臺灣博碩士論文加值系統

本研究共徵募20位男性健康受試者 (體型正常與過重各半)，在不同久站型式(站立與站動，站動定義為每站立20min活動1min) 下，量測在久站2 hr期間，每20 min的腿圍變化，以及久站2 hr 後身體各部位的主觀不適評比。研究結果發現，不同的久站型式、體型、久站持續時間均對腿圍變化有顯著影響 (all p<0.001)。站動時的腿圍增加量顯著小於完全站立作業 (平均0.44 cm : 0.62 cm)，亦即只要短短1 min休息，即可有效舒緩小腿部位負荷。在2 hr內的久站作業中，四種實驗組合 (2種體型x 2種久站型式) 下的腿圍變化均隨時間增加而呈線性增加。此外，體型正常組 (BMI =21.9) 在久站時呈現較過重組 (BMI =26.5) 更顯著的腿圍變化量，此變化量亦反映在下肢部位的主觀不適評比結果，其中以足底不適值最高，本研究結果對於相關站立作業的設計、安排與改善具有實務參考價值。

This study recruited 20 healthy male participants (10 of each BMI in normal and overweight) to examine their shank circumference increases of every 20 min under two prolonged standing conditions, namely static standing and intermittent standing (with 1 min resting after every 20 min standing), for 2 hr. Results show that prolonged standing type, physique, and sustained time significantly affected the participants’ shank circumference increases (all p<.001). No interactions were observed in the analyses. Increases in shank circumference were lower (0.44 cm) when participants performing intermittent standing than when static standing (0.62 cm). This may imply that even though a short rest interval was intervened (i.e. 1 min), the load on participants lower legs can be effectively eliminated during standing. We also found that shank circumference increases linearly related to the sustained time, whatever test combinations were performed in this study. Furthermore, participants with normal physique (BMI=21.9 in this study) exhibited higher shank circumference increases than that with overweight physique (BMI=26.5 in this study). The differences in physical responses were also reflected in subjective discomfort scores on lower limbs, especially on foot region, The findings of this study can be served as references for designing and improving the related prolonged standing task.

指導教授推薦書 i
口試委員審定書 ii
明志科技大學論文授權書 iii
誌謝 iv
中文摘要 v
英文摘要 vi
目錄 vii
圖目錄 x
表目錄 xi
第一章 緒論 1
1.1 研究背景與動機 1
1.2 研究目的 2
1.3 研究限制 2
1.4 研究架構 3
第二章 文獻探討 4
2.1 肥胖定義與指標 4
2.2久站對下肢/背部的影響 5
2.3肢段與圍度變化 6
2.4肥胖者對下肢影響 7
2.5 文獻探討小結 9
第三章 研究方法 10
3.1 實驗架構 10
3.2 實驗設計 12
3.3 實驗流程 12
3.4 實驗設備 13
3.5主觀不適評比 14
3.6統計分析 14
第四章 結果與討論 15
4.1受試者基本資料 15
4.2 三因子變異數分析 16
4.3交叉分析 18
4.3.1不同體型下之二因子ANOVA結果 18
4.3.2不同久站型式下之二因子ANOVA 結果 21
4.3.3單因子時間之ANOVA結果 24
4.4主觀不適分析 25
4.4.1 主觀不適描述性分析 25
4.4.2 主觀不適評比分析 26
第五章 結論與建議 29
5.1結論 29
5.2建議 30
參考文獻 31
一、中文文獻 31
二、英文文獻 32
附錄A 受試者同意書
附錄B人體計測資料值
附錄C 實驗指導語
附錄D 受試者主觀評比表

一、中文文獻
1.行政院衛生署（2002），成人肥胖定義及處理原則。台北市：行政院。
2.洪維振(2003)，運動介入對國小肥胖學童體適能之影響。臺北市立體育學院運動科學研究所，臺北市。
3.洪甄憶（2004），運動介入對大學女生身體組成的影響。成大體育，37（1），88-98。
4.陳志勇、卓旻賢、林彥輝、趙國竣（2009），久站作業下之足—地介面組合對主觀不適及小腿圍度之影響。勞工安全衛生研究季刊，17（3），335-342。
5.行政院勞委會勞工安全衛生研究所(1998) ，職業性下背痛預防手冊。
6.臺北市政府衛生局(2006)，久站族群職業傷病防治手冊。臺北市政府衛生局。
7.行政院衛生署(2002)，國人肥胖定義及處理原則。

