進階搜尋


   電子論文尚未授權公開,紙本請查館藏目錄
(※如查詢不到或館藏狀況顯示「閉架不公開」,表示該本論文不在書庫,無法取用。)
系統識別號 U0026-1908201415351200
論文名稱(中文) 探討年齡對整體盂肱關節前後向關節滑動動作之機械特性-機械手臂活體測試
論文名稱(英文) The Effects of Aging on Mechanical Properties of Anteroposterior Glide on the Glenohumeral Joint en Masse: In Vivo Robotic Testing
校院名稱 成功大學
系所名稱(中) 物理治療學系
系所名稱(英) Department of Physical Therapy
學年度 102
學期 2
出版年 103
研究生(中文) 蔡孟亘
研究生(英文) Meng-Shiuan Tsai
學號 T66014030
學位類別 碩士
語文別 英文
論文頁數 102頁
口試委員 指導教授-徐阿田
口試委員-周一鳴
口試委員-張志涵
口試委員-蔡一如
中文關鍵字 老化  盂肱關節  前後向滑動  力量-位移曲線 
英文關鍵字 Aging  Glenohumeral joint  Anteroposterior glide  Load-Displacement Curve 
學科別分類
中文摘要 實驗背景與目的:老化(aging)是個漸進、廣泛、可預期的過程。隨著老化產生諸多如生物力學、型態學、生化學等的變化。盂肱關節(glenohumeral joint)的活動受到眾多關節囊與韌帶的引導,老化不僅會造成關節囊與韌帶在結構上的改變,更會進一步影響盂肱關節的生物機械特性,例如:關節活動度、位移量、力量、剛性。本研究使用穩定度與信效度高之機械手臂配合力量-位移曲線(load-displacement relation)來做關節機械特性的探討,是較具標準化且具臨床意義的方法。因此,嘗試將關節位置與特定結締組織的老化程度列入考量,並利用力量-位移曲線描繪出不同情境下之關節機械特性,古典的理論觀念,例如圓體穩定觀念及凹凸定律或許需再行討論與修正。本研究之目的為:探討年齡與性別對於不同旋轉角度與正中姿勢下的盂肱關節,在執行前後向滑動動作時,其機械特性的變化。
實驗方法:本研究藉由六軸機械手臂模擬執行關節前後向滑動動作時所測得的力量-位移曲線資料,量化22位年輕(平均年齡23.95 ± 2.01歲)和16位老年(平均年齡55.38 ± 5.71歲)之健康受試者之肩關節在外轉60度、正中姿勢、及內轉60度時進行關節前後向滑動的動作。執行試驗時,受試者仰躺,肱骨固定在肩胛骨平面位置,手臂施予垂直肩胛骨平面、最大達7公斤之穩定等速力量於受試者之肱骨近體端。接著分析力量位移-曲線之:1. 趾區(Toe region)開始(T1);2. 趾區結束(T2);3. neutral zone與linear elastic region交點; 4. 最大力量輸出之相對應之位移、力量、與剛性。運用重複量數三因子混合模型變異數分析(3-way mixed model ANOVA with repeated measures),進一步探討年齡、性別、與關節位置對以上參數的影響。
結果:年齡對位移、T1及T2點的力量、與T2點以外的所有剛性參數皆有影響。年輕組中,在T1點與相對應neutral zone-linear elastic兩線交點之曲線上交點處,外轉相較於內轉有較大之位移量;而在T2與趾區情形相反,內轉相較於外轉有較大之位移量。老年組在T2與趾區則是始終維持內轉相較於外轉有較大之位移量。除此之外,在趾區時,年輕組的內轉剛性較正中姿勢剛性大,老年組則呈現正中姿勢剛性較內轉剛性大。性別對所有參數沒有顯著影響。
結論:年齡造成盂肱關節的剛性增加,切確來說,對其機械特性與力量-位移關係有影響,並在盂肱關節結構上造成鑑別性的改變。此外,肩關節在執行前後向動作時,外轉位置野所造成較小的位移量也說明:除了古典理論中提及後關節囊會造成首要限制,喙肱韌帶與肩旋轉肌交界處之關節囊等次要限制,同樣將影響肩關節之柔軟度與活動度。除了圓圈穩定度觀念及凹凸定律在對於盂肱關節的應用上,需要重新被定義與修正;臨床上處理盂肱關節活動度低落的問題時,喙肱韌帶與肩旋轉肌交界處之關節囊也是需要列入考慮處理的對象之一。
英文摘要 Background and purpose: Aging brings about a series of progressive and broadly predictable changes in the connective tissues, especially, in collagen, the essential substance of many connective tissues including capsules or ligaments. Aging changes in the capsuloligamentous structures of glenohumeral joint (GHJ) brings about alterations in the mechanical properties, such as load-displacement relation. A load-displacement relation is essential for the identification of the underlying mechanics of the motion employed, and could depict the characteristics of GHJ more clinically. With the consideration of different joint positions and the extent of aging of the specific connective tissues, traditional concepts, such as “Circle stability concept” and “Concave-convex rule”, might need to be reconsidered and modified. The purpose of this study was to investigate age and gender related changes in mechanical properties of the GHJ during APG movement in neutral and rotated positions.

