臺灣博碩士論文加值系統

目的：腰椎薦椎化(Lumbar Sacralization)是一種先天性脊椎結構異常，腰椎薦椎化的患者，常常因為下背痛的原因尋求醫療協助。本研究的目的在探討腰椎薦椎化下背痛患者，經過六週腰部肌力訓練後，對下背疼痛、肌力與柔軟度、膝關節疼痛以及股四頭肌肌力的影響。方法：本研究有30位二十至四十歲腰椎薦椎化下背痛患者，接受六週的腰部肌力訓練，訓練分成兩階段，第一階段組A進行腰部伸肌訓練，組B進行腰部屈肌訓練，第二階段訓練課程互換，並於訓練前、第三週後以及第六週後接受評估。使用疼痛自覺量表(Visual Analog Scale, VAS)評估疼痛狀態。使用microFET3 (Hoggan Health Industries, U.S.A.)測量腰部柔軟度，Cybex NORM (Cybex Internation, Inc., Ronkonkoma, New York, U.S.A.)等速肌力測定儀測量腰部伸展和屈的等長肌力，並且在60度/秒，120度/秒以及180度/秒角速度下測量雙側股四頭肌的等速肌力。結果：經過六週的腰部肌力訓練後，兩組下背屈曲與伸展最大等長肌力都有顯著的改善，下背柔軟度兩組也都有顯著的進步，但兩組間肌力與柔軟度並沒有顯著差異；兩組股四頭肌肌力在三個速度下皆有顯著改善，特別是在訓練腰部伸肌的階段；兩組下背痛改善情況，兩組在接受腰部伸肌訓練階段後，改善的程度較屈肌訓練顯著；膝關節疼痛方面，兩組在接受腰部伸肌訓練階段有更減緩趨勢。結論：腰椎薦椎化下背痛患者，藉由六週的腰部肌力訓練後，除了可以改善腰部肌力、柔軟度與疼痛並且也可以增進股四頭肌肌力以及改善膝關節疼痛，特別是在接受了腰部伸肌的訓練，改善效果似乎比腰部屈肌訓練明顯。

The purpose of the study was to investigate: low back strengthening effects of the low back pain patients with lumbar sacralization on (1) low back isometric strength, range of motion (ROM) and back pain scale of (2) quadriceps isokinetic strength and knee pain scale. Thirty low back pain patients with lumbar sacralization were divided into two groups, group A (extensor-flexor) and group B (flexor-extensor). In the 1st session of 6-week training group A started low back extensors strengthening and group B did flexor and in the 2nd session, the training programs were shifted between groups. The visual analog scale (VAS) was used to scale pain of low back of lumbar spine and knee. MicroFET3 was used to evaluate ROM. Cybex NORM was used to measure isometric strength of low back flexor, extensor and isokinetic strength of knee extensor at 60˚/sec, 120˚/sec and 180˚/sec. After 6-week training, low back maximal isometric strengths were significantly improved in both groups. Low back ROM was significantly improved in both groups. However strength and ROM not were significantly different between two groups. Quadriceps strengths were significantly improved in all 3 angular velocities of both right and left, particularly after extensor training. Low back extensor training was more efficient than flexor in pain control of low back and knee. Low back strengthening training for low back patients with lumbar sacralization may improve isometric strength, ROM and pain scale of low back, and further improve quadriceps isokinetic strength and knee pain scale, particularly in extensor strengthening.

第壹章 緒論
第一節 研究背景…………………………………………… 1
第二節 研究目的…………………………………………… 4
第三節 研究範圍…………………………………………… 5
第四節 名詞解釋與操作行定義…………………………… 6
第貳章 文獻探討
第一節 腰椎薦椎化與下背痛……………………………… 8
第二節 腰椎薦椎化並下背痛的處理……………………… 10
第三節 下背和股四頭肌的關係…………………………… 13
第四節 腰部肌力訓練與下背疼痛之關係………………… 15
第五節 文獻總結…………………………………………… 17
第參章 研究方法
第一節 研究對象…………………………………………… 18
第二節 實驗設計…………………………………………… 19
第三節 實驗流程…………………………………………… 20
第四節 實驗時間與地點…………………………………… 21
第五節 研究工具與設備…………………………………… 22
第六節 實驗流程與步驟…………………………………… 23
第七節 資料處理與統計分析……………………………… 35
第肆章 結果與討論
第一節 受試者基本資料…………………………………… 36
第二節 腰部最大等長肌力………………………………… 38
第三節 腰部柔軟度………………………………………… 42
第四節 股四頭肌等速肌力………………………………… 48
第五節 疼痛指數…………………………………………… 54
第六節 討論………………………………………………… 57
第伍章 結論與建議
第一節 結論………………………………………………… 62
第二節 建議………………………………………………… 64
參考文獻 ……………………………………………………………… 65
附錄
附錄一 人體試驗暨倫理計畫審查書………………………… 73
附錄二 受試者同意書………………………………………… 74
附錄三 受試者基本資料……………………………………… 75
附錄四 腰部關節活動度測量表……………………………… 77
附錄五 Borg’s運動自覺量表………………………………… 78
附錄六 腿後肌資料…………………………………………… 79

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【中文部分】
陳金山 (民93)。最新解剖生理學。華騰股份有限公司。臺北市。
鄧志娟，鄭賀珍 (民92)。運動傷害防護。禾楓發行。臺北市。
劉浩霖 (民98)。冰敷對拳擊選手頸部功能之研究。臺北市立體育學院體育與健康碩士班論文。