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頁籤選單縮合
題名 | 由坐至站之動態分析與中風病人跌倒之關係=The Kinetic Assessment of Sit-to-Stand in Stroke Patients and its Relationship to Fall |
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作者 | 鄭寶釵; 吳淑霞; 廖美雲; 林佩欣; 黃美涓; 陳協慶; 鄧復旦; | 書刊名 | 復健醫學會雜誌 |
卷期 | 25:2 1997.12[民86.12] |
頁次 | 頁119-127 |
分類號 | 418.996 |
關鍵詞 | 由坐至站; 動力學分析; 中風; 跌倒; Sit to stand; Stroke; Fall; Kinetic analysis; |
語文 | 中文(Chinese) |
中文摘要 | 腦中風病人經復健治療後,大部份可恢復行走的能力,但因其仍留有部份神經機 能障礙,故中風病人跌倒的機率比一般人高出許多。有很多因素均會導致中風病人跌倒,除 了環境因素外,視力減退、年齡因素引起的身體機能退化,柔軟度,關節活動度及肌力減弱 ,均易導致跌倒。本研究共收集了 58 人,正常對照組 25 人,平均年齡 63.3 歲,中風病 人無跌倒者 15 人,平均年齡 63 歲,中風病人有跌倒者 18 人,平均年齡 62.8 歲。藉 動力分析系統來評估中風病人由坐至站或由站至坐時,身體重心移動軌跡,站立時身體搖晃 情形,和兩腳著力情形等作為評估,以期能找出易造成中風病人跌倒危險之指標。研究結果 顯示,中風病人,尤其是有跌倒病史的中風病人,與正常人間有明顯的差異。(一)由坐至 站, 中風病人明顯耗費較多時間,正常人 1.88 ± 0.48 秒, 中風病人無跌倒者 2.73 ± 1.19 秒,有跌倒者 4.32 ± 2.22 秒,統計學上有明顯意義,p<0.005。 (二)中風病人 由坐姿站起來,其兩腳承重差異較大,有跌倒者達體重的 53%,無跌倒者 42%,正常對照組 17%,p<0.005。而中風病人由站至坐,兩腳承重差異有跌倒者為 47%,無跌倒者 43%,亦明 顯的比正常對照組 14 % 大,p<0.005。 (三)中風病人,尤其是有跌倒者,由坐姿站起來 時, 其足底與地面作用力增加之改變率( dF/dT )明顯的比正常控制組低,其值分別為控 制組的 85.96 ± 42.4Kg /s,無跌倒者 55.23 ± 31.24kg/s,有跌倒者 23.78 ± 17.38 Kg/s,p<0.005。 (四)中風病人由坐站起來時,其身體重心左右及前後位移,均比正常對 照組明顯增大,p<0.05。尤其是有跌倒者,其身體重心左右位移更大,與無跌倒之間的差異 , 亦達統計學上有意義的差異( 21.05 ± 9.91 公分 vs 12.0 ± 58.0 公分,p<0.05 ) 。(五)中風病人在站立平衡時,其健側腳仍承受較大的重量,p<0.05,但其身體重心左右 搖晃的最大距離則與正常控制組無統計學上有意義的差異。(六)當中風患者在站立時,身 體盡量向前或向左右偏移時, 其身體重心位移明顯的偏向健側, 與正常組之間的差異,亦 達 p<0.05。 |
英文摘要 | Fall has been Reported as a major Cause of Morbidity, Hospitalization and Mortality of Older People. Stroke Patients are More Prone to Fall than Non-Stroke Subjects, Because of the Pathological Conditions Inposing Upon the Physiological Aging Process. Since Fall is so Frequent, Fall Prevention Strategies Should Therefore be developed and Included in Rehabilitation Programs. Falls are Associated with Many Physical and Environmental Factors. Excluding Tripping, Many of the Falls in Stroke Patients Occurred During the Patients Changing their Positions, Such as Standing up, Sitting down or Initiation of Steps. Therefore, the Purpose of this Study is Focus on the Kinetic Analysis of Rising/Sitting down Activities and to Find its Relationship to the Fall in Stroke Patients. Totally 25 Normal Subjects, and 33 Stroke Patients (18 Faller, 15 Non-Faller) were Included in this Study. There was a Significant Difference between Stroke Patients and Normal Controls in the Tested Motor Tasks--the Stroke Patients Favoured their Non-Affected Leg. The Body Weight Distribution was Asymmetric While Patients Rising/Sitting down Spontaneously. The Vertical Floor Reaction Force Difference between Affected and Non-Affected Leg was 53% of Body Weight in Stroke Patients with Fall, 42% of Body Weight in Stroke Without Fall (p<0.05), While Only 17% in the Normal Control (p<0.005). The Rate of Change in Force (dF/dT) for Rising from the Chair was Calculated from the data collected by Computer. Stroke Patients with Fall Had Significantly Lower dF/dT than Non-Fallers,(23.78 ± 17.38 Kg/sec vs 55.23 ± 31.24 Kg/sec,p<0.05).As Compared to the Mormal Control dF/dT(85.96 ± 42.4 kg/sec),Stroke Patients Had Significant Low dF/dT(p<0.005) . The Hemiplegic Patients Have Also shown Significantly Increased Postural Sway, Especially in Medio-Lateral Direction While Rising/Sitting down, p<0.05. The Centers of Pressure (COP) Sway were Greater in Medio-Lateral Directopm tham Antero-Posterior Direction in Stroke Patients During Rising / Sitting Down. In Contrast, the Cop Sway were Greater in Antero-Posterior Direction in Normal Controls. With Feet Parallel, the Stroke Patient was Deficient in Shifting Weight Toward the Hemiplegic Leg(p<0.05). |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。