Materials and methods: The young group included 22 participants (23.95±2.01y/o) and the elderly group comprised 16 middle-aged/elderly participants (55.38±5.71y/o). With the participant lying supine his/her right humerus was positioned in 30° elevation in the plane of scapula. The APG was performed by a 6-DOF robot with a ramped load up to 7 Kg on the proximal humerus in a direction perpendicular to the plane of scapula. Participants were tested in 60° external rotation (ER), neutral rotation (NP), and 60° internal rotation (IR) in a random order. The displacement of the head of humerus and the applied load were registered by the robot and a 6 component load cell installed at its distal end. The displacement, force, and stiffness at the following points on the load-displacement curves were computed: 1) beginning of toe-region (T1), 2) end of toe-region (T2), 3) intersection of lines representing neutral-zone and linear-elastic region, and 4) the maximal loading level. A 3-way mixed model ANOVA with repeated measures was employed to assess effects of age, gender, and joint position for all parameters.

Result: Age effects were observed in all displacement parameters (p ranged from .000-.018; Young group > Elderly group at T1 and the correlated intersection on the load-displacement curve; Elderly group > Young group at T2, Toe, and 7Kg), force at point T1 and T2 (p=.017 and .000), and all stiffness parameters (p ranged from .000-.042; Elderly group > Young group) with the exception of point T2. The value of displacement in ER was greater than that of IR in the young group at the correlated intersection point of neutral zone-linear elastic region intersection (ER>IR), but the precedence was reversed at point T2 (IR>ER), while measurements from the elderly group consistently maintained the same ranking (IR>ER) at the toe region and point T2. Furthermore, in the young group, the stiffness at the toe region was greater in IR than in NP (IR>NP, t=-2.272, p=.034) while the opposite was true in the elderly group (NP>IR, t=2.381, p=.031). No gender effect was found in the present study.

Conclusions: Aging brings about changes in GHJ in its load-displacement relation. The stiffness of the toe region in IR was greater than in NP in the young group. However, the priority was reversed in the elderly group. Such results are, most likely, brought about by differential changes due to aging in structures of GHJ. Despite of age and gender, the displacement of ER remained the smallest from toe region to the maximal loading phase, indicating that in addition to the posterior capsule restraints, other capsuloligamentous constraints, such as CHL and RIC, might also had an impact on the mobility and flexibility of GHJ during APG movement. Therefore, it is necessary to modify the concave-convex rule and the circle stability concept when considering their application to the GHJ. Additional considerations such as CHL and RIC are necessary when dealing with hypomobility issues of the GHJ.
論文目次 中文摘要………………………………………………………………….………..Ⅰ
ABSTRACT……………………………………………………………….….……Ⅲ
致謝……………………………………………………………………….……..…Ⅵ
CONTENTS……………………………………………………………….……….Ⅷ
TABLE LIST…………………………………………………………….………ⅩⅡ
FIGURE LIST…………………………………………….………………..…....ⅩⅤ
CHAPTER 1 INTRODUCTION………………………..……………………….1
1.1 Normal Aging in the musculoskeletal system………………………..….....1
1.1.1 Biomechanical change of aging…………………………………...….1
1.1.2 Morphological change of aging………………………………………3
1.2 Biomechanics of Glenohumeral Joint…………………..………..…….…..5
1.2.1 Anatomic arrangement of RIC and CHL…..…………………..……....6
1.2.2 Mechanical properties of shoulder joint capsule……………..………..8
1.2.3 Circle stability concept and Concave-convex rule..……………….....11
1.3 Related Literature…………………………………………..……….....….14
1.3.1 Load-Displacement Curve…………………………………………..14
1.3.2 In Vivo Robotic Testing……………………………………………..22
1.4 Motivation and Purpose……………………………………..……….........23
CHAPTER 2 MATERIALS and METHODS……………………………......…24
2.1 Participant……………………………………………..……………....….24
2.2 Instrument…….………………………………..………………...…….....25
2.3 Experimental Procedures……………………………………….……...…28
2.4 Data Processing……………………………………..………….…...……30
2.4.1 Phase Definition……………………………………..……..…...……31
2.4.2 Outcome Measures……………………………………..….…...……33
2.5 Statistical Analyses……………………………………..……….…..……34
CHAPTER 3 RESULTS…………………………………………..…….………35
3.1 Basic Data………………………………………..………………...……..35
3.2 Reliability…………………………………………………..……….……36
3.3 Displacement Parameters……………………….………………………..37
3.3.1 Age effect……………………………………………………….……37
3.3.2 Gender effect…………………………………..……..…………....…38
3.3.3 Main Effect of Joint Position………………….………………..……38
3.3.4 Interaction………………………………………..………….……….39
3.4 Force Parameters……………………………………….…………..….....40
3.4.1 Age effect……………………………………..…….....………..……40
3.4.2 Gender effect…………………………………………..………..……40
3.4.3 Main Effect of Joint Position………………………….………..……41
3.4.4 Interaction…………………………………………..….…………….41
3.5 Stiffness Parameters……………………………………..….……………42
3.5.1 Age effect……………………………………..…………..…….……42
3.5.2 Gender effect………………………………………..……..…………42
3.5.3 Main Effect of Joint Position……………………………….……..…42
3.5.4 Interaction…………………………………………..……….……….43
CHAPTER 4 DISCUSSION…………………………………………….…..….63
4.1 Characteristics of the Participants…………………………………..……63
4.2 Age effect…………………………….…………………….………….…65
4.3 Gender effect………………………………………………..……………70
4.4 Main Effect of Joint Position………………………………..……………73
4.5 Limitations……………………………………………………..………....78
4.6 Clinical Relevance…………………………….……………….…………79
CHAPTER 5 CONCLUSION…………………………….………….…………80
References………………………….……………………………………….…...…81
參考文獻 Abate M, Schiavone C, Pelotti P, Salini V. Limited joint mobility in diabetes and ageing: recent advances in pathogenesis and therapy. Int J Immunopathol Pharmacol. 2010;23(4):997-1003.
