臺灣博碩士論文加值系統

等速肌力測試儀提供了一套既安全且可信度高的系統，可將肌力各種表現數據化，使得臨床上的復健情形及運動訓練的成果有了客觀衡量的標準。本研究使用等速肌力測試儀量測肩關節各個不同平面的肌肉力量，以探討運動速度，運動平面與肩關節位置對於肩關節動態肌力表現的影響。
120位正常的年輕受測者參與本實驗，60位男性與60位女性，年齡介於20與30歲之間。使用等速肌力測試儀來量測他們在各個不同運動平面的上舉、下壓與旋轉肌力，八個不同的旋轉角速度測試(每秒30，60，90，120，150，180，210，240度)，量取最大力矩，並記錄相對應之關節角度，以了解肌力的基本特性。最大力矩值是以定速期量測到的最大力量乘以受測者運動力臂決定。統計方法採用多維變異數分析，以了解運動速度，運動平面與肩關節位置之間的關係。
實驗結果顯示，運動速度，運動平面與肩關節位置對於肩關節肌力的表現皆有顯著性的影響。隨著運動速度的增加，離心肩關節肌力會隨著增加，但是向心肩關節肌力則隨之減少。肩關節的表現會隨著運動平面與肩關節位置改變而產生不同的肌力。上舉與下壓肌力無論是向心收縮或是離心收縮皆於矢狀面產生最大的肌力，而在冠狀面產生最小的肌力。外旋運動在冠狀面上的表現於外展30度時產生最大的肌力，而在外展90度時產生最小的肌力。內旋運動於冠狀面外展60~90度時產生最大的肌力，而在外展105度時產生最小的肌力。此外，運動平面與肩關節位置會交互影響離心肌力的表現，但在向心的肌力表現，並不受到運動平面與肩關節位置交互作用的影響。
希望藉著肩關節肌力研究，提供臨床復健與運動訓練的參考，以助於提昇復健成效及避免運動傷害的造成。

The purpose of this study was to determine the effects of speed, test plane, and humerus position on peak torque values produced by shoulder elevators, depressors, internal and external rotators during concentric and eccentric contraction in young and healthy adults. Absolute peak torque value was calculated by multiplying the maximal force of constant velocity phase by the perpendicular distance from the axis of rotation to the pad. The constant velocity phase was defined the period with the speed between 90% and 110% of the testing velocity.
120 healthy subjects (60 males and 60 females) between the ages of 20 and 30 years were tested. The mean peak torque values of their shoulders were measured at speeds of 0o, 30o, 60o, 90o, 120o, 150o, 180o, 210o, and 240o per second for dominant side using a Kin-Com robotic dynamometer (Chattanooga Corp., Chattanooga, TN). MANOVA was used to analyze whether the shoulder strength was different in the different positions, humerus positions, and testing speeds. Tukey tests were adopted for post hoc analysis in the event that significant interaction effects occurred. The probability level of 0.05 was used through the study.
Speed, testing plane, and humerus position had all significant influence on the shoulder strength. As speed increased, torque value decreased during eccentric contraction and increased during concentric contraction. Shoulder performed different strength with testing plane and humerus position changed. Cross-interaction between testing plane and humerus position was significant in the eccentric contraction for both elevation and depression. No statistical significance found in the concentric contraction. The study may help clinicians plan and rehabilitate shoulder injury patients.

