https://scholars.lib.ntu.edu.tw/handle/123456789/159126
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor | 毛慧芬 | en |
dc.contributor | 臺灣大學:職能治療研究所 | zh_TW |
dc.contributor.author | 黃小玲 | zh |
dc.contributor.author | Huang, Sheau-Ling | en |
dc.creator | 黃小玲 | zh |
dc.creator | Huang, Sheau-Ling | en |
dc.date | 2004 | en |
dc.date.accessioned | 2007-11-27T01:00:00Z | - |
dc.date.accessioned | 2018-07-09T00:33:46Z | - |
dc.date.available | 2007-11-27T01:00:00Z | - |
dc.date.available | 2018-07-09T00:33:46Z | - |
dc.date.issued | 2004 | - |
dc.identifier | en-US | en |
dc.identifier.uri | http://ntur.lib.ntu.edu.tw//handle/246246/55385 | - |
dc.description.abstract | 目的:探討軀幹側支撐對脊髓損傷個案脊柱與骨盆曲線的影響。 背景:臨床上特殊擺位系統廣泛地被用來改善脊髓損傷個案的坐姿,但軀幹側支撐對脊柱側彎及臀部壓力的影響,卻少有相關文獻之驗證。 方法:共有8位脊柱側彎的男性脊髓損傷個案參與本研究。受試者坐於實驗用椅上,在有/無軀幹側支撐兩種情況下,分別量測脊柱及骨盆的位置與形狀。首先照射X光,然後三維脊柱骨盆曲線及臀部壓力利用動作分析系統 (Vicon 512, Oxford Metrics, U. K.) 及壓力量測系統 (Tekscan Advanced Clinsear, U. S. A.) 同步測量。脊柱側彎的嚴重度分別在X光影像上用科布角度 (Cobb angles),脊突角度 (spinous process angles) 及側彎指數 (scoliotic index) 來表示。利用配對-t檢定來比較上述X光影像取得之三種角度及由三維立體脊柱骨盆曲線投影在冠狀面 (coronal plane) 之脊突角度在兩種擺位情況的差異。二維X光影像與三維脊柱骨盆曲線投影在冠狀面影像的相關性;及三維脊柱骨盆曲線與壓力中心位移的相關性用皮爾森相關(Pearson’s correlation )作分析。 結果:X光影像的結果顯示,有軀幹側支撐的座位,受試者的科布角度,脊突角度及側彎指數都明顯較小(p = 0.005 ~ 0.043)。科布角度,脊突角度及側彎指數的改善比率分別為31.38%,31.69%及23.71%。從X光影像與三維脊柱骨盆曲線投影在冠狀面影像所得的脊突角度二者間有明顯的相關性(r = 0.624, p = 0.010)。但軀幹各部分與骨盆間的相對移動角度在兩種座位間的差異卻不顯著。有軀幹側支撐時,所有受試者的臀部最高壓力值都降低,但是壓力中心位移並沒有明顯改變。脊柱各區段及骨盆的相對角度與壓力中心位移比率也沒有發現明顯的相關性存在。 結論:藉由X光影像分析可知,利用有側支撐的坐姿擺位系統達到靜態矯正脊柱側彎的作用。但在三維脊柱骨盆運動分析中卻沒有顯示相同的現象,可能是因為計算方法的不同。此議題仍待未來研究的進一步驗證。有側支撐時臀部最高壓力值降低,但是對稱指數及壓力中心位移卻沒有同時降低。此結果隱喻臨床上,脊柱與骨盆在給予脊髓損傷個案輪椅特殊擺位處方時,需要視為一體,不可偏廢。 | zh_TW |
dc.description.abstract | Objective. To investigate the effects of lateral trunk supports (LTSs) on spinal and pelvic alignment for the spinal cord injured (SCI) persons with scoliosis. Background. Special seating has been widely used in clinic to improve sitting postures of SCI persons. However, little has been known about the effects of LTSs on the scoliotic curve and buttock pressures. Methods. Eight male SCI subjects with scoliosis participated in this study. The shapes of the spine and pelvis were measured with subjects sitting on an experimental chair in two seating configurations. Radiographs were taken first and then 3-dimensional (3-D) spine-pelvis curve and buttock pressures were measured simultaneously using a motion analysis system (Vicon 512, Oxford Metrics, U. K.) and a pressure plate (Tekscan Advanced Clinseat, U.S.A.). The severity of scoliosis was described by Cobb angles, spinous process angles, and scoliotic index calculated from the radiographic images. Paired-t test was used to compare differences of the Cobb angles, spinous process angles and scoliotic index as well as the corresponding angles calculated from the coronal projection of the 3-D spine-pelvis curve between two seating configurations. Relationships between the results from 2-D radiographs and coronal projection of the 3-D spine-pelvis curves, and between the results from 3-D spine-pelvis curves and COP movements were analyzed by Pearson’s correlation. Results. The results of the radiographic data revealed that Cobb angles, spinous process angles, and scoliotic index with LTSs were all significantly smaller than those without LTSs (p = 0.005 ~ 0.043). The scoliosis correction rate in terms of Cobb angles, spinous process angles, and