Alnaqeeb MA, Al Zaid NS, Goldspink G. Connective tissue changes and physical properties of developing and ageing skeletal muscle. Journal of anatomy 1984;139(4):677.
Amini R, Voycheck CA, Debski RE. A method for predicting collagen fiber realignment in non-planar tissue surfaces as applied to glenohumeralcapsule during clinically relevant deformation. J Biomech Eng. 2014;136(3):031003.
Aniansson A, Grimby G, Hedberg M. Compensatory muscle fiber hypertrophy in elderly men. J Appl Physiol. 1992;73:812-816.
Araújo CGS. Flexibility assessment: normative values for flexitest from 5 to 91 years of age. Arq Bras Cardiol. 2008;90(4):257-263.
Bailey AJ. Extracellular and Supporting Structures. Comprehensive Biochemistry 1968;26B.
Bak K, Magnusson SP. Shoulder strength and range of motion in symptomatic and pain-free elite swimmers. Am J Sports Med. 1997;25(4):454-459.
Barnes CJ, Van Steyn SJ, Fischer RA. The Effects of Age, Sex, and Shoulder Dominance on Range of Motion of the Shoulder. J Shoulder Elbow Surg. 2001;10:242-246.
Bell DR, Blackburn JT, Norcorss MF, Ondrak KS, Hudson JD, Hackney AC, Padua DA. Estrogen and muscle stiffness have a negative relationship in females. Knee Surg Sports Traumatol Arthrosc. 2012;20(2):361-367.
Bell RD, Hoshizaki TB. Relationships of age and sex with range of motion of seventeen joint act ions in humans. Can j Appl Sport Sci.1981;6:202-206.
Bellew JW, Symons TB, Vandervoort AA. Geriatric Fitness Effects of Aging and Recommendations for Exercise in Older Adults. Cardiopulmonary Physical Therapy Journal. 2005;16(1):20-31.
Beltran J, Rosenberg ZS, Chandnani VP, Cuomo F, Beltran S, Rokito A. Glenohumeral instability: evaluation with MR arthrography. Radiographics. 1997;17(3):657-573.
Benjamin M, Tyers RN, Ralphs JR. Age-related changes in tendon fibrocartilage. J Anat. 1991;179:127-136.
Bennett WF. Subscapularis, medial, and lateral head coracohumeral ligament insertion anatomy: arthroscopic appearance and incidence of “hidden” rotator interval lesions. Arthroscopy 2001;17:173-180.
Berman R, Haxby JV, Pomerantz RS. Physiology of aging, part 1: normal changes. Patient Care 1988;22:20-36.
Bernick S, Walker JM, Paule WJ. Age Changes to the Anulus Fibrosus in Human Intervertebral Discs. Spine 1991;16(5):520-524.
Bigliani LU, Pollock RG, Soslowsky LJ, Flatow EL, Pawluk RJ, Mow VC. Tensile properties of the inferior glenohumeral ligament. J Orthop Res. 1992;10(2):187-197.
Blasier RB, Goldburg RE, Rothman ED. Anterior shoulder stability: contributions of rotator cuff forces and the capsular ligaments in a cadaver model. J Shoulder Elbow Surg. 1992;1:140-150.
Blasier RB, Soslowsky LJ, Malicky DM, et al. Posterior glenohumeral subluxation: Active and passive stabilization in a biomechanical model. J Bone Joint Surg Am. 1997;79:433-440.
Boardman ND III, Debski RE, Warner JJP, et al. Tensile properties of the superior glenohumeral and coracohumeral ligaments. J Shoulder Elbow Surg. 1996;5:249-254.
Bokor DJ. Variability of measurement of glenoid version on computed tomography scan. J Shoulder Elbow Surg. 1999;8(6):595-598.
Borsa PA, Laudner KG, Sauer EL. Mobility and Stability Adaptations in the Shoulder of the Overhead Athlete. Sports Medicine 2008;38(1):17-36.
Borsa PA, Sauers EL, Herling DE. Glenohumeral Stiffness Response Between Men and Women for Anterior, Posterior, and Inferior Translation. J Athl Train. 2002;37(3):240-245.
Borsa PA, Sauers EL, Herling DE. Patterns of glenohumeral joint laxity and stiffness in healthy men and women. Med Sci Sports Exerc. 2000;32:1685-1690.
Borsa PA, Sauers EL, Herling DE, Manzour WF. In vivo quantification of capsular end-point in the nonimpaired glenohumeral joint using an instrumented measurement system. J Orthop Sports Phys Ther. 2001;31:427-431.
