簡易檢索 / 詳目顯示

研究生: 林藝庭
Lin, Yi-Ting
論文名稱: 健康與具跌倒風險高齡者執行座椅起身與坐下的動作分析
Analysis of Sit-to-Stand and Stand-to-Sit Movements in Healthy and Faller Elderly
指導教授: 李恆儒
Lee, Heng-Ju
口試委員: 王令儀
Wang, Li-i
陳家祥
Chen, Chia-Hsiang
李恆儒
Lee, Heng-Ju
口試日期: 2021/06/18
學位類別: 碩士
Master
系所名稱: 體育與運動科學系
Department of Physical Education and Sport Sciences
論文出版年: 2022
畢業學年度: 110
語文別: 中文
論文頁數: 67
中文關鍵詞: 生物力學老人坐到站站到坐肌電圖
英文關鍵詞: biomechanics, elderly, sit-to-stand, stand-to-sit, electromyography
研究方法: 實驗設計法
DOI URL: http://doi.org/10.6345/NTNU202200431
論文種類: 學術論文
相關次數: 點閱:184下載:33
分享至:
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報
  • 目的:本研究的目的為比較健康與具跌倒風險高齡者執行起立和坐下動作的策略差異,以及起立與坐下動作的下肢運動學、動力學與肌肉活化特徵差異。方法:招募10名健康與10名過去一年內具跌倒經歷之男性高齡者。使用8台Vicon紅外線攝影機(200 Hz)、2塊Kistler測力板(1000 Hz)與6顆Delsys無線肌電(2000 Hz)同步收集動作的生物力學參數。參與者在高度等同小腿長、深度等同大腿長一半的木箱上,執行起立和坐下動作各3次。計算動作過程的執行時間;軀幹、髖、膝、踝關節矢狀面活動度;髖、膝關節伸直力矩峰值;質心左右及前後總晃動範圍,以及下肢6條肌肉:臀大肌、股二頭肌、股外側肌、股直肌、股內側肌、外側腓腸肌的肌肉活化。統計方法以獨立樣本t檢定進行組別分析,以及成對樣本t檢定分析動作的比較(α =.05)。結果:具跌倒風險高齡者在關節活動度、下肢力矩峰值、下肢肌肉活化以及質心左右晃動範圍皆顯著與健康高齡者有差異,並且起立和坐下動作在執行時間和上述參數皆有顯著差異。結論: 具跌倒風險高齡者在起立和坐下時,額狀面會有更多晃動,並採用屈曲更多軀幹、髖、膝關節,肌肉活化更高或週邊肌肉協同完成,以補償下肢力矩不足和身體的晃動。另外,起立和坐下不完全為單純相反方向的運動。

    Objective: The purpose of this study was to compare the differences in lower extremity kinematics and electromyogram between healthy and faller elderly when performing Sit-to-Stand (SitTS) and Stand-to-Sit (StandTS) movements. Methods: Ten healthy male elderly and ten male elderly who had fall history at least once in the past year were recruited for this study. Kinematics data were collected synchronously with 8 VICON cameras (200 Hz) and 2 Kistler force plates (1000 Hz). Participants were asked to perform SitTS and StandTS movements for 3 trials. Calculate the duration; sagittal range of motion (ROM) of lower extremities; lower extremities peak extension moment; center of mass (COM) total trajectory, and the 6 muscle activation of the lower extremities. Independent Sample t test and Paired Sample t test were used for statistical analysis. Alpha was set at 0.05. Result: When compare to healthy elderly, elderly fallers have significant differences in joint ROM, lower extremities peak extension moment, lower extremities muscle activation, and total COM sway distance, and there are significant differences in the duration of above parameters as well as SitTS and StandTS movements. Conclusion: Elderly fallers use more flexion of the trunk, hip and knee joints and higher muscle activation and coordination of peripheral muscles to compensate for insufficient lower extremities moment and body sway.