scoliotic index from the radiographs were 31.38% (14% ~ 50%), 31.69% (-7% ~ 69%), 23.71% (-27% ~ 54%) respectively. Spinous process angles on A-P radiographs and coronal projection of the 3-D spine-pelvis curves were obviously correlated (r = 0.624, p = 0.010). But there was no significant difference in relative positions of the 3-D spine-pelvis curves between the two seating configurations. With LTSs, peak pressures at the buttock were smaller than those without LTSs for all subjects, but symmetry index and center of pressure displacement (COPd) did not change significantly. None of the relative movements among the spinal segments and pelvis were related to the movement of center of pressure percentage (COPp) on the pressure plate. Conclusions. Significant static correction of the scoliotic spine could be achieved by special seating with lateral trunk supports as shown by radiographic analysis results. But kinematic analysis of 3-D spine-pelvis movements did not show the same phenomenon, which could be related to the calculated methods. Further study on this issue is necessary. Peak pressures at the buttock were decreased after using LTSs. Nevertheless, symmetry index and COPd were not reduced accordingly. The results implied that spine and pelvis should be regarded as a whole when prescribing the special seating for SCI persons with scoliosis. | en |
dc.description.tableofcontents | Table of Contents 學位考試審查表 誌謝 Abstract I 中文摘要 III Table of Contents V List of Tables VIII List of Figures IX Chapter 1 Introduction 1 1.1 Background and Significance 1 1.2 Literature Review 2 1.2.1 Posture problems of SCI persons 2 1.2.2 Importance of wheelchair positioning for SCI persons with scoliosis 3 1.2.3 Wheelchair positioning principles for scoliosis 4 1.2.4 Measurement methods for spinal and pelvic Alignment 5 1.2.5 Measurement of buttock interface pressures 10 1.3 Purposes, Problems and Hypotheses 12 Chapter 2 Materials and Methods 16 2.1 Subjects 16 2.2 Experimental Equipment 16 2.2.1 Modified adjustable seating chair 16 2.2.2 Radiographic System 17 2.2.3 Kinematic measurement system (Motion analysis system) 18 2.2.4 Kinetic measurement system (Pressure measurement system) 18 2.2.5 Integration of the measurement systems 19 2.3 Experimental Procedures 19 2.4 Terminology and Operational Definitions 23 2.5 Data Analysis 27 Chapter 3 Results 30 3.1 Demographic and Neurological Characteristics of the Subjects 30 3.2 Spine and pelvic alignment from A-P X-ray 30 3.3 3-D Relative Positions of the Spine and Pelvis in Two Seating Configurations 31 3.4 Symmetry Index and COP Positions in Two Seating Configurations 32 3.5 COP Positions and Relative Movements of the Spine and Pelvis in Two Seating Configurations 33 Chapter 4 Discussion 34 4.1 Spine and pelvic alignment from A-P X-ray 34 4.2 3-D Relative Positions of the Spine and Pelvis in Two Seating Configurations 37 4.3 Symmetry Index and COP Positions in Two Seating Configurations 38 4.4 COP Positions and Relative Movements of the Spine and Pelvis in Two Seating Configurations 39 4.5 Limitations 40 4.6 Recommendations for Future Research 41 Chapter 5 Conclusions and Clinical Applications 42 References 43 Tables 48 Figures 56 Appendix 81 | zh_TW |
dc.format.extent | 2245402 bytes | - |
dc.format.mimetype | application/pdf | - |
dc.language | en-US | en |
dc.language.iso | en_US | - |
dc.subject | 脊柱側彎 | en |
dc.subject | 軀幹側支撐 | en |