Bowen MK,Warren RF. Ligamentous control of shoulder stability based on selective cutting and static translation experiments. Clin Sports Med. 1991;10:757-782.
Brandt C, Sole G, Krause MW, and Nel M. An evidence-based review on the validity of the Kaltenborn rule as applied to the glenohumeral joint. Man Ther. 2007;12(1):3-11.
Brewer BJ. Aging of the Rotator Cuff. Am J Sports 1979;7(2):102-110.
Brown WF, Strong MJ, Snow R. Methods for estimating numbers of motor units in biceps–brachialis muscles and losses of motor units with aging. Muscle Nerve 1988;11:423-432.
Buckwalter JA, Woo SL, Goldberg VM, Hadley EC, Booth F, Oegema TR, Eyre DR. Soft-tissue aging and musculoskeletal function. J Bone Joint Surg Am. 1993;75(10):1533-1548.
Cain PR, Mutschler TA, Fu FH, et al. Anterior stability of the glenohumeral joint: A dynamic model. Am J Sports Med. 1987;15:144-148.
Chandran PL, Paik DC, Holmes JW. Structural mechanism for alteration of collagen gel mechanics by glutaraldehyde crosslinking. Connect Tissue Res. 2012;53(4):285-297.
Ciccone WJ 2nd, Hunt TJ, Lieber R, Pedowitz R, Esch J, Tasto JP. Multiquadrant digital analysis of shoulder capsular thickness. Arthroscopy 2000;16(5):457-461.
Clarnette RC, Miniaci A. Clinical exam of the shoulder. Med Sci Sports Exerc. 1998;30(4 Suppl):1-6.
Conn PM. Handbook of Models for Human Aging. Amsterdam, Netherlands: Elsevier Science; 2011.
Connell D, Padmanabhan R, Buchbinder R. Adhesive capsulitis: role of MR imaging in differential diagnosis. Eur Radiol. 2002;12:2100-2106.
Connor PM, Banks DM, Tyson AB, Coumas JS, D’Alessandro DF. Magnetic Resonance Imaging of the Asymptomatic Shoulder of Overhead Athletes: A 5-Year Follow-up Study. Am J Sports Med. 2003;31(5):724-727.
Cooper DE, O’Brien SJ, Arnoczky SP, et al. The structure and function of the coracohumeral ligament: An anatomic and microscopic study. J Shoulder Elbow Surg 2. 1993;70-77.
Curl LA, Warren RF. Glenohumeral joint stability. Selective cutting studies on the static capsular restraints. Clin Orthop. 1996;330:54-65.
Daley MJ, Spinks WL. Exercise, mobility and aging. Sports Med. 2000;29(1):1-12.
DeGroot J, Verzijl N, Budde M, Bijlsma JW, Lafeber FP, TeKoppele JM. Accumulation of advanced glycation end products decreases collagen turnover by bovine chondrocytes. Exp Cell Res. 2001a;266(2):303-310.
DeGroot J, Verzijl N, Jacobs KM, Budde M, Bank RA, Bijlsma JW, TeKoppele JM, Lafeber FP. Accumulation of advanced glycation endproducts reduces chondrocyte-mediated extracellular matrix turnover in human articular cartilage. Osteoarthritis Cartilage 2001b;9(8):720-726.
DeGroot J, Verzijl N, Wenting-Van Wijk MJ, Bank RA, Lafeber FP, Bijlsma JW, TeKoppele JM. Age-related decrease in susceptibility of human articular cartilage to matrix metalloproteinase-mediated degradation: the role of advanced glycation end products. Arthritis Rheum 2001c;44(11):2562-2571.
Debski RE, Sakane M, Woo SL, Wong K, Fu FH, Warner JJ. Contribution of the passive properties of the rotator cuff to glenohumeral stability during anterior-posterior loading. J Shoulder Elbow Surg. 1999;8:324-329.
Einkauf DK, Gohdes ML, Jensen GM, Jewell MJ. Changes in spinal mobility with increasing age in women. Phys Ther. 1987;67:370-375.
Enzi G, Gasparo M, Biondetti PR, Fiore D, Semisa M, Zurlo F. Subcutaneous and visceral fat distribution according to sex, age, and overweight, evaluated by computed tomography. Am J Clin Nutr. 1986;44(6):739-746.
Evans WJ. What is sarcopcnia? J Gerontol Bio Sci Med Sci. 1995;50:A5-8.
Fahy GM, West MD, Harris SB. The future of aging: pathways to human life extension. 7th ed. Springer Netherlands; 2010.
Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods 2009;41:1149-1160.
Ferrari DA. Capsular ligaments of the shoulder: Anatomical and functional study of the anterior superior capsule. Am J Sports Med. 1990;18(1):20-24.
Friedman RJ. Glenohumeral capsulorrhaphy. In: Matsen FA, Fu FH, Hawkins RJ, eds. The Shoulder: A Balance of Mobility and Stability. Rosemont, IL: American Academy of Orthopaedic Surgeons; 1993:445-458.
Frischknecht R. Effect of training on muscle strength and motor function in the elderly. Rep Nutr Dev. 1998;38:167-174.
