摘要：標題：肌肉肌束行為、血液動力學與肌肉肌腱材料力學在不同阿基里氏肌腱修補手術後固定方式與振動介入之差異與療效此三年計畫之第一年將徵招一年內(3 到12 個月內)單側接受阿基里氏肌腱修補手術之患者，依據其術後固定方式收試者分為兩組；石膏固定組與功能性輔具組，目的在分析和比較兩組之間與健患兩側之間(組內)其內側腓腸肌肌束型態特徵，在踝關節等長、向心與離心動作時之差別，以及肌肉內腱性組織包含腱膜與肌腱之剛性，並分析肌腱微循環、神經控制與功能性之差異。第二年目的主要在(1)比較和分析單側阿基里氏肌腱修補手術後1 個月內之受試者，其被修補的阿基里氏肌腱接受為期1 個月的震動介入，是否具有短期(立即)及長期(一個月後)增加肌腱內微循環之療效，(2)另外徵招使用髕骨肌腱自體移植做為膝關節十字韌帶重建材料之病患，以縱貫性研究(longitudinal study)方式，量測手術前以及手術後第1、2、3 及6 個月與9 個月時髕骨肌腱內微循環，以及機械特性的之特徵與改變，建立正常肌腱斷裂後微循環改變的模式。第三年除延續第二年之主要研究目的，在持續比較和分析術後接受並增加肌腱內微循環的受試者(震動實驗組)，與沒有接受震動介入之對照組，兩組在手術後3、6 及9 個月時，肌肉束行為和肌肉腱膜剛性差別，以及觀察高血糖受試者髕骨肌腱與其阿基里氏肌腱內之微循環、機械剛性肌腱與對照組之差異，為將來發展代謝性疾病骨科物理治療做準備。
Abstract: This is a three-year research project mainly focused on post-surgery physiotherapy strategies to improve theoutcomes of Achilles tendon repair. The research seeks to determine the following: (1) whether the therapeuticeffects of different types of functional postoperative treatment of Achilles tendon repair, including castimmobilization and functional orthosis, reflect on aspects of the calf muscle and tendon; (2) whetherpost-surgery microcirculation in the Achilles tendon can be manipulated by vibration massage; and (3) whether anearly intervention of vibration massage after an Achilles tendon repair can improve outcomes afterwards.Furthermore, our research interests include the establishment of a model of human tendon healing afterincision, as well as an improved understanding of the characteristics of tendon microcirculation insubjects with hyperglycemia for the purposes of tendon healing and injury prevention. In the first year of the project, subjects who have undergone a unilateral Achilles repair within the last year will berecruited. These subjects will be divided into either a cast immobilization group or a functional orthosis groupaccording to the type of post-surgery management they received. In the first year of the project, 15 subjects will berecruited for each group. The research aims to compare the therapeutic effects of the two aforementioned types ofpost-surgery immobilization in terms of the following: muscle fascicle morphologies, fascicular behaviors, andforce during isometric, concentric, and eccentric contraction; the mechanical properties of the tendinous tissuesincluding the proximal aponeurosis and the Achilles tendon; muscle activation; functional performance in thelower extremities; and the subjective assessments of the subjects with a unilateral Achilles tendon repair.Furthermore, bilateral comparisons between the injured and non-injured legs will be made in the first year of theresearch project to investigate whether there are significant bilateral differences within each group.For the second year of the project, subjects who have undergone a unilateral Achilles repair within the last monthwill be recruited. Those subjects will then be randomly divided into a vibration massage group or a no-vibrationgroup. For this portion of the research, 15 subjects will be recruited for each group. This portion of the project aimsto investigate both the acute and chronic effects of, respectively, a short-term and a long-term mechanical vibrationmassage intervention on Achilles tendon microcirculation. In addition, for another part of the project, subjects witha unilateral cruciate ligament rupture in the knee joint will be recruited for a ligament reconstruction with a patellartendon autograft. The microcirculatory and mechanical changes in the autografted patellar tendon will then beobserved at 1, 2, 3, 6 and 9 months post-reconstruction surgery for comparison with condition of the tendon priorto the reconstruction. Bilateral comparisons between the autografted and healthy patellar tendons will also be made.The aims of this portion the research project are to understand and establish the characteristics of microcirculationand mechanical recovery after a tendon incision in the human patellar tendon.In the third year of the project, the second-year portions of the project described above will be extended to includemeasurements of the therapeutic effects of post-surgery vibration massage at 3, 6, and 9 months post-surgery onthe outcomes measured during the first year of the project, such as muscle fascicle morphologies and behaviors,the mechanical properties of the tendinous tissues, functional performance, and subjective assessments. In addition,30 male subjects with hyperglycemia and 30 controls will be recruited. This part of the research aims to measurethe microcirculatory and mechanical characteristics of the patellar and Achilles tendons in the subjects withhyperglycemia, as well as the differences between the two groups.