dc.subject | 特殊擺位 | en |
dc.subject | 姿勢 | en |
dc.subject | 脊髓損傷 | en |
dc.subject | Posture | en |
dc.subject | Scoliosis | en |
dc.subject | Lateral trunk supports | en |
dc.subject | Special seating | en |
dc.subject | Spinal cord injury | en |
dc.title | 軀幹側支撐對脊髓損傷個案脊柱與骨盆曲線影響之探究 | zh |
dc.title | Effects of Lateral Trunk Supports on Spinal and Pelvic alignment for Persons with Spinal Cord Injury | en |
dc.type | text | en |
dc.identifier.uri.fulltext | http://ntur.lib.ntu.edu.tw/bitstream/246246/55385/1/ntu-93-R91429001-1.pdf | - |
dc.relation.reference | Aissaoui, R., Kauffmann, C., Dansereau, J., & de Guise, J. A. (2001). Analysis of pressure distribution at the body-seat interface in able-bodied and paraplegic subjects using a deformable active contour algorithm. Med Eng Phys, 23(6), 359-367. Alm, M., Gutierrez, E., Hultling, C., & Saraste, H. (2003). Clinical evaluation of seating in persons with complete thoracic spinal cord injury. Spinal Cord, 41(10), 563-571. Apatsidis, D. P., Solomonidis, S. E., & Michael, S. M. (2002). Pressure distribution at the seating interface of custom-molded wheelchair seats: effect of various materials. Arch Phys Med Rehabil, 83(8), 1151-1156. Bolin, I., Bodin, P., & Kreuter, M. (2000). Sitting position - posture and performance in C5 - C6 tetraplegia. Spinal Cord, 38(7), 425-434. Brown, J. C., Swank, S. M., Matta, J., & Barras, D. M. (1984). Late spinal deformity in quadriplegic children and adolescents. J Pediatr Orthop, 4(4), 456-461. Burns, S. P., & Betz, K. L. (1999). Seating pressures with conventional and dynamic wheelchair cushions in tetraplegia. Arch Phys Med Rehabil, 80(5), 566-571. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates. Cook, A. M., & Hussey, S. M. (2002). Seating systems as extrinsic enablers for assistive technologies. In A. M. Cook & S. M. Hussey (Eds.), Assistive Technologies: Principles and Practice (2nd ed., pp. 165-211). St. Louis: Mosby, Inc. Fuhrer, M. J., Garber, S. L., Rintala, D. H., Clearman, R., & Hart, K. A. (1993). Pressure ulcers in community-resident persons with spinal cord injury: prevalence and risk factors. Arch Phys Med Rehabil, 74(11), 1172-1177. Garrett, A. L., Perry, J., & Nickel, V. L. (1961). Paralytic scoliosis. Clin Orthop, 21, 117-124. Goetz, L. L., Brown, G. S., & Priebe, M. M. (2002). Interface pressure characteristics of alternating air cell mattresses in persons with spinal cord injury. J Spinal Cord Med, 25(3), 167-173. Greenspan, A. (2000). Scoliosis and Anomalies with general affect on the skeleton. In A. Greenspan (Ed.), Orthopedic Radiolody : A Practical Approach (3rd ed., pp. 891-930). Philadelphia: Lippincott Williams & Wilkins. Harms, M. (1990). Effect of wheelchair design on posture and comfort of users. Physiotherapy., 76(5), 266-271. Harstall, C. (1996). The Effectiveness of Interface Pressure Measurements: interface pressure measurement systems for management of pressure: Alberta Heritage Foundation for Medical Research. Hastings, J. D., Fanucchi, E. R., & Burns, S. P. (2003). Wheelchair configuration and postural alignment in persons with spinal cord injury. Arch Phys Med Rehabil, 84(4), 528-534. Herzenberg, J. E., Waanders, N. A., Closkey, R. F., Schultz, A. B., & Hensinger, R. N. (1990). Cobb angle versus spinous process angle in adolescent idiopathic scoliosis. The relationship of the anterior and posterior deformities. Spine, 15(9), 