Gagey OJ, Boisrenoult P. Shoulder capsule shrinkage and consequences on shoulder movements. Clin Orthop Relat Res. 2004;218-222.
Gay S, Gay ER, Miller JE. The collagens of the joint. Arthritis Rheum. 1980;23:937.
Gay S, Miller JE. Collagen in the Physiology and Pathology of Connective Tissue. New York: Gustav Fischer; 1978.
Gerber C, Ganz R. Clinical assessment of instability of the shoulder: with special reference to anterior and posterior drawer tests. J Bone Joint Surg Br. 1984;66:551-556.
Gohlke F, Essigkrug B, Schmitz F. The pattern of the collagen fiber bundles of the capsule of the glenohumeral joint. J Shoulder Elbow Surg. 1994;3(3):111-28.
Goswami T. Human Musculoskeletal Biomechanics. Croatia: InTech; 2012.
Hansen M, Kongsgaard M, Holm L, Skovgaard D, Magnusson SP, Qvortrup K, Larsen JO, Aagaard P, Dahl M, Serup A, Frystyk J, Flyvbjerg A, Langberg H, Kjaer M. Effect of estrogen on tendon collagen synthesis, tendon structural characteristics, and biomechanical properties in postmenopausal women. J. Appl. Physiol. 2009;106:1385-1393.
Harkness RD, Harkness MLR. Functional aspects on the aging of connective tissues: Functional aspects of extracellular material and age. Scandinavian Journal of Clinical & Laboratory Investigation 1974;34(S141):45-56.
Harryman DT, Sidles JA, Harris SJ, Matsen FA. The role of the rotator interval capsule in passive motion and stability of the shoulder. J Bone Joint Surg Am. 1992;74:53-66.
Harryman DT, Sidles JA, Harris BS, Matsen FA. Laxity of normal glenohumeral joint: a quantitative in vivo assessment. J Shoulder Elbow Surg. 1992;1:66-76.
Hawkins RJ, Mohtadi GH. Clinical evaluation of shoulder instability. Clin J Sport Med. 1991;1:59-64.
Herbert C, Jayson MI, Bailey AJ. Joint capsule collagen in osteoarthrosis. Ann Rheum Dis. 1973; 32(6): 510-514.
Hertling D, Kessler RM. Management of common musculoskeletal disorders, physical therapy principles and methods. 3rd ed. Philadelphia: Lippincott; 1996.
Ho KY and Hsu AT. Displacement of the Head of Humerus while Performing “Mobilization with Movements” in Glenohumeral Joint: A Cadaver Study. Manual Therapy 2009;14:160-166.
Hobara H, Kato E, Kobayashi Y, Ogata T. Sex differences in relationship between passive ankle stiffness and leg stiffness during hopping. J Biomech. 2012;45(16):2750-2754.
Hsu AT, Chiu JF, Chang JH. Biomechanical Analysis of Axial Distraction Mobilization of the Glenohumeral Joint - A Cadaver Study. Manual Therapy 2009;14:381-386.
Hsu AT, Hedman T, Chang JH, et al. Changes in abduction and rotation range of motion in response to simulated dorsal and ventral translational mobilization of the glenohumeral joint. Phys Ther. 2002;82:544-556.
Hsu AT, Ho L, Chang JH, Chang GL, and Hedman T. Characterization of Tissue Resistance during a Dorsally Directed Translational Mobilization of the Glenohumeral Joint. Arch Phys Med Rehabil. 2002;83(3):360-366.
Hsu AT, Ho L, Ho S, Hedman T. Immediate response of glenohumeral abduction range of motion to a caudally directed translational mobilization: a fresh cadaver simulation. Arch Phys Med Rehabil. 2000;81:1511-1516.
Hsu AT, Ho L, Ho S, Hedman T. Joint position during anterior-posterior glide mobilization: its effect on glenohumeral abduction range of motion. Arch Phys Med Rehabil. 2000;81(2):210-214.
Hughes RE, Johnson ME, and O’Driscoll SW. Age-Related Changes in Normal Isometric Shoulder Strength. The American Journal of Sports Medicine 1999;27(5):651-657.
Hunt SA, Kwon YW, Zuckerman JD. The Rotator Interval: Anatomy, Pathology, and Strategies for Treatment. J Am Acad Orthop Surg. 2007;15(4):218-227.
Hurschler C, Loitz-Ramage B, Vanderby R, Jr. A structurally based stress-stretch relationship for tendon and ligament. J Biomech Eng. 1997;119:392-399.
Itoi E, Berglund LJ, Grabowski JJ, Naggar L, Morrey BF, An KN. Superior–inferior stability of the shoulder: role of the coracohumeral ligament and the rotator interval capsule. Mayo Clin Proc. 1998;73:508-515.
Izumi T, Aoki M, Tanaka Y, Uchiyama E, Suzuki D, Miyamoto S, and Fujimiya M. Stretching positions for the coracohumeral ligament: Strain measurement during passive motion using fresh/frozen cadaver shoulders. Sports Med Arthrosc Rehabil Ther Technol. 2011;9;3(1):2.
Johns RJ, Wright V. Relative importance of various tissues in joint stiffness. J Appl Physiol. 1962;17:824-828.
