https://scholars.lib.ntu.edu.tw/handle/123456789/157880
標題: | 行政院國家科學委員會專題研究計畫:肌電圖生物迴饋對胸髓損傷患者坐姿平衡的影響 | 作者: | 林光華 | 關鍵字: | 脊髓損傷;舉臂向前;肌電圖生物迴饋;Spinal cord injury;Reach;EMG Biofeedback | 公開日期: | 1999 | 出版社: | 臺北市:國立臺灣大學醫學院物理治療學系暨研究所 | 摘要: | 脊髓損傷者的日常生活,以坐輪椅為主,如何改善或維持其動靜態的 坐姿平衡,為物理治療的主要項目。肌電圖生物迴饋儀(EMG Biofeedback)多被 用於中風患者平衡訓練。但對於脊髓損傷者,缺乏這方面之研究報告。本研究 的目的是探討胸髓完全損傷患者接受背伸直肌肌電圖生物迴饋一次訓練後, 坐姿舉臂向前動作的立即效果,與訓練兩星期後的長期效果。本研究篩選十 一位男性胸髓(T4-T12)完全性損傷患者,平均年齡為37.3±4.9 歲,身高為 167.6±4.7 公分,體重為62.2±9.0 公斤,平均受傷為9.6±5.3 年。受試者接受 背直肌(T5-6 及T11-12 paraspinal muscles)肌電圖生物迴饋訓練(Myoexerciser III, Verimed Inc, Florida), 訓練方式為:(1)舉臂向前至最遠距20 下,測其立即 效果;(2)舉臂向前至最遠距20 下/天,共兩星期,測其長期訓練效果。評估 時,受試者坐於測力板(AMTI)上,測近距(手臂長),遠距(125%手臂長)與最 遠距(最大距離)。受試者平均手長為69.8±2.0 公分。結果顯示: (1) 肌電圖生 物迴饋一次訓練後,坐姿舉臂向前動作的最遠距(104.9±7.9 公分)明顯增加。 (2) 肌電圖生物迴饋兩星期訓練後,坐姿舉臂向前動作的最遠距(109.2±6.8 公分)也比訓練一次更明顯增加。(3) 於動力學分析(kinetic analysis),肌電圖 生物迴饋訓練一次或兩星期後,患者於舉臂儘量向前時,其前後、左右與向 下重力位移距離增大(表一),雖然其增加無統計上的意義。(4) 於運動學分析 (kinematic analysis),肌電圖生物迴饋訓練一次後反應時間與動作時間皆減 少,訓練兩星期後,動作時間減少。患者於舉臂儘量向前時,其前後反應前 預備動作時間縮短,而左右與向下重力位移之預備動作時間延長(表二),雖 然上述改變無統計上的意義。結論是肌電圖生物迴饋訓練使胸髓完全損傷患 者舉臂向前動作控制趨向正常,造成向前距離明顯增加。 The major device for locomotion is wheelchair in subjects with spinal cord injury. How to improve their sitting balance would be an important program for daily activities. EMG biofeedback has been used in stroke patients for balance training, but it lacks this kind of study in patients with spinal cord injury. The purposes of this project were to investigate the immediate and long-term effects of back extensors-EMG biofeedback on reach in thoracic cord injured patients. There were 11 thoracic (T4-T12) completely injured male paraplegics with age 37.3±4.9 years old, height 167.6±4.7 cm, weight 62.2±9.0 kg, and duration 9.6± 5.3 years participated in this study. They received EMG biofeedback training (Myoexerciser III, Verimed Inc, Florida) on back extensors (T5-6 and T11-12 paraspinal muscles) to obtain the followings: (1) the immediate effect by performing 20 forward reaches, and (2) the long-term effect by performing 20 forward reaches per day for two weeks. The effects were assessed by having subjects seated on a AMTI force plate to perform near (arm length), far (125% arm length) and maximal reaches. The mean arm length of the participants was 69.8±2.0cm . The results indicated that: (1) Immediate effect of EMG biofeedback on maximal reach (104.9±7.9 公分) was significantly increased. (2) Long-term effect of EMG biofeedback on maximal reach (109.2±6.8 公分) was significantly increased than that of immediate effect. (3) Kinetic analysis revealed that both immediate and long-term (two-weeks) EMG biofeedback training resulted in greater increases in anterior-posterior, right-left, and vertical force shifting (Table 1), although the increase was not statistically significant. (4) Kinematic analysis revealed that immediate EMG biofeedback training resulted in decreases in reaction time and movement time, but long-term (two-weeks) EMG biofeedback training resulted in a decrease in movement time. The anticipatory time for anterior-posterior force was reduced, but the anticipatory times for right-left, and vertical force shifting were increased (Table 2), although the increases were not statistically significant. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/25598 | 其他識別: | 882314B002301 | Rights: | 國立臺灣大學醫學院物理治療學系暨研究所 |
顯示於: | 物理治療學系所 |
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