臺灣博碩士論文加值系統

本研究旨在探討本體感覺神經肌肉促進術(Proprioceptive neuromuscular facilitation, PNF)與靜態伸展對蹠屈肌等速肌力與踝關節本體感覺之影響。九位男性(年齡, 24.00±.50歲)與七位女性(年齡, 22.86±.77歲)未接受規律運動訓練之健康大學生志願參與本實驗。實驗採隨機分配，重複量數測驗設計，所有受試者接受各兩次之PNF伸展與靜態伸展。為了要瞭解PNF伸展與靜態伸展對肌力與本體感覺之影響，在伸展前、後與30分鐘恢復期後，測量蹠屈肌等速肌力與踝關節位置知覺。本研究以Biodex III等速肌力測量儀分別設定角速度為500°•s-1與2°•s-1，來量測個體主動與被動的關節誤差角度，以作為本體感覺的評估指標；以同樣儀器進行踝關節低速30°•s-1與高速120°•s-1蹠屈等速肌力測試，測量扭力峰值(peak torque, PT)、平均動力(average power, AP)、平均扭力峰值(average peak torque, APT)與總作工量(total work, TW)；研究結果以二因子（2×3）重覆量數變異數分析考驗不同伸展方式、不同測驗時間下之PT, AP, APT 與TW之差異；以四因子（2×3×2×3）重覆量數變異數分析考驗不同伸展方式、不同測驗時間、不同復位模式(主動復位模式和被動復位模式)下之絕對誤差角度之差異。統計顯著差異水準定為α=.05。以杜凱氏事後比較法(Tukey’s post-hoc test)進行事後考驗。研究結果顯示，PNF伸展與靜態伸展並未造成PT, AP, APT 和 TW顯著的改變；顯示在增進關節活動度的同時，伸展並未對蹠屈肌肌力造成負面影響。另外，被動模式之絕對誤差角度顯著小於主動模式之絕對誤差角度，但並未發現有伸展與測驗時間的交互作用，PNF伸展與靜態伸展並未顯著影響踝關節本體感覺功能；然而，由於伸展造成的影響其有效程度(effect size)很小，臨床上當要納入靜態伸展或PNF伸展時應該要考慮損益比。

Stretching is commonly used as part of a warm-up routine to increase joint range of motion in an attempt to promote better performance and/or reduce the risk of injury. Some previous studies had shown that the effects of stretching may affect the performance of the muscle strength assessment, proprioception assessment and/or return to play. Therefore, the purpose of this study was to evaluate the effects of proprioceptive neuromuscular facilitation (PNF) stretching and static stretching on strength of plantar flexors and joint position sense of the ankle joint. A randomized, within-subjects experimental repeated-measures design was used. Nine male (age, 24.00±.50 years) and 7 female (age, 22.86±.77years) healthy volunteers participated in the study. All subjects received 2 static and 2 PNF stretching during 2 randomly ordered laboratory visits. The peak torque (PT), average power (AP), average peak torque (APT), total work (TW) were measured at 30°•s-1 and 120°•s-1 velocities and absolute errors of angle were measured in active (500•s-1) and passive (2°•s-1) modes before stretching, immediately following the conclusion of stretching, and 30 minutes after the conclusion of stretching. The results showed that there were no stretching-related changes in PT, AP, APT or TW (P > .05). Both static and PNF stretching caused no significant effects on PT, AP, APT and TW at both slow (30°•s-1) and fast velocities (120°•s-1). Overall, the results indicated that stretching may greatly increase flexibility while not compromising muscle strength. Furthermore, there was significant difference in absolute errors of angle between passive mode and active mode. No differences were noted regarding the interaction of stretching × testing sequence. The effect size, however, corresponding to these stretch-induced changes was small, which suggested the need for practitioners to consider a risk-to-benefit ratio when incorporating static or PNF stretching.

目 錄

第壹章 緒論

第一節 研究動機------------------------------------------ 1
第二節 研究目的------------------------------------------ 5
第三節 研究假設------------------------------------------ 6
第四節 研究範圍與限制------------------------------------ 6
第五節 名詞解釋與操作定義-------------------------------- 7

第貳章 文獻探討

第一節 伸展的原理--------------------------------------- 10
第二節 伸展對神經肌肉特性之影響------------------------- 17
第三節 伸展對本體感覺的影響----------------------------- 26
第四節 總結--------------------------------------------- 33

第叁章 研究方法

第一節 研究對象----------------------------------------- 34
第二節 實驗儀器----------------------------------------- 35
第三節 實驗方法與流程----------------------------------- 36
第四節 資料處理與統計分析------------------------------- 41

第肆章 結果與討論

第一節 PNF伸展與靜態伸展對肌力的影響-------------------- 43
第二節 PNF伸展與靜態伸展對本體感覺的影響---------------- 49

第伍章 結論與建議---------------------------------------- 56

參考文獻-------------------------------------------------- 58

附錄------------------------------------------------------ 74



表 目 錄

表 一 單次伸展對肌力之影響----------------------------- 24
表 二 受試者基本資料----------------------------------- 35
表 三 伸展前後踝關節蹠屈肌力之變化情形(30°•s-1)-------- 44
表 四 伸展前後踝關節背屈肌力之變化情形(120°•s-1)------- 44
表 五 伸展前後踝關節主動與被動復位能力之變化情形------- 50
表 六 伸展前後踝關節絕對誤差角度在不同目標角度、不同復位
模式下之變化情形------------------------------------ 51


圖 目 錄

圖 一 PNF伸展之說明圖------------------------------------ 8
圖 二 受試者擺位----------------------------------------- 36
圖 三 實驗流程圖----------------------------------------- 39
圖 四 伸展前後踝關節主動與被動復位能力之變化情形--------- 50
圖 五 伸展前後踝關節絕對誤差角度在不同目標角度、不同
復位模式下之變化情形------------------------------- 51

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