Johnson AJ, Godges JJ, Zimmerman GJ, Ounanian LL. The effect of anterior versus posterior glide joint mobilization on external rotation range of motion in patients with shoulder adhesive capsulitis. J Orthop Sports Phys Ther. 2007;37(3):88-99.
Johnson DH, Pedowitz RA. Practical Orthopaedic Sports Medicine & Arthroscopy. 1st ed. Philadelphia: Lippincott Williams & Wilkins; 2007.
Johnson GR, Fife NCM, Heward M. Ranges of movement at the shoulder complex using an electromagnetic movement sensor. Ann Rheum Dis. 1991;50:824-827.
Jorgić B, Pantelić S, Milanović Z. Functional Fitness Changes Regarding the Level of Physical Activity in Older Adults. Acta Kinesiologica. 2013;1:17‐21.
Jost B, Koch PP, Gerber C. Anatomy and func-tional aspects of the rotator interval. J Shoulder Elbow Surg. 2000;9:336-341.
Kaltenborn FM, Evjenth O. Manual mobilization of the extremity joints. Basic examination and treatment techniques (I). 4th ed. Oslo: Olaf Norlin Bokhandel; 1989.
Kaltsas DS. Comparative Study of the Properties of the Shoulder Joint Capsule with Those of Other Joint Capsules. Clinical Orthopaedics & Related Research 1983;173:20-26.
Kanehisa H, Miyatani M, Azuma K, Kuno S, Fukunaga T. Influences of age and sex on abdominal muscle and subcutaneous fat thickness. European Journal of Applied Physiology. 2004;91(5):534-537.
Kim YS, Lee HJ, Park IJ. Clinical outcomes do not support arthroscopic posterior capsular release in addition to anterior release forshoulder stiffness: a randomized controlled study. Am J Sports Med. 2014;42(5):1143-1149.
Kronberg M, Brostrom L-A, Soderlund V. Retroversion of the humeral head in the normal shoulder and its relationship to the normal range of motion. Clin Orthop. 1990;253:113-117.
Kukreti U, Belkoff SM. Collagen fibril D-period may change as a function of strain and location in ligament. J Biomech. 2000;33:1569-1574.
Levine WN, Flatow EL. The pathophysiology of shoulder instability. Am J Sports Med. 2000;28(6):910-917.
Lewis CB. Musculoskeletal changes with age. Clin Manage Phys Ther 1984;4:12-15.
Li ZM, Davis G, Gustafson NP, Goitz RJ. A robot-assisted study of intrinsic muscle regulation on proximal interphalangeal joint stiffness by varying metacarpophalangeal joint position. J Orthop Res. 2006;24(3):407-415.
Lin JJ, Hanten WP, Oslon SL, Roddey TS. Functional activities characteristics of shoulder complex movements: Exploration with a 3-D electromagnetic measurement system. Journal of Rehabilitation Research & Development 2005;42(2):199-210.
Lippitt S, Matsen F. Mechanisms of glenohumeral joint stability. Clin Orthop. 1993;291:20-28.
Lung MW, Hartsell HD, Vandervoort AA. Effects of aging on joint stiffness: implications for exercise. Physiother Canada. 1996;48:96-106.
MacConaill MA. The movements of bones and joints. The significance of shape. The Journal of Bone and Joint surgery 1953;35B(2):290-297.
Majumdar S, Genant HK, Grampp S, Newitt DC, Truong VH, Lin JC, Mathur A. Correlation of trabecular bone structure with age, bone mineral density, and osteoporotic status: in vivo studiesin the distal radius using high resolution magnetic resonance imaging. J Bone Miner Res. 1997;12(1):111-118.
Markolf KL, Amstutz HC. The clinical relevance of instrumented testing for ACL insufficiency: experience with the UCLA clinical knee testing apparatus. Clin Orthop. 1987;223:198-207.
Markolf KL, Graff-Radford A, Amstutz HC. In vivo knee stability: a quantitative assessment using an instrumented clinical testing apparatus. J Bone Joint Surg Am. 1978;60:664-674.
McFarland EG, Torpey BM, Curl LA. Evaluation of shoulder laxity. Sports Med. 1996;22:264-272.
McNair PJ, Wood GA, Marshall RN. Stiffness of the hamstring muscles and its relationship to function in anterior cruciate ligament deficient individuals. Clin Biomech. 1992;7:131-137.
McQuade KJ, Shelley I, Cvitkovic J. Patterns of stiffness during clinical examination of the glenohumeral joint. Clin Biomech (Bristol, Avon).1999;14:620-627.
Meachim G. Effect of Age on the Thickness of Adult Articular Cartilage at the Shoulder Joint. Ann. Rhum. Dis. 1971;30:43-46.
Medeiros H, Araújo D, and Araújo C. Age-related Mobility Loss Is Joint-specific: An Analysis from 6,000 Flexitest Results. Age 2013;35(6):2399-2407.
Miller JE. Biochemica1 characteristics and biological significance of the genetically distinct collagens. Mol. Cell. Biochem. 1976;13:165.
Morag Y, Jacobson JA, Shields G, et al. MR arthrography of rotator interval, long head of the biceps brachii, and biceps pulley of the shoulder. Radiology 2005;235:21-30.