CONTENTS
___________________________________________________________________
CHINESE ABSTRACT…………………………………………………………….I
ENGLISH ABSTRACT……………………………………………………………..II
CONTENTS………………………………………………………………...……….III
LIST OF FIGURES…………………………………………………….……………V
LIST OF TABLES…..………………………………………………………………VI
CHAPTER……………………………………………………………………….…1
1. INTRODUCTION……………………………………………………………1
1.1 Introduction…………………..……………………………………………...1
1.1.1 Shoulder joint articulation………………...……………………………3
1.1.2 Isokinetic dynamometry testing………...……………………...………4
1.2 Literatures review………………...………………………………………….5
1.3 Motivation and Purpose………………………………………….………….8
2. MATERIALS AND METHODS……………………………………………10
2.1 Instrumentation………………………………….....………………………10
2.2 Subjects……………………………………………...……………..………11
2.3 Position and speed setting……………………………...…………….….…13
2.4 Procedure………………………………………………...………..….….…14
2.5 Data collection and statistical analysis……………………...……….….…15
3. RESULTS…………………………………………………………...…………18
3.1 Elevation and depression testing…………………………………...………18
3.1.1 Isokinetic shoulder elevation muscle strength…………………...……18
3.1.2 Statistical analysis of shoulder elevation…………………………...…23
3.1.3 Isokinetic shoulder depression muscle strength……….……………...25
3.1.4 Statistical analysis of shoulder depression strength………..…………30
3.2 Rotation testing…………………………………..……...…………………32
3.2.1 Isokinetic shoulder rotation muscle strength………...……..…………32
3.2.2 Statistical analysis of shoulder rotation………………...……………..37
3.3 Ratio value…...…………………………………..……...…………………40
4. DISCUSSION………………………………...……………………………….43
4.1 Testing plane effect on elevation and depression strength….………...……47
4.2 Humerus rotation effect on elevation and depression strength..……...……49
4.3 Glenohumeral abduction position effect on rotation strength..…….………50
4.3 Speed effect………………..…………………….....………………………54
5. CONCLUSIONS AND CLINICAL RELEVANCE………….……………56
REFERENCES…………………………………………………………………58
LIST OF FIGURES
Figure
1.1 The acromioclavicular joint and associated ligaments, and the capsule of the shoulder joint…………………………………………………………………..3
1.2 Anterior view of the shoulder joint……………………………………………..3
1.3 Pilot study of force-velocity curve……….……………………………………..9
1.4 Difference percentage of isokinetic dynamometer.……………………………..9
2.1 Kin-Com dynamometer.………………………...……………………………..10
2.2 Anterior view of 90o humerus rotation position.…………………………..…..16
2.3 Anterior view of neutral humerus rotation position…………………………..16
2.4 Superior view of four different test planes for elevation/depression test…..….16
2.5 Anterior view of rotation test position……………………………………….17
2.6 Anterior view of four different test planes for rotation test…………..………..17
3.1 Force-velocity curve of shoulder elevation at different test plan..…….………21
3.2 Bar chart of mean peak torque values performed in different testing planes………………………………..………………….……………………...22
3.3 Force-velocity curve of shoulder depression at different test plan.…………..28
3.4 Bar chart of mean peak torque values performed in different testing planes……………………………………………………………………….….29
3.5 Mean torque values of shoulder external rotation………..………..…………..35
3.6 Mean torque values of shoulder internal rotation.………………………..…..36
4.1 Muscle force-velocity curve for skeletal muscle…………………………..…..55
LIST OF TABLES
Table
2.1 Subjects'' anthropometric parameters in elevation/depression test with shoulder in neutral position (shoulder position 1)….……………………………………12
2.2 Subjects'' anthropometric parameters in elevation/depression test with shoulder in 90 degrees internal rotation (shoulder position 2).…………………………12
2.3 Subjects'' anthropometric parameters in internal/external rotation test………. 12
2.4 P values in subjects'' anthropometric parameters of three groups……...………12
3.1 Values for the various speeds, testing planes and shoulder positions for the concentric elevation testing……………………………………………………19
3.2 Values for the various speeds, testing planes and shoulder positions for the eccentric elevation testing.………….……….……………………...…………20
3.3 ANOVA summary across speed, testing plane, and shoulder position for the female concentric elevation…….………………………...……………………24
3.4 ANOVA summary across speed, testing plane, and shoulder position for the female eccentric elevation…..…………………………………………………24
3.5 ANOVA summary across speed, testing plane, and shoulder position for the male concentric elevation…………..…………………………………………24
3.6 ANOVA summary across speed, testing plane, and shoulder position for the male eccentric elevation.………………………………………………………25
3.7 Values for the various speeds, testing planes and shoulder positions for the concentric depression testing.….………………………………………………26
3.8 Values for the various speeds, testing planes and shoulder positions for the eccentric depression testing..……………………………………………..……27
3.9 ANOVA summary across speed, testing plane, and shoulder position for the female concentric depression.…………………………………………………30
3.10 ANOVA summary across speed, testing plane, and shoulder position for the female eccentric depression.…………………………………………………31
3.11 ANOVA summary across speed, testing plane, and shoulder position for the male concentric depression.……………………………………………………31
3.12 ANOVA summary across speed, testing plane, and shoulder position for the male eccentric depression.………………………………………….…………31
3.13 Values for the various speeds and testing planes for the concentric ER testing….……….……………………………………………….……………33
3.14 Values for the various speeds and testing planes for the eccentric ER testing.………….…………………………………………………..…………33
3.15 Values for the various speeds and testing planes for the concentric IR testing….……….…………………………………………………..…………34
3.16 Values for the various speeds and testing planes for the eccentric IR testing…………….……………………………………………………………34
3.17 ANOVA summary across speed and testing plane for the female concentric ER……..………….……………………………………………………………38
3.18 ANOVA summary across speed and testing plane for the female eccentric ER……..………….……………………………………………………………38
3.19 ANOVA summary across speed and testing plane for the male concentric ER……..………….……………………………………………………………38
3.20 ANOVA summary across speed and testing plane for the male eccentric ER……..………….……………………………………………………………38
3.21 ANOVA summary across speed and testing plane for the female concentric IR……...………….……………………………………………………………39
3.22 ANOVA summary across speed and testing plane for the female eccentric IR……...………….……………………………………………………………39
3.23 ANOVA summary across speed and testing plane for the male concentric IR……...………….……………………………………………………………39
3.24 ANOVA summary across speed and testing plane for the male eccentric IR……………...….……………………………………………………………39
3.25 Elevation/Depression ratios at the various speeds and testing planes in the 90o humerus rotation position……………...………………………………………40
3.26 Elevation/Depression ratios at the various speeds and testing planes in the neutral humerus rotation position.……………………………..………………41
3.27 ER/IR ratios at the various speeds and testing planes……………..…………42
4.1 Mean isokinetic peak torque values (Nm) in different studies…...……………46

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