    第壹章 緒論 1 第一節 問題背景 1 第二節 研究問題 2 第三節 研究目的 3 第四節 研究假設 3 第五節 名詞解釋與操作性定義 4 第六節 研究範圍與限制 5 第貳章 文獻探討 6 第一節 高齡者跌倒風險相關研究 6 第二節 起立與坐下的動作分析 7 第三節 起立與坐下動作的肌電學 9 第四節 文獻總結 10 第參章 研究方法 11 第一節 研究對象 11 第二節 研究工具 11 第三節 實驗設計 21 第四節 實驗流程 22 第五節 資料處理 23 第六節 統計分析 25 第肆章 結果 26 第一節 實驗參與者基本資料 26 第二節 座椅起身與坐下的運動學特徵 27 第三節 座椅起身與坐下的動力學特徵 34 第四節 座椅起身與坐下的肌肉活化特徵 36 第五節 座椅起身與坐下的身體質心活動 44 第伍章 討論 45 第一節 健康和具跌倒風險高齡者執行動作的時間差異 45 第二節 健康和具跌倒風險高齡者執行動作的下肢活動度差異 46 第三節 健康和具跌倒風險高齡者執行動作的下肢伸直力矩峰值差異 48 第四節 健康和具跌倒風險高齡者執行動作的下肢肌肉活化差異 48 第五節 健康和具跌倒風險高齡者執行動作的身體質心活動差異 50 第六節 結論 50 第七節 建議 51 引用文獻 52 附錄一 研究參與者須知與同意書 58 附錄二 Tinetti步態與平衡評估量表 61

    衛生福利部國民健康署(2019)。106年國民健康訪問調查。取自:https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=363&pid=10523
    衛生福利部國民健康署(2018)。107年國人主要死因統計結果。取自:https://www.mohw.gov.tw/cp-16-48057-1.html
    Bento, P. C. B., Pereira, G., Ugrinowitsch, C., & Rodacki, A. L. F. (2010). Peak torque and rate of torque development in elderly with and without fall history. Clinical Biomechanics, 25(5), 450-454. doi: 10.1016/j.clinbiomech.2010.02.002
    Bhardwaj, S., Khan, A. A., & Muzammil, M. (2019). Lower limb rehabilitation using multimodal measurement of sit-to-stand and stand-to-sit task. Disability and Rehabilitation: Assistive Technology, 1-8. doi: 10.1080/17483107.2019.1629701
    Bohannon, R. W., Smith, J., Hull, D., Palmeri, D., & Barnhard, R. (1995). Deficits in lower extremity muscle and gait performance among renal transplant candidates. Archives of Physical Medicine and Rehabilitation, 76(6), 547-551. doi: 10.1016/S0003-9993(95)80509-5
    Borowicz, A., Zasadzka, E., Gaczkowska, A., Gawłowska, O., & Pawlaczyk, M. (2016). Assessing gait and balance impairment in elderly residents of nursing homes. Journal of Physical Therapy Science, 28(9), 2486-2490. doi: 10.1589/jpts.28.2486
    Burnett, D. R., Campbell-Kyureghyan, N. H., Cerrito, P. B., & Quesada, P. M. (2011). Symmetry of ground reaction forces and muscle activity in asymptomatic subjects during walking, sit-to-stand, and stand-to-sit tasks. Journal of Electromyography and Kinesiology, 21(4), 610-615. doi: 10.1016/j.jelekin.2011.03.006
    Cadore, E. L., Casas-Herrero, A., Zambom-Ferraresi, F., Idoate, F., Millor, N., Gómez, M., ... & Izquierdo, M. (2014). Multicomponent exercises including muscle power training enhance muscle mass, power output, and functional outcomes in institutionalized frail nonagenarians. Age, 36(2), 773-785. doi: 10.1007/s11357-013-9586-z
    Cadore, E. L., & Izquierdo, M. (2013). New strategies for the concurrent strength-, power-, and endurance-training prescription in elderly individuals. Journal of the American Medical Directors Association, 14(8), 623-624. doi: 10.1016/j.jamda.2013.04.008
    Cadore, E. L., Rodríguez-Mañas, L., Sinclair, A., & Izquierdo, M. (2013). Effects of different exercise interventions on risk of falls, gait ability, and balance in physically frail older adults: a systematic review. Rejuvenation Research, 16(2), 105-114. doi: 10.1089/rej.2012.1397