Muraki T, Yamamoto N, Berglund LJ, Sperling JW, Steinmann SP, Cofield RH, An KN. The effect of cyclic loading simulating oscillatory joint mobilization on the posterior capsule of the glenohumeraljoint: a cadaveric study. J Orthop Sports Phys Ther. 2011;41(5):311-318.
Murray MP, Gore DR, and Gardner GM. Shoulder Motion and Muscle Strength of Normal Men and Women in Two Age Groups. Clinical orthopaedics and related research 1985;192:268-273.
Neer CS, Satterlee CC, Dalsey RM, Flatow EL. The anatomy and potential effects of contracture of the coracohumeral ligament. Clin Orthop Relat Res. 1992;182-185.
Norris TR. Shoulder and Elbow Update 2. Rosemont, IL: American Academy of Orthopaedic Surgeons; 2002.
Novelli C, Costa JBV, Souza RR. Effects of aging and physical activity on articular cartilage: a literature review. Morphol. Sci. 2012;29(1):1-7.
Nové-Josserand L, Walch G, Adeleine P, Courpron P. Effect of age on the natural history of the shoulder: a clinical and radiological study in the elderly. Rev Chir Orthop Reparatrice Appar Mot. 2005;91(6):508-514.
O’Brien SJ, Schwartz RE, Warren RF, Torzill PA. Capsular restraints to anterior/posterior motion of he shoulder. Orthop Trans. 1988;12:143.
O’Brien SJ, Neves MC, Arnoczky SP, Rozbruch SR, DiCarlo EF, Warren RF. The anatomy and histology of the inferior glenohumeral ligament complex of the shoulder. Am J Sports Med. 1990;18:449-456.
O'Brien SJ, Schwartz RS, Warren RF, Torzill PA. Capsular restraints to anterior-posterior motion of the abducted shoulder: A biomechanical study. J Shoulder Elbow Surg. 1995;4(4):298-308.
O’Brien SJ, Vertinsky PA. Elderly women, exercise and healthy aging. J Women Aging 1990;2:41-65.
Ochala J, Lambertz D, Pousson M, Goubel F, Van Hoecke J. Changes in mechanical properties of human plantar flexor muscles in ageing. Exp Gerontol. 2004;39:349-358.
Ozaki J, Nakagawa Y, Sakurai G, Tamai S. Recalcitrant chronic adhesive capsulitis of the shoulder. Role of contracture of the coracohumeral ligament and rotator interval in pathogenesis and treatment. J Bone Joint Surg Am. 1989;71:1511-1515.
Pagnani MJ, Warren RF. Stabilizers of the glenohumeral joint. J Shoulder Elbow Surg 3. 1994;173-190.
Panjabi MM, Crisco JJ, Vasavada A, Oda T, Cholewicki J, Nibu K, Shin E. Mechanical Properties of the Human Cervical Spine as Shown by Three-Dimensional Load–Displacement Curves. Spine 2001;26(24):2692-2700.
Panjabi MM, Oxland TR, Yamamoto I, CriscoJJ. Mechanical behavior of the human lumbar and lumbosacral spine as shown by three-dimensional load-displacement curves. J Bone Joint Surg Am. 1994;76(3):413-424.
Panjabi MM, Yoldas E, Oxland TR, Crisco JJ, 3rd. Subfailure injury of the rabbit anterior cruciate ligament. J Orthop Res. 1996;14:216-222.
Park SK, Stefanyshyn DJ, Ramage B, Hart DA, Ronsky JL. Alterations in knee joint laxity during the menstrual cycle in healthy women leads to increases in joint loads during selected athletic movements. Am. J. Sports Med. 2009;37:1169-1177.
Perreault EJ, Kirsch RF, Crago PE.Effects of shoulder stability on endpoint stiffness. IEEE 2000;19(6):53-58.
Petchprapa CN, Beltran LS, Jazrawi LM, Kwon YW, Babb JS, Recht MP. The rotator interval: a review of anatomy, function, and normal and abnormal MRI appearance. JR Am J Roentgenol. 2010;195(3):567-576.
Petrofsky JS, Prowse M, Lohman E. The influence of ageing and diabetes on skin and subcutaneous fat thickness in different regions of the body. Journal of Applied Research 2008;8(1):55-61.
Phillips VA, Chang DE, Hartigan C, Smith JF, Edlich RF. Influence of gender and age on the behind-the-back reach test. J Burn Care Rehabil. 1987;8(3):227-232.
Pollock ML, Gaesser GA, Butcher JD, Després J, Dishman RK, Franklin BA, Garber E. American College of Sports Medicine (ACSM) position stand: The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc. 1998;30(6):975-991.
Pollock RG, Wang VM, Bucchieri JS, et al. Effects of repetitive subfailure strains on the mechanical behavior of the inferior glenohumeral ligament. J Shoulder Elbow Surg. 2000;9:427-435.
Prescher A. Anatomical basics, variations, and degenerative changes of the shoulder joint and shoulder girdle. Eur J Radiol. 2000;35(2):88-102.
Provenzano PP, Heisey D, Hayashi K, Lakes R, Vanderby R, Jr. Subfailure damage in ligament: a structural and cellular evaluation. J Appl Physiol. 2002;92:362-371.
Ralphs JR and Benjamin M. The joint capsule: structure, composition, ageing and disease. J Anat. 1994;184(3):503-509.
