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題名 | 血友病病人膝部的等速運動肌力= |
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作者 | 黃麗麗; |
期刊 | 中華民國物理治療學會雜誌 |
出版日期 | 19891000 |
卷期 | 14 1989.10[民78.10] |
頁次 | 頁16-24 |
分類號 | 415.625 |
語文 | chi |
關鍵詞 | 肌力; 血友病; 病人; 等速; 運動; 膝部; |
中文摘要 | 本研究的目的在利用等速肌力測驗儀測試血友病病人,探討其在不同角 速度運動時,膝伸肌與屈肌之最大肌力(torque)與產生最大肌力之關節角度,將此 結果與正常人比較,並探討影響肌力之可能相關因素。從民國76年1月至12月間, 在台大醫院血友病醫療中心的病人中,選取28位重度血友病(血中第八或第九凝 血因子濃度為正常值1以下者)男性病人,接受完整測試。其平均年齡是24.3±7.9 歲。測試時,除查詢病人確定診斷的年齡外,並測量病人身高、體重與雙膝之關 節活動度,膝部作放射線檢查外,並記錄其畸型。同時分別測試膝伸肌與屈肌之 等長收縮(角速度等於°/sec)與等速運動(30°,60°,120°,180°,240°,300°/sec) 時的最大肌力與產生最大肌力時之關節角度。結果發現血友病病人左右膝部肌力 沒有明顯差異(p>0.05)。病人與正常人的膝部肌力均以等長收縮之肌力為最大, 等速運動之肌力隨著測試角速度增加,其肌力有逐漸減小的現象,且最大肌力逐 漸發生在伸膝或屈膝動作的後期。血友病病人在各角速度之最大肌力或每公斤體 重的平均肌力均較正常人小,以膝伸肌之減小更為明顯,平均減少50左右,故屈 肌與伸肌肌力之比值(F/E ratio)均較正常人大(p<0.05)。在本研究中利用相關統計 法分析結果顯示,病人確定診斷的年齡愈大者,X光片慢性關節病變之程度愈嚴 重者,關節之活動度愈小者,則其肌力皆愈小(p<0.05)。若病人膝部呈現畸型, 則膝伸肌肌力明顯減少(p<0.05)。血友病病人較正常人更需強而有力的膝部,故 應指導病人運動,尤應加強膝伸肌,至於其方法與效果,仍待進一步之研究與探 討。 |
英文摘要 | The purpose of this study were to useisokinetic dynamometer in studying the peaktorques of knee muscles at various speeds ofisokinetic exercise and the joint angles whenthe peak torques occurred, comparing thefinding with those of the normal persons, andstudying the possible correlated factors influenc-ing the muscle strength. From January, 1987to December, 1987, twenty-eight severehemophilic male patients (with a circulatingtiter of Factor VIII or Factor IX of less thanI per cent) were selected and examined inHemophilia Center, National Taiwan UniversityHospital. The average age of the patientswere 24.3±7.9 year-old. The following dataincluding the age when the diagnosis wasconfirmed, body height, body weight, kneedeformities, radiographic change of knees andthe range of motion of the knees were alsocollected. The isometric strength (angularvelocity equals to 0°/sec) and the peak torqueof knee muscles at various speeds (30°, 60°,120°, 180°, 240°, 300°/sec) and the angle ofmotions when the peak torques occurred werealso recorded. The result showed that therewas no significant difference in the strengthof the right and the left knee muscles (p>0.05).Both the hemophilic patients and normal personshad the same phenomena that the isometricstrength was higher than any isokinetic strength at various setting speeds. It was also foundthat the isokinetic strength of knee musclesdecreased as the testing speed increased, andthe peak torques also occurred in the laterrange of motion either in extension or flexionas the testing speed increased. The peak torqueor average torque per kilogram body weightof knee muscles of the hemophilic patientsat all set speeds were lower than that of thenormal persons especially in the knee extensorsthat reduced about 50 in average. Hence,the ratio of the torques of flexor to extensorat different speeds were higher than that ofthe normal persons (p<0.05). In this study,it was shown that the later the patient wasdiagnosed, the severer chronic arthropathychange found in the radiographic examination,the more limitation of knee mobility of thepatients had, the less strength they would have(p<.05). If there were deformity in the knees,the strength of the knee extensor will reducedsignificantly (p<0.05). A hemophilic patientneeds stronger knee strength than the normalperson, therefore, to strengthen the kneeextensor should be emphasized during the treatment was given. However, it needs furtherstudy to find the suitable treatment methodsand the effect of therapeutic exercise in themanagement of the hemophilic patients. |
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