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題 名 | 跟腱斷裂患者在縫合手術後之步態分析個案研究=A Case Study of Gait After Achilles Tendon Rupture Repair |
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作 者 | 劉于詮; | 書刊名 | 國立體育學院論叢 |
卷 期 | 12:1 2001.10[民90.10] |
頁 次 | 頁299-316 |
分類號 | 416.26 |
關鍵詞 | 跟腱斷裂; 縫合手術; 步態分析; Achilles tendon rupture; Repair; Gait analysis; |
語 文 | 中文(Chinese) |
中文摘要 | 跟腱連接著小腿肌肉與足部,跟腱斷裂時足部便無法產生推蹬動作讓人體行走,而這也意味著人體將喪失最基本之運動能力。臨床治療上以手術接合最常被採用(Leppilahti, Siira, Vanharanta, & Orava, 1996),但是手術後的固定會使患處關節活動度降低及行走不便(Neumann, Vogt, Banzer, Schreiber, 1997)。基於如此,本研究以一接受跟腱縫合手術的大專男性學生為受試者,使用Panasonic AG-456攝影機、Peak Performance動作分析系統與Pedar足底壓力測量系統在其手術後一星期能行走時、手術後一個半月與三個月時進行步態分析,以探討手術對人體行走所造成之影響。實驗結果發現:1.從受試者下半身各肢段移動軌跡發現,第一與第二次實驗受試者會以類似跺步的方式來完成足部平伸,足部推蹬也較不明顯,到第三次實驗才與正常人相似。2.時間-距離參數方面,步頻、擺動期之時間、跨步長╱腿長和步速遞增,步行週期和支撐期之時間遞減,足部平伸的時間遞增,支撐中期的時間遞減,足部推蹬的時間遞增。3.膝與踝關節運動參數方面,支撐期與擺動期之關節角度變化,都以第三次實驗最大,第二次次之,第一次最少。4.對地作用力參數方面,第一次實驗足底壓力中心線呈三角形,到第三次實驗才和正常人一樣呈兩個對稱之三角形。撞擊力與推蹬力峰值,均以第三次實驗最大,第二次次之,第一次最小。由結果可知,患者在手術後初期會因小腿不敢出力與不敢讓跟腱被動伸展導致各項步態參數會和正常人之數值有所差異,必須經過一段時間之恢復(本研究為三個月)後才會減低此種情形。 |
英文摘要 | Achilles tendon is the structure to connect foot and calf muscle. If it suffers from rupture, human body will lose the basic ability of walking because the motion- push off can't been done. In all treating methods, surgical therapy is mostly used (Leppialhti, Siira, Vanharanta, & Orava, 1996). But long periods immobilization after surgery will result in the decreasing of ankle's range of motion and trouble human's gait. So in this study, one male colleger suffering from Achilles tendon rupture and treating by operation served as subject. Photo camera (Panasonic AG-456), motion analysis system (Peak Performance), foot measuring system (Novel-Win Pedar) were used to analyze subject's gait when it was operated for 1 week (can walking without crutch), 6 weeks and 12 weeks. Results as following: 1.B observing these moving trajectories of lower-limb, we found the subject did the motion- foot flat by drubbing and the motion- push off wasn't so obviously like normal people did in experiment I and experiment II. 2.In temporal distance parameter, cadence, the time of swing phase, stride length/ lower extremity length and walking speed decreased. The time of foot flat increased, the time of mid-swing decreased and the time of push off increased. 3.In knee and ankle joint angular motion parameter, they were maximum in experiment III and minimum in experiment I. 4.In ground action force parameter, the trajectory of COP (center of foot pressure) was forming triangular in experiment I. Until experiment III, it was like the shape of normal people's trajectory- a butterfly. Impact force peak and active force peak were maximum in experiment III and were minimum in experiment I. According to the results we could understand: In the beginning, subject was operated just now so it would prevent to contract it's calf muscle and prevent it's Achilles tendon to been stretch. So it's parameters of gait were different from normal people. After a period time of recovery (12 weeks in this study), the situation was gradually disappear. |
本系統中英文摘要資訊取自各篇刊載內容。