    Canbek, J., Fulk, G., Nof, L., & Echternach, J. (2013). Test-retest reliability and construct validity of the tinetti performance-oriented mobility assessment in people with stroke. Journal of Neurologic Physical Therapy, 37(1), 14-19. doi: 10.1097/NPT.0b013e318283ffcc
    Chorin, F., Cornu, C., Beaune, B., Frère, J., & Rahmani, A. (2016). Sit to stand in elderly fallers vs non-fallers: new insights from force platform and electromyography data. Aging Clinical and Experimental Research, 28(5), 871-879. doi: 10.1007/s40520-015-0486-1
    Chumacero-Polanco, E. A., & Yang, J. (2017, August). Fall prevention therapies for individuals with stroke: a survey. In International Design Engineering Technical Conferences and Computers and Information in Engineering Conference (Vol. 58110, p. V001T02A045). American Society of Mechanical Engineers.
    Clark, B. C., & Manini, T. M. (2008). Sarcopenia≠ dynapenia. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 63(8), 829-834. doi: 10.1093/gerona/63.8.829
    Dall, P. M., & Kerr, A. (2010). Frequency of the sit to stand task: an observational study of free-living adults. Applied Ergonomics, 41(1), 58-61. doi: 10.1016/j.apergo.2009.04.005
    Davidson, B. S., Judd, D. L., Thomas, A. C., Mizner, R. L., Eckhoff, D. G., & Stevens-Lapsley, J. E. (2013). Muscle activation and coactivation during five-time-sit-to-stand movement in patients undergoing total knee arthroplasty. Journal of Electromyography and Kinesiology, 23(6), 1485-1493. doi: 10.1016/j.jelekin.2013.06.008
    Dehail, P., Bestaven, E., Muller, F., Mallet, A., Robert, B., Bourdel-Marchasson, I., & Petit, J. (2007). Kinematic and electromyographic analysis of rising from a chair during a “Sit-to-Walk” task in elderly subjects: Role of strength. Clinical Biomechanics, 22(10), 1096-1103. doi: 10.1016/j.clinbiomech.2007.07.015
    Fotoohabadi, M. R., Tully, E. A., & Galea, M. P. (2010). Kinematics of rising from a chair: image-based analysis of the sagittal hip-spine movement pattern in elderly people who are healthy. Physical Therapy, 90(4), 561-571. doi: 10.2522/ptj.20090093
    Ganea, R., Paraschiv-Ionescu, A., Büla, C., Rochat, S., & Aminian, K. (2011). Multi-parametric evaluation of sit-to-stand and stand-to-sit transitions in elderly people. Medical Engineering & Physics, 33(9), 1086-1093. doi: 10.1016/j.medengphy.2011.04.015
    Gillespie, L. D., Robertson, M. C., Gillespie, W. J., Sherrington, C., Gates, S., Clemson, L. M., & Lamb, S. E. (2012). Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, 2012(9), CD007146. doi: 10.1002/14651858.CD007146.pub3
    Goulart, F. R. D. P., & Valls-Solé, J. (1999). Patterned electromyographic activity in the sit-to-stand movement. Clinical Neurophysiology, 110(9), 1634-1640. doi: 10.1016/S1388-2457(99)00109-1
    Hughes, M. A., Myers, B. S., & Schenkman, M. L. (1996). The role of strength in rising from a chair in the functionally imred elderly. Journal of Biomechanics, 29(12), 1509-1513. doi: 10.1016/S0021-9290(96)80001-7
    Hughes, M. A., & Schenkman, M. L. (1996). Chair rise strategy in the functionally impaired elderly. Journal of Rehabilitation Research and Development, 33(4), 409.
