背景：隨著年齡的增長，退化性疾病也隨之而來，退化性關節炎為造成老年人疼痛與失能的主要疾病，其中又以膝關節最易好發。關節的退化與肌力的不足影響許多功能活動表現，而坐到站為日常常見的重複性動作，退化性膝關節炎患者因肌力不足與疼痛，在動作期間會產生異常的生物力學型式，故為改善上述問題，本研究參照臨床退化性膝關節炎建議治療，將生物力學介入與運動治療合併，開發一改良式膝關節護具，期望能延緩一般人膝關節退化之速度。目的：(1)探討改良式膝關節護具，是否能提供膝伸直肌或膝屈曲肌肌力訓練與協助動作完成之功用。(2) 欲探討穿戴改良式膝關節護具對於日常功能活動-坐到站於動作期間，膝關節動作、受力及肌肉收縮上的立即變化。設計：交叉設計(crossover design)。方法：徵收20名健康受試者，在無穿戴膝護具與穿戴三種膝護具(護具一、二、三)情況下進行動作測試，動作測試分為2種：(1) 訓練肌肉與協助動作測試：量測膝伸直與膝彎曲動作時，膝伸直肌和膝屈曲肌的肌電訊號變化；(2)功能活動─坐到站測試：量測坐到站於動作期間，膝關節動作、受力及肌電訊號的變化。而資料分析上先計算三種膝護具情況與無穿戴膝護具的改變量，再進行三種護具下膝關節動作、受力及肌電訊號的比較。結果：在訓練肌肉與協助動作測試中，發現穿戴改良式膝關節護具可提供膝伸直肌或膝屈曲肌肌力訓練與協助動作完成之功用；在坐到站測試中發現穿戴護具二在動量相應期間比起傳統膝護具可在做坐到站動作時產生訓練之功用；而穿戴護具三在動量相應期間可協助肌肉完成坐到站動作。結論：穿戴改良式膝關節護具比起傳統膝護具可提供肌力訓練與協助動作之功效，若可善用此護具的特性，將治療訓練與協助完成日常活動並用，期望此護具能延緩一般人膝關節退化之速度，且有更好的生活品質。Background: With age increasing, degenerative disease also arise with it. Osteoarthritis(OA) is the main cause of pain and disability in the elderly. The knee joint is most commonly affected by OA. Both joint degeneration and lack of muscle strength may influence many functional activities. Sit to stand(STS) is a complex motion routinely repeated in daily life. People with knee OA may perform abnormal biomechanical pattern during STS, because of muscle weakness and pain. In order to improve the above problems, this study is to develop a modified knee brace which is combined protection and exercise for OARSI clinical guideline recommended. This modified knee brace is expected to delay joint degeneration. Purpose: (1) Whether people with modified knee brace could provide knee extensor or flexor training and assisting on action. (2) To investigated that people with modified knee brace would immediately affect on the knee joint action, moment and muscle activation during STS. Design: Crossover design. Method: 20 healthy subjects participated in this study. Subjects were tested in 4 conditions (E.g.: no knee brace and with 3 different types of knee brace ). Motion test was divided into (1) Muscle training and assisting action test (MT & AA test): Knee extensor or flexor was measured in electromyographic(EMG) changes during knee extension movement or flexion movement. (2) Functional activity- STS test: Measuring knee joint action, moment and EMG changes during STS. In data analysis, Parameters of 3 different brace conditions were separately compared with no brace condition first, and then receiving 3 different brace “changes”. Next, compared knee joint action, moment and EMG parameter among 3 different brace “changes”. Results: The MT & AA test indicated that subjects with modified knee brace could provide knee extensor or flexor strength training and assisting on action. In STS test, people with brace II had more benefit of training than other braces in momentum phase, while people with brace III had more benefit of assisting than other braces in momentum phase. Conclusion: The modified knee brace could strengthen and assist around knee joint muscles of healthy adults. If we can make good use of the modified knee brace which is expected to delay knee joint degeneration and to have better functional activity.
