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研究生: 胡昱安
Yu-an Hu
論文名稱: 低能量雷射對下肢骨膜炎之療效暨平衡功能控制表現
Evaluation of Therapeutic Effect of Low Energy Laser on Periostitis in Lower Extremity, as well as Assessment of Balance Control
指導教授: 許維君
Wei-chun Hsu
口試委員: 呂東武
Tung-wu Lu
張幸初
Shin-tsu Chang
林上智
Shang-chih Lin
陳顥齡
Hao-ling Chen
學位類別: 碩士
Master
系所名稱: 應用科技學院 - 醫學工程研究所
Graduate Institute of Biomedical Engineering
論文出版年: 2012
畢業學年度: 100
語文別: 中文
論文頁數: 72
中文關鍵詞: 骨膜炎雷射治療疼痛平衡核醫骨骼掃描
外文關鍵詞: periostitis, laser therapy, pain, balance, skeletal nuclear scintigraphy
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  • 成年人在密集的體育訓練後的小腿疼痛及無力普遍是由於骨膜炎引起伴隨著肌肉與骨骼間的問題。合乎治療的工具或設備這醫療問題仍受到限制。本研究目的為評估低能量雷射對疼痛及功能的改善暨骨骼掃描數據的影響。病人被診斷為骨膜炎,大腿及小腿疼痛者均納入。進一步以核醫骨骼掃描影像確認下肢病徵,該項檢查在診斷評估反覆性的下肢疼痛方面已被證實是有用的工具。治療方案是以低能量雷射介入五天、每天三次,劑量為1.4J/cm2。使用疼痛量表評估疼痛的嚴重程度。平衡控制的評估是透過觀察功能性結果。以雷射治療下肢骨膜炎即使是短期的介入治療上似乎有一個累積效應。


    Pain and disability in the lower legs due to periostitis is a commonly seen musculoskeletal problems in adults after internsive physical exercise. An eligible tool or device to treat the medical issue is still limited. The purpose of this study was to evaluate the therapeutice effect of low energy laser on pain and functional improvement as well as its influence on bone scan data. Patients presenting thigh and/or leg pain were enrolled after diagnosed with periostitis. It was further confirmed with a skeletal nuclear scintigraphy in lower extremity, which has been demonstrated as a valuable tool in the diagnostic evaluation of adult with persistent limb pain. Treatment protocol commenced since intervention with laser three times per day for 5 days and dosage of 1.4J/cm2 in low energy. Pain scale was used to evaluate the severity of pain. Evaluation of balance control were adopted to observe the function outcomes. The laser therapy seems have an accumulated effect in treatment of the lower limb periostitis even in a short duration of intervention.

    論文摘要 I ABSTRACT II 誌謝 III 目錄 III 圖目錄 VI 第一章 緒論 1 1.1 研究背景 1 1.1.1 骨膜炎 1 1.1.1.1 骨膜炎的介紹 1 1.1.1.2 骨骼應力對骶髂關節之影響 2 1.1.2 核子醫學造影 2 1.1.2.1 核子醫學造影的原理 3 1.1.2.2 骨骼掃描 5 1.1.2.3 骶髂關節定量比值 6 1.1.3 平衡功能 6 1.1.4 低能量雷射 7 1.1.4.1 雷射的種類 7 1.1.4.2 雷射的光學性質及儀器原理 8 1.1.4.3 低能量雷射的特性 9 1.1.4.4 雷射的生物調節效應 9 1.2 研究動機 10 1.3 研究目的 10 1.4 研究假設 11 第二章 實驗設計及方法 12 2.1 實驗設計 14 2.2 實驗對象 14 2.3 實驗設備 15 2.3.1 評估工具 15 2.3.1.1 核子醫學影像 15 2.3.1.2 疼痛視覺類比刻度尺 16 2.3.1.3 多自由度傾斜平台之平衡系統 17 2.3.2 介入治療用設備 26 2.4 統計分析 27 第三章 結果 29 3.1 雷射組治療前後之定性資料及骶髂關節定量比值 29 3.2 雷射組療程期間患處的疼痛指數 31 3.3 健康對照組第一次及間隔六週後之平衡功能控制表現 32 3.4 雷射組前測及健康對照組之平衡功能控制表現 36 3.5 雷射組治療前後之平衡功能控制表現 40 3.6 雷射組後測及健康對照組之平衡功能控制表現 44 第四章 討論 48 4.1 雷射組治療前後之定性資料及骶髂關節定量比值 48 4.2 雷射組療程期間患處的疼痛指數 48 4.3 健康對照組第一次及間隔六週後之平衡功能控制表現 49 4.4 雷射組前測及健康對照組間之平衡功能控制表現 50 4.5 雷射組治療前後之平衡功能控制表現 51 4.6 雷射組後測及健康對照組平衡功能控制表現 52 第五章 結論 54 第六章 參考文獻 55

    Gotliv, A.A., [Periostites due to over-strain in military personnel]. Voenno-Meditsinskii Zhurnal, 1959. 10: p. 68-9.
