subjects’ baseline. Independent t test used to detect differences between patients with different variables to see the homogeneity. Finally, ANCOVA was used to examine the differences within and between experimental and control group, upon BBS score, the sway index of CTSIB and the differences in WOMAC score. It was found that performance in BBS scale decreased significantly (p＜.05) compared to the controlled group. In WOMAC, self-reported disease status was inprove in 4 parts: pain, stiffness, physical activity and total score. In clinical test of sensory interaction and balance, the sway index was improved including basic status（p＜.05）, non-proprioception（p＜.05）, non-visual and proprioception（p＜.05） compared to the controlled group. Whole-body vibration training is a time-saving method to improve the pain, stiffness and health status of knee osteoarthritis, also, it can enhance the static balance ability, reduce the falling risk.

Keywords：Knee osteoarthritis, Static balance, Fall risk, Whole body vibration

並列關鍵字

Knee osteoarthritis ； Static balance ； Fall risk ； Whole body vibration

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