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題 名 | Effect on Spasticity after Performance of Dynamic-repeated-passive Ankle Joint Motion Exercise in Chronic Stroke Patients=連續動態性被動式踝關節運動對慢性中風病人痙攣之影響 |
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作 者 | 吳瑾俐; 黃茂雄; 李佳玲; 劉晉瑋; 林麗蓉; 陳嘉炘; | 書刊名 | The Kaohsiung Journal of Medical Sciences |
卷 期 | 22:12 民95.12 |
頁 次 | 頁610-617 |
分類號 | 418.996 |
關鍵詞 | 踝關節痙攣; 慢性中風; 連續性被動關節運動; 動態性牽拉; Ankle spasticity; Chronic stroke; Continuous passive motion; Dynamic stretch; |
語 文 | 英文(English) |
中文摘要 | 痙攣與異常的肌肉張力為中風後常見的運動障礙,且踝關節痙攣可能影響行走的功能。本研究的目的是為了檢視動態性被動踝關節運動,對於慢性中風患者下肢肌肉痙攣與行走功能的立即效應。共有十二位具有下肢痙攣及異常步態的慢性中風患者參與本研究,我們利用一台定速的直立式電動機器,讓中風病人於站立姿勢下作十五分鐘的踝關節動態性被動牽拉運動。評估的項目包括:踝關節的痙攣等級 (MAS;0-4 級)、深腱反射 (DTR;0-4 級)、肌陣攣程度 (0-5級) 等對肌張力的評估,以及計時性起立-行走時間測驗 (TUG)、十公尺行走時間測試和步頻等行走功能的測量。此外,病人對張力變化的主觀感受則用視覺類比量表 (visual analog scale,VAS) 和滿意度問卷來評估。比較治療前後的測試結果,我們發現病人於踝關節的痙攣等級、視覺類比量表值、計時性起立-行走時間測驗、十公尺行走時間測試等,均有非常顯著的進步 (p < 0.01),同時步頻也有顯著的增加 (p < 0.05),且多數病人對此治療的效果表示滿意。因此,我們的結論為:利用此直立式的等速機器,讓慢性中風的病人站立接受十五分鐘的動態性被動式踝關節運動,可以有效地降低其下肢的痙攣,並促進其行走的功能。 |
英文摘要 | Spasticity associated with abnormal muscle tone is a common motor disorder following stroke, and the spastic ankle may affect ambulatory function. The purpose of this study was to investigate the short-term effect of dynamic-repeated-passive ankle movements with weight loading on ambulatory function and spastic hypertonia of chronic stroke patients. In this study, 12 chronic stroke patients with ankle spasticity and inefficient ambulatory ability were enrolled. Stretching of the plantar-flexors of the ankle in the standing position for 15 minutes was performed passively by a constant-speed and electrically powered device. The following evaluations were done before and immediately after the dynamic-repeated-passive ankle movements. Spastic hypertonia was assessed by the Modified Ashworth Scale (MAS; range, 0-4), Achilles tendon reflexes test (DTR; range, 0-4), and ankle clonus (range, 0-5). Improvement in ambulatory ability was determined by the timed up-and-go test (TUG), the 10-minute walking test, and cadence (steps/minute). In addition, subjective experience of the influence of ankle spasticity on ambulation was scored by visual analog scale (VAS). Subjective satisfaction with the therapeutic effect of spasticity reduction was evaluated by a five-point questionnaire (1 = very poor, 2 = poor, 3 = acceptable, 4 = good, 5 = very good). By comparison of the results before and after intervention, these 12 chronic stroke patients presented significant reduction in MAS and VAS for ankle spasticity, the time for TUG and 10-minute walking speed (p < 0.01). The cadence also increased significantly (p < 0.05). In addition, subjective satisfaction with the short-term therapeutic effect was mainly good (ranging from acceptable to very good). In conclusion, 15 minutes of dynamic-repeated-passive ankle joint motion exercise with weight loading in the standing position by this simple constant-speed machine is effective in reducing ankle spasticity and improving ambulatory ability. |
本系統中英文摘要資訊取自各篇刊載內容。