張家豪Chang, Jia-Hao賴力綱Lai, Li-Kang2023-12-082022-09-272023-12-082022https://etds.lib.ntnu.edu.tw/thesis/detail/0b64a6a361af6ab9ff0ecd80cd6ab04b/http://rportal.lib.ntnu.edu.tw/handle/20.500.12235/121407目的：探討退化性膝關節炎第四級患者，於全人工膝關節置換術前進行功能性肌力訓練，是否影響術前及術後關節炎症狀與功能性動作表現。方法：從臺灣中部某醫院骨科門診招募12位受試者，將其平均分配至單次訓練組、雙次訓練組及控制組。單次訓練組於手術前一週額外進行一次運動介入，雙次訓練組於手術前二週額外進行每週一次運動介入，運動介入前後使用腳踏機進行暖身及收操，並於主訓練過程採用穿戴式負重背心執行三項功能性運動訓練，分別為平地直線行走、上下樓梯及椅子坐站訓練，三組皆會執行常規衛教、術後床邊運動及助行器行走訓練。分別於安排手術之當次門診進行前測(T0)、手術前一天入院第一次後測(T1)、手術後第6週第二次後測(T2)、手術後第12週第三次後測(T3)收集數據，包括WOMAC膝關節功能量表、膝伸肌力、椅子坐站測試、功能性伸手測試、四方格跨步測試、起身繞圓測試、40公尺快步行走測試、樓梯攀登測試與Y字平衡測試，並使用敘述性統計描述各組內及組間差異。結果：單次訓練組相較控制組更有助於在T1有功能性動作表現及自覺感受立即性增長，而後維持表現至T3，但控制組於T0至T3之功能性動作表現也呈現漸進式進步至相似水平。結論：對於退化性膝關節炎第四級患者，進行全人工膝關節置換術前功能性肌力訓練介入，於術前一週額外使用負重背心進行單次功能性動作訓練，相較控制組更有助於提早在術前有功能性動作表現及自覺感受立即性增長，但控制組於術後十二週亦以產生足夠學習效應改善膝關節退化者術後功能性動作表現。Purpose: This study is aimed to investigate whether preoperative functional-based muscle strengthening in patients with grade 4 knee osteoarthritis affects the arthritis symptoms and functional-based performance. Method: Twelve participants were recruited from the orthopedic clinic of a hospital in central Taiwan, and they were equally divided into three groups which are single-training group, double-training group, and control group. Single-training group trained for one time a week before the operation while double-training group trained for two cycles before the operation. A pedal machine was used to warm up and cool down during experiments. Also, participants wore a weight-bearing vest to perform three functional-based exercises, which were respectively walking, stair climbing, and sit-to-stand. The baseline data came from the day when participants recruited from the clinic, the day before the operation(T1), six weeks after the operation(T2) and twelve weeks after the operation(T3). Data from different times included WOMAC, knee extensor strength, chair-standing test, functional-reaching test, four-squared steps test, time-up-and-go, forty meters fast-paced walking test, stair-climbing test and Y-balance test. Data was analyzed through descriptive statistics to explore the difference among each group. Result: Compared with control group, single-training group was more conducive to the immediate increase of functional-based movement performance and symptoms improvement at T1 and maintained until T3. The functional-based movement performance of the control group also showed a gradual progression from T0 progress to a similar level at T3. Conclusion: For patients with grade 4 knee osteoarthritis, preoperative functional-based muscle strengthened once had immediately improved the knee joint symptoms and physical function before the surgery. On the other hand, control group also had gradual improvement from baseline to twelve weeks after the surgery. This learning effect was adequate to improve the functional-based movement performance for those who had knee osteoarthritis.復健術前復健關節炎負重背心運動醫學rehabilitationprehabilitationosteoarthritisweighted vestsport medicineetd