    2. Ivanova, L.A., [Diagnosis and expertise in "march periostitis"]. Voenno-Meditsinskii Zhurnal, 1970. 12: p. 30-2.
    3. Kelm, J., et al., [Sports injuries, sports damages and diseases of world class athletes practicing modern pentathlon]. Sportverletzung Sportschaden, 2003. 17(1): p. 32-8.
    4. Holmes, W.S., et al., Case report 413. Skeletal Radiology, 1987. 16(2): p. 163-165.
    5. Consolaro, A. and L. Furquim, Mecanica intrusiva gera forcas de inclinacao e estimulos ortopedicos com reposicionamento dentario e remodelacao ossea simultaneos OU Na mecanica intrusiva nao se aplica forcas de intrusao, mas obtem-se o efeito intrusivo. Dental Press Journal of Orthodontics, 2011. 16: p. 20-29.
    6. Gerow, G., et al., Compartment syndrome and shin splints of the lower leg. Journal of Manipulative & Physiological Therapeutics, 1993. 16(4): p. 245-52.
    7. 盧冠霖、胡明一、蔡宜容、黃慧貞、王玉文、王慈娟、陳昀佑、郭純琦、秦作威、張林松及林淑玟, 實用人體解剖學. 初版 ed. 2005, 臺中市: 華格納企業有限公司.
    8. Bates, P., Shin splints--a literature review. British Journal of Sports Medicine, 1985. 19(3): p. 132-7.
    9. Tweed, J.L., et al., Etiologic factors in the development of medial tibial stress syndrome: a review of the literature. Journal of the American Podiatric Medical Association, 2008. 98(2): p. 107-11.
    10. Stropek, S. and M. Dvorak, [Arthroscopic treatment for calcaneal spur syndrome]. Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca, 2008. 75(5): p. 363-8.
    11. 賴金鑫, 運動傷害. 初版二刷 ed. 1998, 臺北市: 國立空中大學.
    12. Detmer, D.E., Chronic shin splints. Classification and management of medial tibial stress syndrome. Sports Medicine, 1986. 3(6): p. 436-46.
    13. Wilder, R.P. and S. Sethi, Overuse injuries: tendinopathies, stress fractures, compartment syndrome, and shin splints. Clinics in Sports Medicine, 2004. 23(1): p. 55-81.
    14. Crockett, H.C., et al., Sacral Stress Fracture in an Elite College Basketball Player After the Use of a Jumping Machine. The American Journal of Sports Medicine, 1999. 27(4): p. 526-528.
    15. Boden, B.P., D.C. Osbahr, and C. Jimenez, Low-risk stress fractures. American Journal of Sports Medicine, 2001. 29(1): p. 100-11.
    16. Major, N.M. and C.A. Helms, Pelvic stress injuries: the relationship between osteitis pubis (symphysis pubis stress injury) and sacroiliac abnormalities in athletes. Skeletal Radiology, 1997. 26(12): p. 711-717.
    17. Nusselt, T., et al., Fatigue stress fractures of the pelvis: a rare cause of low back pain in female athletes. Acta Orthopaedica Belgica, 2010. 76(6): p. 838-43.
    18. Czarnecki, D.J., E.W. Till, and J.L. Minikel, Unique sacral stress fracture in a runner. AJR, 1988. American Journal of Roentgenology. 151(6): p. 1255.
    19. Delvaux, K. and R. Lysens, Lumbosacral pain in an athlete. American Journal of Physical Medicine & Rehabilitation, 2001. 80(5): p. 388-91.
    20. Haasbeek, J.F. and N.E. Green, Adolescent Stress Fractures of the Sacrum: Two Case Reports. Journal of Pediatric Orthopaedics, 1994. 14(3): p. 336-338.
    21. Alsobrook, J. and S.M. Simons, Sacral Stress Fracture in a Marathon Runner. Current Sports Medicine Reports, 2007. 6(1): p. 39-42 10.1097/01.CSMR.0000306555.26711.89.
    22. Lin, J.T. and J.M. Lane, Sacral stress fractures. Journal of Women's Health, 2003. 12(9): p. 879-88.
    23. Micheli, L.J. and C. Curtis, Stress fractures in the spine and sacrum. Clinics in Sports Medicine, 2006. 25(1): p. 75-88.