    Hutchinson, E. B., Riley, P. O., & Krebs, D. E. (1994). A dynamic analysis of the joint forces and torques during rising from a chair. IEEE Transactions on Rehabilitation Engineering, 2(2), 49-56. doi: 10.1109/86.313146
    Jung, Y. M., Lee, S. E., & Chung, K. S. (2006). Prevalence and associated factors of falls according to health status in elderly living in the community. Journal of the Korean Gerontological Society, 26(2), 291-303.
    Kawagoe, S., Tajima, N., & Chosa, E. (2000). Biomechanical analysis of effects of foot placement with varying chair height on the motion of standing up. Journal of Orthopaedic Science, 5(2), 124-133. doi: 10.1007/s007760050139
    Kerr, K. M., White, J. A., Barr, D. A., & Mollan, R. A. B. (1997). Analysis of the sit-stand-sit movement cycle in normal subjects. Clinical Biomechanics, 12(4), 236-245. doi: 10.1016/S0268-0033(96)00077-0
    Kuh, D., Hardy, R., Butterworth, S., Okell, L., Richards, M., Wadsworth, M., ... & Sayer, A. A. (2006). Developmental origins of midlife physical performance: evidence from a British birth cohort. American Journal of Epidemiology, 164(2), 110-121. doi: 10.1093/aje/kwj193
    Kusumoto, Y., Nitta, O., & Takaki, K. (2016). Impact of loaded sit-to-stand exercises at different speeds on the physiological cost of walking in children with spastic diplegia: A single-blind randomized clinical trial. Research in Developmental Disabilities, 57, 85-91. doi: 10.1016/j.ridd.2016.06.006
    Lamontagne, M., Beaulieu, M. L., Varin, D., & Beaulé, P. E. (2012). Lower‐limb joint mechanics after total hip arthroplasty during sitting and standing tasks. Journal of Orthopaedic Research, 30(10), 1611-1617. doi: 10.1002/jor.22127
    Lehtola, S., Koistinen, P., & Luukinen, H. (2006). Falls and injurious falls late in home-dwelling life. Archives of Gerontology and Geriatrics, 42(2), 217-224. doi: 10.1016/j.archger.2005.07.002
    Mapaisansin, P., Suriyaamarit, D., & Boonyong, S. (2020). The development of sit-to-stand in typically developing children aged 4 to 12 years: Movement time, trunk and lower extremity joint angles, and joint moments. Gait & Posture, 76, 14-21. doi: 10.1016/j.gaitpost.2019.10.030
    McDaniel, L. K., Anderson, K. O., Bradley, L. A., Young, L. D., Turner, R. A., Agudelo, C. A., & Keefe, F. J. (1986). Development of an observation method for assessing pain behavior in rheumatoid arthritis patients. Pain, 24(2), 165-184. doi: 10.1016/0304-3959(86)90039-4
    McKay, C., Prapavessis, H., & Doherty, T. (2012). The effect of a prehabilitation exercise program on quadriceps strength for patients undergoing total knee arthroplasty: a randomized controlled pilot study. Physical Medicine and Rehabilitation, 4(9), 647-656. doi: 10.1016/j.pmrj.2012.04.012
    Orr, R., De Vos, N. J., Singh, N. A., Ross, D. A., Stavrinos, T. M., & Fiatarone-Singh, M. A. (2006). Power training improves balance in healthy older adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 61(1), 78-85. doi: 10.1093/gerona/61.1.78
    Pai, Y. C., & Patton, J. (1997). Center of mass velocity-position predictions for balance control. Journal of Biomechanics, 30(4), 347-354. doi: 10.1016/S0021-9290(96)00165-0
    Panzer, V. P., Wakefield, D. B., Hall, C. B., & Wolfson, L. I. (2011). Mobility assessment: sensitivity and specificity of measurement sets in older adults. Archives of Physical Medicine and Rehabilitation, 92(6), 905-912. doi: 10.1016/j.apmr.2011.01.004