二、英文文獻

1.Aglietti, P., Baldini, A., Buzzi, R., Lup, D., & De Luca, L. (2005). Comparison of mobile-bearing and fixed-bearing total knee arthroplasty: a prospective randomized study. The Journal of Arthroplasty, 20(2), 145-153.
2.Bhutia, S. G., Balakrishnan, A., & Lees, T. (2008). Varicose veins. Journal of Perioperative Practice, 18(8), 346-353.
3.Chester, M. R., Rys, M. J., & Konz, S. A. (2002). Leg swelling, comfort and fatigue when sitting, standing, and sit/standing. International Journal of Industrial Ergonomics, 29(5), 289-296.
4.Chung, M. K., Lee, I., & Kee, D. (2003). Assessment of postural load for lower limb postures based on perceived discomfort. International Journal of Industrial Ergonomics, 31(1), 17-32.
5.Cham, R., & Redfern, M. S. (2001). Effect of flooring on standing comfort and fatigue. Human Factors: The Journal of the Human Factors and Ergonomics Society, 43(3), 381-391.
6.Cicuttini, F. M., Spector, T., & Baker, J. (1997). Risk factors for osteoarthritis in the
tibiofemoral and patellofemoral joints of the knee. The Journal of Rheumatology, 24(6),
1164-1167.
7.Cook, J., Branch, T. P., Baranowski, T. J., & Hutton, W. C. (1993). The effect of surgical floor mats in prolonged standing: an EMG study of the lumbar paraspinal and anterior tibialis muscles. Journal of Biomedical Engineering, 15(3), 247-250.
8.Deusinger, S. S., Deusinger, R. H., & Racette, S. B. (2004). The obesity epidemic. PT Magazine, 6, 82-98.

9.Gelber, A. C., Hochberg, M. C., Mead, L. A., Wang, N. Y., Wigley, F. M., & Klag, M. J. (1999). Body mass index in young men and the risk of subsequent knee and hip osteoarthritis. The American Journal of Medicine, 107(6), 542-548.
10.Gourgou, S., Dedieu, F., & Sancho-Garnier, H. (2002). Lower limb venous insufficiency and tobacco smoking: a case-control study. American Journal of Epidemiology, 155(11), 1007-1015.
11.Hansen, L., Winkel, J., & Jørgensen, K. (1998). Significance of mat and shoe softness during prolonged work in upright position: based on measurements of low back muscle EMG, foot volume changes, discomfort and ground force reactions. Applied Ergonomics, 29(3), 217-224.
12.Holmberg, S., Thelin, A., & Thelin, N. (2005). Knee osteoarthritis and body mass index: a population-based case-control study. Scandinavian Journal of Rheumatology, 34(1), 59-64.
13.Hulens, M., Beunen, G., Claessens, A. L., Lefevre, J., Thomis, M., Philippaerts, R., & Vansant, G. (2001). Trends in BMI among Belgian children, adolescents and adults from 1969 to 1996. International Journal of Obesity & Related Metabolic Disorders, 25(3). 395-399.
14.Karvonen, M. J., Viitasalo, J. T., Komi, P. V., Nummi, J., & Järvinen, T. (1979). Back and leg complaints in relation to muscle strength in young men. Scandinavian Journal of Rehabilitation Medicine, 12(2), 53-59.
15.Kahng, S. K., Dunkle, R. E., & Jackson, J. S. (2004). The Relationship Between the Trajectory of Body Mass Index and Health Trajectory Among Older Adults Multilevel Modeling Analyses. Research on Aging, 26(1), 31-61.
16.Labs K, Tschoepl, M., Gamba, G., Aschwanden, M., & Jaeger, K. A. (2000). The reliability of leg circumference assessment: a comparison of spring tape measurements and optoelectronic volumetry. Vascular Medicine, 5(2), 69-74.
17.Lin, Y. H., Chen, C. Y., & Cho, M. H. (2012). Effectiveness of leg movement in reducing leg swelling and discomfort in lower extremities. Applied Ergonomics,43(6), 1033-1037..
18.Madeleine, P., Voigt, M., & Arendt-Nielsen, L. (1997). Subjective, physiological and biomechanical responses to prolonged manual work performed standing on hard and soft surfaces. European Journal of Applied Physiology and Occupational physiology, 77(1-2), 1-9.
19.Messing, K., Tissot, F., & Stock, S. R. (2006). The International Ergonomics Association, Maastricht. Lower Limb Pain, Standing, Sitting, Walking: The Importance of Freedom to Adjust One’s Posture.
20.Pensri, P., Janwantanakul, P., Worakul, P., & Sinsongsook, T. (2010). Biopsychosocial Factors and Perceived Disability in Saleswomen with Concurrent Low Back Pain. Safety and Hhealth at Work, 1(2), 149-157.
21.Redfern, M. S., & Chaffin, D. B. (1988). The effects of floor types on standing tolerance in industry. Ann Arbor, 1001, 48109-2117.
22.Ross, C. M., & Worrell, T. W. (1998). Thigh and calf girth following knee injury and surgery. Journal of Orthopaedic& Sports Physical Therapy, 27(1), 9-15.
23.Smith, B., Roan, M., & Lee, M. (2000). The effect of evenly distributed load carrying on lower body gait dynamics for normal weight and overweight subjects. Gait & Posture, 32(2), 176-180.
24.Tokunaga, K., Matsuzawa, Y., Kotani, K., Keno, Y., Kobatake, T., Fujioka, S., & Tarui, S. (1991). Ideal body weight estimated from the body mass index with the lowest morbidity. International Journal of Obesity, 15(1), 1-5.
25.Tüchsen, F., Krause, N., Hannerz, H., Burr, H., & Kristensen, T. S. (2000). Standing at work and varicose veins. Scandinavian Journal of Work, Environment Health, 26(5), 414-420.
26.Van Wely, P. (1970). Design and disease. Applied Ergonomics, 1(5), 262-269.