    24. Volpin, G., et al., Stress fractures of the sacrum following strenuous activity. Clinical Orthopaedics & Related Research, 1989(243): p. 184-8.
    25. Renstrom, P. and R.J. Johnson, Overuse injuries in sports. A review. Sports Medicine, 1985. 2(5): p. 316-33.
    26. 莊克士, 醫學影像物理學. 2006, 臺北市: 合記圖書出版社.
    27. 張永學, 核醫學. 初版四刷 ed. 2006, 北京: 科學出版社.
    28. Tsuchie, H., et al., Bilateral stress fracture of the fibulae and periostitis of the tibiae. Medical Principles & Practice, 2010. 19(6): p. 490-2.
    29. Thakore, K., A. Viroslav, and J. Vansant, Role of bone scintigraphy in the detection of periostitis in secondary syphilis. Clinical Nuclear Medicine, 1994. 19(6): p. 536-41.
    30. Loyens, M., et al., Florid reactive periostitis. Journal Belge de Radiologie, 1995. 78(3): p. 175-6.
    31. Heyman, S. and G.A. Mandell, Skeletal scintigraphy in congenital syphilis. Clinical Nuclear Medicine, 1983. 8(11): p. 531-4.
    32. Hansen, K., et al., Bone lesions in early syphilis detected by bone scintigraphy. British Journal of Venereal Diseases, 1984. 60(4): p. 265-8.
    33. Veerapen, K., et al., Periostitis in secondary syphilis: a place for bone scintigraphy. Journal of the Royal Society of Medicine, 1985. 78(9): p. 721-4.
    34. Diedrich, O., et al., [Secondary hypertrophic osteoarthropathy. Differential diagnosis of post-traumatic ossification of the interosseous crural membrane]. Unfallchirurg, 2000. 103(7): p. 597-601.
    35. Hansen-Flaschen, J. and J. Nordberg, Clubbing and hypertrophic osteoarthropathy. Clin Chest Med, 1987. 8(2): p. 287-98.
    36. Ory, P.A., D.D. Gladman, and P.J. Mease, Psoriatic arthritis and imaging. Annals of the Rheumatic Diseases, 2005. 64(suppl 2): p. ii55-ii57.
    37. Pineda, C.J., et al., Periostitis in hypertrophic osteoarthropathy: relationship to disease duration. AJR, 1987. American Journal of Roentgenology. 148(4): p. 773-8.
    38. Namey, T.C., et al., Nucleographic Studies of Axial Spondarthritides I. Quantitative Sacroiliac Scintigraphy in Early HLA-B27-Associated Sacroiliitis. Arthritis & Rheumatism, 1977. 20(5): p. 1058-1064.
    39. Lentle, B.C., et al., The scintigraphic investigation of sacroiliac disease. Journal of Nuclear Medicine, 1977. 18(6): p. 529-33.
    40. Dunn, N.A., et al., Quantitative sacroiliac scintiscanning: a sensitive and objective method for assessing efficacy of nonsteroidal, anti-inflammatory drugs in patients with sacroiliitis. Annals of the Rheumatic Diseases, 1984. 43(2): p. 157-9.
    41. Goldberg, R.P., et al., Applications and limitations of quantitative sacroiliac joint scintigraphy. Radiology, 1978. 128(3): p. 683-6.
    42. Ho, G., et al., Quantitative sacroiliac joint scintigraphy. Arthritis & Rheumatism, 1979. 22(8): p. 837-844.
    43. Chen, W.-L., Determination of the active marrow dose distribution within the paediatric pelvis and spine. Physics in Medicine and Biology, 1982. 27(1): p. 133.
    44. Shieh, S.D., et al., [Relationship between soft tissue calcification and calcium--phosphorus product in uremic patients studied by 99mTc-methylene diphosphonate bone scan]. Taiwan i Hsueh Hui Tsa Chih - Journal of the Formosan Medical Association, 1983. 82(1): p. 91-8.
    45. Guan, S.I., et al., The differential diagnosis of benign and malignant bony lesions in bone scanning. Using the ratio of radiouptake at different times. Clinical nuclear medicine, 1990. 15(6): p. 424-7.
    46. Aydoğ, E., et al., Dynamic postural balance in ankylosing spondylitis patients. Rheumatology, 2006. 45(4): p. 445-448.
    47. Alexandrov, A.V., et al., Feedback equilibrium control during human standing. Biological Cybernetics, 2005. 93(5): p. 309-22.