    Papa, E., & Cappozzo, A. (2000). Sit-to-stand motor strategies investigated in able-bodied young and elderly subjects. Journal of Biomechanics, 33(9), 1113-1122. doi: 10.1016/S0021-9290(00)00046-4
    Park, S. H. (2018). Tools for assessing fall risk in the elderly: a systematic review and meta-analysis. Aging Clinical and Experimental Research, 30(1), 1-16. doi: 10.1007/s40520-017-0749-0
    Parveen, H., & Noohu, M. M. (2017). Evaluation of psychometric properties of Tinetti performance-oriented mobility assessment scale in subjects with knee osteoarthritis. Hong Kong Physiotherapy Journal, 36, 25-32. doi: 10.1016/j.hkpj.2016.07.001
    Pluijm, S. M., Smit, J. H., Tromp, E. A. M., Stel, V. S., Deeg, D. J., Bouter, L. M., & Lips, P. T. A. M. (2006). A risk profile for identifying community-dwelling elderly with a high risk of recurrent falling: Results of a 3-year prospective study. Osteoporosis International, 17(3), 417-425. doi: 10.1007/s00198-005-0002-0
    Scarborough, D. M., Krebs, D. E., & Harris, B. A. (1999). Quadriceps muscle strength and dynamic stability in elderly persons. Gait & Posture, 10(1), 10-20. doi: 10.1016/S0966-6362(99)00018-1
    Shafizadehkenari, M. (2016). Movement coordination during Sit-to-Stand in low back persons. Human Movement, 17(2), 107-111. doi: 10.1515/humo-2016-0012
    Shum, G. L., Crosbie, J., & Lee, R. Y. (2005). Effect of low back pain on the kinematics and joint coordination of the lumbar spine and hip during sit-to-stand and stand-to-sit. Spine, 30(17), 1998-2004. doi: 10.1097/01.brs.0000176195.16128.27
    Shum, G. L., Crosbie, J., & Lee, R. Y. (2007). Three-dimensional kinetics of the lumbar spine and hips in low back pain patients during sit-to-stand and stand-to-sit. Spine, 32(7), 211-219. doi: 10.1097/01.brs.0000259204.05598.10
    Tinetti, M. E., Doucette, J., Claus, E., & Marottoli, R. (1995). Risk factors for serious injury during falls by older persons in the community. Journal of the American Geriatrics Society, 43(11), 1214-1221. doi: 10.1111/j.1532-5415.1995.tb07396.x
    Tinetti, M. E., Speechley, M., & Ginter, S. F. (1988). Risk factors for falls among elderly persons living in the community. New England Journal of Medicine, 319(26), 1701-1707. doi: 10.1056/NEJM198812293192604
    Tung, F. L., Yang, Y. R., Lee, C. C., & Wang, R. Y. (2010). Balance outcomes after additional sit-to-stand training in subjects with stroke: a randomized controlled trial. Clinical Rehabilitation, 24(6), 533-542. doi: 10.1177/0269215509360751
    Verbunt, J. A., Seelen, H. A., Vlaeyen, J. W., van de Heijden, G. J., Heuts, P. H., Pons, K., & Knottnerus, J. A. (2003). Disuse and deconditioning in chronic low back pain: concepts and hypotheses on contributing mechanisms. European Journal of Pain, 7(1), 9-21. doi: 10.1016/S1090-3801(02)00071-X
    World Health Organization (2018, January 16). Fact sheet 344: Falls. Retrieved from http://www.who.int/mediacentre/factsheets/fs344/en/
    Wretenberg, P., & Arborelius, U. P. (1994). Power and work produced in different leg muscle groups when rising from a chair. European Journal of Applied Physiology and Occupational Physiology, 68(5), 413-417. doi: 10.1007/BF00843738

    下載圖示
    QR CODE