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題 名 | 恢復良好的車禍腦傷病患之站立平衡研究--初步報告=Standing Balance in the Traumatic Brain Injured with Good Recovery--A Preliminary Report |
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作 者 | 曹昭懿; 莊麗玲; 黃勝堅; 胡名霞; | 書刊名 | 中華民國物理治療學會雜誌 |
卷 期 | 24:5 1999.09[民88.09] |
頁 次 | 頁9-16 |
分類號 | 418.996 |
關鍵詞 | 平衡; 感覺整合; 腦傷; Balance; Dynamic posturography; Traumatic brain injury; |
語 文 | 中文(Chinese) |
中文摘要 | 交通事故所導致之腦傷對國人之健康、生產力實有重大之不良影響。但在現今之 醫療體系及醫學研究中,多著眼於嚴重之腦傷病患,較少關心輕度及恢復良好之病患。本研 究之目的即是為了解輕度腦傷及中、重度腦傷卻恢復良好之患者的站立平衡狀況及其可能之 影響因素。以某醫學中心神經外科在民國 87 年 5 月至 88 年 3 月間,因車禍導致之腦傷 病患中,恢復良好者為對象;共 20 名。以電腦動態姿勢平衡儀進行站立平衡檢查。本研究 發現,輕度與中、重度腦傷患者之各項平衡測驗結果並無明顯差異,但與他篇論文中正常人 之資料比較,恢復良好之腦傷病患,其平衡能力依然比正常人為差。在感覺整合測驗中之底 板同步、 閉眼及底板同步、與視覺同步及底板同步等 3 項及平均平衡分數年老組皆明顯較 年輕組差( p<0.05 )。以是否有頭暈及眩暈症狀分組作比較,在平衡分數上,張眼、閉眼 、底板同步 3 種測試二組間有差異( p<0.05 ); 以搖晃面積比值來看,則是視覺同步、 底板同步、閉眼及底板同步 3 種測試二組間有差異( p<0.05 )。 由本研究結果可知,恢 復良好之腦傷病患,雖然以臨床神經學檢查無法發現任何不正常現象,但以精密之平衡儀器 檢查則可發現與正常人確有不同,值得臨床工作者多加注意。 |
英文摘要 | Traffic-related traumatic brain injury leads to great cost in the society. The medical personnel tend to focus on the management of severely injured patients and ignore those patients with mild injury or who have regained good function. The aims of this study were to explore the balance performance of brain injured patients who had gained good recovery by clinical judgment and to find the possible correlating factors to their balance performance. Twenty patients ( age range 18 to 73 years ) were recruited from the neurosurgical department of a medical center from May 1998 to March 1999. All the patients sustained traffic-related brain injury with initial Glasgow Coma Scales between 3 to 15 points, among them, 4 were severe injury, 5 were moderate injury and 11 were mild injury. All patients had gained good recovery, i.e. had no motor deficits by clinical standards at the time of balance test. The patients were tested on a dynamic posturographic system ( Smart Balance Master system, NeuroCom Int Inc, Clack mas, Oregon, USA ) for a their balance ability. The results revealed no significant difference between the mildly and the moderately or severely injured patients. How-ever, when the patients were compared to the data of normal subjects in the literature, differences in sensory integration ability to maintain balance, in rhythmic weight shifting ability, and in sustained weight shifting ability were apparent. Comparison between age groups ( using 65 y/o as cut off point ) showed significant difference between the young and the old patients while maintaining balance under sensory changing conditios ( sway-referenced surface condition, eyes closed and sway-referenced surface condition, sway-referenced surface and vision condition, and average score )( p<.05 ).Furthermore, the older patients weight shift slower in the right-posterior, left-posterior, and left directions than the younger patients ( P<.05 ). The patients with dizziness ( n=15 ) were less able to maintain stability during the sensory integration test than the patients without dizziness ( n=5 ). We conclude that balance deficits remains to be present in traumatic brain injured patients due to traffic injury who were judged clinically to have gained good recovery. The balance deficits are related to their age and dizziness symptom. Furthermore, the balance deficit is more apparent under sensory changing environment. Clinicians should pay more attention to these patients and their balance deficits. |
本系統中英文摘要資訊取自各篇刊載內容。