    48. Stelmach, G.E., et al., Age related decline in postural control mechanisms. International Journal of Aging & Human Development, 1989. 29(3): p. 205-23.
    49. Allum, J.H.J., et al., Proprioceptive control of posture: a review of new concepts. Gait & Posture, 1998. 8(3): p. 214-242.
    50. Carter, M., Movement Science Foundations for Physical Therapy in Rehabilitation, 2nd ed. Pediatric Physical Therapy, 2002. 14(4): p. 223-225.
    51. Bacsi, A.M. and J.G. Colebatch, Evidence for reflex and perceptual vestibular contributions to postural control. Experimental Brain Research, 2005. 160(1): p. 22-8.
    52. Kristinsdottir, P.-A.F., M. Magnusson, E.K., Changes in Postural Control in Healthy Elderly Subjects are Related to Vibration Sensation, Vision and Vestibular Asymmetry. Acta Oto-laryngologica, 2001. 121(6): p. 700-706.
    53. Shumway-Cook, A., S. Brauer, and M. Woollacott, Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Physical Therapy, 2000. 80(9): p. 896-903.
    54. Baldwin, S.L., T.W. VanArnam, and L.L. Ploutz-Snyder, Reliability of Dynamic Bilateral Postural Stability on the Biodex Stability System in Older Adults. Medicine & Science in Sports & Exercise, 2004. 36(5): p. S30.
    55. Karimi, N., et al., RELIABILITY OF POSTURAL BALANCE EVALUATION USING THE BIODEX BALANCE SYSTEM IN SUBJECTS WITH AND WITHOUT LOW BACK PAIN. 2011. Vol. 22. 2011.
    56. England, S., et al., Low Power Laser Therapy of Shoulder Tendonitis. Scandinavian Journal of Rheumatology, 1989. 18(6): p. 427-431.
    57. Bliddal, H., et al., Soft-laser therapy of rheumatoid arthritis. Scandinavian Journal of Rheumatology, 1987. 16(4): p. 225-8.
    58. Lirani-Galvao, A.P.R. and M. Lazaretti-Castro, Physical approach for prevention and treatment of osteoporosis. Arquivos Brasileiros de Endocrinologia e Metabologia, 2010. 54(2): p. 171-8.
    59. Vescovi, P. and S. Nammour, Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ) therapy. A critical review. Minerva Stomatologica. 59(4): p. 181-203.
    60. Hardie, E.M., C.S. Carlson, and D.C. Richardson, Effect of Nd:YAG laser energy on articular cartilage healing in the dog. Lasers in Surgery and Medicine, 1989. 9(6): p. 595-601.
    61. 廖文炫、張梅蘭、蔡美文及王淑芬, 物理因子治療學. 初版五刷 ed. 冷、熱、光、水療及機械性治療. 2006, 臺北市: 合記圖書出版社.
    62. 行政院國家科學委員會光電小組, 雷射醫學. 初版二刷 ed. 原理及臨床應用. 2003, 臺北市: 行政院國家科學委員會.
    63. 閻吉祥, 雷射原理與技術. 初版 ed. 2007, 臺北縣: 新文京開發出版股份有限公司.
    64. Hecht, J., The Laser Guidebook. Second Edition ed. 1992, PA, U .S . A . TAB Books, Blue Rides Summit.
    65. Svelto, O., Principles of Lasers. Third Edition ed. 1989, New York, U .S .A . Plenum.
    66. Tafur, J. and P.J. Mills, Low-intensity light therapy: exploring the role of redox mechanisms. Photomedicine and Laser Surgery, 2008. 26(4): p. 323-8.
    67. Gebbers, N., et al., Water-filtered infrared-A radiation (wIRA) is not implicated in cellular degeneration of human skin. Ger Med Sci, 2007. 14(5).
    68. Applegate, L.A., et al., Induction of the putative protective protein ferritin by infrared radiation: implications in skin repair. International journal of molecular medicine, 2000. 5(3): p. 247-51.
    69. 行政院國科會光電小組, 雷射醫療(二). 1992, 臺北市: 行政院國家科學委員會.
    70. Huskisson, E.C., MEASUREMENT OF PAIN. The Lancet, 1974. 304(7889): p. 1127-1131.
    71. Biodex, Balance System SD Operation/Service Manual: Biodex Medical Systems, Inc.
    72. Shomina, S.A., V.V. Bogatov, and V.M. Chervinets, [Clinical-microbiological evaluation of the efficacy of combined use of chitosan, low intensity laser radiation and photosensitizer in treatment of patients with acute suppurative maxillofacial periostitis]. Stomatologiia, 2005. 84(3): p. 23-6.

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