Reeves B. Experiments in the tensile strength of the anterior capsular structures of the shoulder in man. J. Bone Joint Surg. 1990;50B:858-865.
Riemann BL, DeMont RG, Ryu K, Lephart SM. The Effects of Sex, Joint Angle, and the Gastrocnemius Muscle on Passive Ankle Joint Complex Stiffness. J Athl Train. 2001;36(4):369-375.
Robert L, Robert AM, Fülöp T. Rapid increase in human life expectancy: will it soon be limited by the aging of elastin? Biogerontology 2008;9(2):119-133.
Salthouse TA. Speed of behaviour and its implications for cognition. Handbook of the psychology of aging. New York: Van Nostrand; 1985.
Sato S, Demura S. Regional subcutaneous fat characteristics stratified by sex, age, and obesity, and their relationships with total and visceral fat in a Japanese population. J Physiol Anthropol. 2009;28(5):231-238.
Sauers EL, Borsa PA, Herling DE, Manzour WF, Stanley RD. Validity of an instrumented measurement technique for quantifying glenohumeral joint laxity and stiffness. J Athl Train. 2001;36:S40.
Sell DR, Biemel KM, Reihl O, Lederer MO, Strauch CM, Monnier VM. Glucosepane is a major protein cross-link of the senescent human extracellular matrix: relationship with diabetes. J Biol Chem 2005;280(13):12310-12315.
Shadwick RE. Elastic energy storage in tendons: mechanical differences related to function and age. Journal of Applied Physiology. 1990;68:1033-1040.
Shultz SJ, Kirk SE, Johnson ML, Sander TC, Perrin DH. Relationship between sex hormones and anterior knee laxity across the menstrual cycle. Med. Sci. Sports Exerc. 2004;36:1165-1174.
Snow M, Boutros I, Funk L. Posterior arthroscopic capsular release in frozen shoulder. Arthroscopy 2009;(1):19-23.
Terry GC, Hammon D, France P, and Norwood LA. The Stabilizing Function of Passive Shoulder Restraints. Am J Sports Med. 1991;19(1):26-34.
Traub W, Piez KA. The chemistry and structure of collagen. Advanc. Protein Chem.1971;25:243.
Tsai WW, Lee MY, Lei KF, Lin WY, Yeh WL, Soon KS. A novel radiation-free shoulder joint stiffness evaluation protocol using non-invasive ultrasonographic images. SMC 2011;597-601.
Turkel SJ, Panio MW, Marshall JL, Girgis FG. Stabilizing mechanisms preventing anterior dislocation of the glenohumeral joint. J Bone Joint Surg Am. 1981;63:1208-1217.
Vasan S, Foiles PG, Founds HW. Therapeutic potential of AGE inhibitors and breakers of AGE protein cross-links. Expert Opin Investig Drugs 2001;10(11):1977-1987.
Walker JM, Sue D, Miles-Elkousy N, et al. Active mobility of the extremities in older subjects. Phys Ther. 1984;64:919-923.
Warner JJP, Deng XH, Warren RF, Torzilli PA. Static capsuloligamentous restraints to superior-inferior translation of the glenohumeral joint. Am J Sports Med. 1992;20:675-685.
Warner JP. The gross anatomy of the joint surfaces, ligaments, labrum, and capsule. In: Matsen FA, Fu FH, Hawkins RJ, eds. The Shoulder: A Balance of Mobility and Stability. Rosemont, IL: American Academy of Orthopaedic Surgeons; 1993:7-27.
Warren RF, Kornblatt IB, Morehand R. Static factors affecting posterior shoulder stability. Orthop Trans. 1984;8:89-93.
Weishaupt D. posterior glenoid rim deficiency in recurrent and atraumatic posterior shoulder instability. Skeletal Radiol. 2000;29(4):204-210.
Wilk KE, Arrigo CA, Andrews JR. Current concepts: the stabilizing structures of the glenohumeral joint. J Orthop Sports Phys Ther. 1997;25(6):364-379.
Wilmore JH. The aging of bone and muscle. Clin Sports Med. 1991; 10: 231-44.
Wong AM, Lin YC, Chou SW, Tang FT, Wong PY. Coordination exercise and postural stability in elderly people: Effect of Tai Chi Chuan. Archives of Physical Medicine and Rehabilitation 2001;82(5):608-612.
Wright V. Stiffness: a review of its measurement and physiological importance. Physiotherapy. 1973;59:107-111.
Yamasaki M. Fibrous Structure of the Joint capsule in the Human Shoulder. Okajimas Folia Anat Jpn. 1990;67(2-3):127-139.
Yu TY, Tsai WC, Cheng JW. The Effects of Aging on Quantitative Sonographic Features of Rotator Cuff Tendons. Journal of Clinical Ultrasound 2012;40(8):471-478.
Yu WD, Liu SH, Hatch JD, Panossian V, Finerman GA. Effect of estrogen on cellular metabolism of the human anterior cruciate ligament. Clin. Orthop. Relat. Res. 1999;366:229-238.
論文全文使用權限
  • 同意授權校內瀏覽/列印電子全文服務,於2019-09-01起公開。


  • 如您有疑問,請聯絡圖書館
    聯絡電話:(06)2757575#65773
    聯絡E-mail:etds@email.ncku.edu.tw