874-879. Hobson, D. A., & Tooms, R. E. (1992). Seated lumbar/pelvic alignment. A comparison between spinal cord-injured and noninjured groups. Spine, 17(3), 293-298. Holmes, K. J., Michael, S. M., Thorpe, S. L., & Solomonidis, S. E. (2003). Management of scoliosis with special seating for the non-ambulant spastic cerebral palsy population--a biomechanical study. Clin Biomech (Bristol, Avon), 18(6), 480-487. Janssen-Potten, Y. J., Seelen, H. A., Drukker, J., Huson, T., & Drost, M. R. (2001). The effect of seat tilting on pelvic position, balance control, and compensatory postural muscle use in paraplegic subjects. Arch Phys Med Rehabil, 82(10), 1393-1402. Keim, H. A. (1978). Scoliosis. Clin Symp, 30(1), 1-30. Kernozek, T. W., & Lewin, J. E. (1998). Seat interface pressures of individuals with paraplegia: influence of dynamic wheelchair locomotion compared with static seated measurements. Arch Phys Med Rehabil, 79(3), 313-316. Koo, T. K., Mak, A. F., & Lee, Y. L. (1996). Posture effect on seating interface biomechanics: comparison between two seating cushions. Arch Phys Med Rehabil, 77(1), 40-47. Lancourt, J. E., Dickson, J. H., & Carter, R. E. (1981). Paralytic spinal deformity following traumatic spinal-cord injury in children and adolescents. J Bone Joint Surg Am, 63(1), 47-53. Lonstein, J. E., & Akbarnia, A. (1983). Operative treatment of spinal deformities in patients with cerebral palsy or mental retardation. An analysis of one hundred and seven cases. J Bone Joint Surg Am, 65(1), 43-55. Magee, D. J. (2002). Assessment of Posture. In D. J. Magee (Ed.), Orthopedic Physical Assessment (4th ed., pp. 873-903). Philadelphia: Saunders. Ragan, R., Kernozek, T. W., Bidar, M., & Matheson, J. W. (2002). Seat-interface pressures on various thicknesses of foam wheelchair cushions: a finite modeling approach. Arch Phys Med Rehabil, 83(6), 872-875. Salerno, S., & Kirshblum, S. (2002). Wheelchairs/adaptive mobility equipment and seating. In S. Kirshblum, D. I. Campagnolo & J. A. Delisa (Eds.), Spinal Cord Medicine. Philadelphia: Lippincott Williams & Wilkins. Shields, R. K., & Cook, T. M. (1992). Lumbar support thickness: effect on seated buttock pressure in individuals with and without spinal cord injury. Phys Ther, 72(3), 218-226. Tanimoto, Y., Tokuhiro, A., Takechi, H., & Yamamoto, H. (2001). Measurement of SCI patient's buttock pressure on wheelchair and bed. Paper presented at the Intelligent Data Acquisition and Advanced Computing Systems: Technology and Applications, International Workshop. Vaccaro, A. R., & Silber, J. S. (2001). Post-traumatic spinal deformity. Spine, 26(24 Suppl), S111-118. Wilkins, K. E., & Gibson, D. A. (1976). The patterns of spinal deformity in Duchenne muscular dystrophy. J Bone Joint Surg Am, 58(1), 24-32. Zollars, J. A. (1993). Special Seating (3rd ed.). Santa Cruz: PAX Press. | en |
item.openairecristype | http://purl.org/coar/resource_type/c_18cf | - |
item.openairetype | text | - |
item.languageiso639-1 | en_US | - |
item.grantfulltext | open | - |
item.cerifentitytype | Publications | - |
item.fulltext | with fulltext | - |
crisitem.author.dept | Occupational Therapy | - |
crisitem.author.orcid | 0000-0002-2675-2302 | - |
crisitem.author.parentorg | College of Medicine | - |
顯示於: | 職能治療學系 |
檔案 | 描述 | 大小 | 格式 | |
---|---|---|---|---|
ntu-93-R91429001-1.pdf | 23.31 kB | Adobe PDF | 檢視/開啟 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。