碩士 / 國立臺灣科技大學 / 醫學工程研究所 / 107 / Mal-alignment at the knee could not only alter the knee compartment space, but also being reported as risk factor of several musculoskeletal disorders of the knee such as knee osteoarthritis, patella-femoral osteoarthritis, and anterior cruciate ligament injury. Previous studies suggested that mal-alignment affected biomechanical variables during level walking, squat and stair ascent/descent tasks, such as knee abductor moment, knee adduction angle, and knee internal rotation angle. Unloading knee brace could be used clinically as a non-surgical treatment for mild to moderate mal-alignment at the knee. It can alter knee loadings through three-point bending force-correction system. Researches have shown that unloading knee brace was helpful in decreasing knee loadings. However, some studies also reported no significant difference after applying unloading knee brace. The effect of unloading knee brace need more investigations. In addition, knee strength is also an important factor to influence biomechanical performance. Previous studies have adopted different means of strength evaluation methods to correlate with biomechanical variables. Nevertheless, there is no consensus about the muscle contraction type or speed to evaluate the strength. Therefore, the purpose of this study is to find the interactive effect of knee alignment and unloading knee brace in gait, squat, and stair ascent/descent tasks and to correlate biomechanical variables with knee strength through different strength evaluation methods. Results suggested that strength variables was highly correlated with biomechanical variables calculated at knee and hip joints, indicating that knee strength influences movements both at the hip and knee joints. These compensation of inadequate strength at the knee occurs not only in sagittal plane but also in frontal plane and transverse plane. For the effect of knee brace, positive effects during level walking were found that knee loading decreases while muscle contraction increases in both affected side and sound side when applying knee brace. However, caution should be paid as some variables were found as the risk factor of injury when applying knee brace. For the comparison between varus and valgus group, hip external rotation moment, knee adduction angle, knee abduction moment, and ankle invertor moment have been found to be significant different between groups. Between group difference was also found in knee external rotation angle, representing that frontal plane mal-alignment also affects transverse plane movement. In addition, these group difference happens not only in knee joint but also in hip and ankle joint. Increased sample size is suggested for future study in order to have sufficient statistical power and better application of the data. Two factors statistical analysis should be applied in various functional movements in order to have throughout understanding of the effect of brace and mal-alignment at the knee.
| Identifer | oai:union.ndltd.org:TW/107NTUS5159017 |
| Date | January 2019 |
| Creators | Yah-Shiun Jiang, 姜雅薰 |
| Contributors | Wei-Chun Hsu, 許維君 |
| Source Sets | National Digital Library of Theses and Dissertations in Taiwan |
| Language | en_US |
| Detected Language | English |
| Type | 學位論文 ; thesis |
| Format | 61 |
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