臺灣博碩士論文加值系統

休閒運動的效益，一直以來被視為是促進健康的重要收穫。近幾年自行車運動的提倡，主要因為此運動需熟練度的門檻較低，同時兼顧交通工具的使用。一般自行車騎乘者在購買考量的選項中，多以身高作為車架尺寸的選擇、並以成車出廠的元件進行購置。然而，自行車騎乘係一種肌肉收縮的重複性循環，在騎乘過程中，生理軟組織須不斷適應突發性的暴力對身體組織所產生的破壞作用，累積多次機械性作用力所造成的「微傷」，可能產生症狀或功能障礙，因此傷害可視為「由一次或多次的內發性或外加性作用力，對身體組織所造成的破壞結果」。臨床上對於運動傷害的評估，主要以疼痛問診、觸診與放射線檢查施予處方箋，然而此類檢驗的靜態性診斷卻無法反映動態性騎乘以及個體差異的動態活動。以常見的自行車運動傷害來看，本研究推測膝關節的解剖構造（脛骨、股骨、髕骨）與自行車兩側曲柄的寬度是造成疼痛發生的可能因素，因此本研究開發一動態性運動傷害評估系統，結合運動訓練及運動傷害處置（急性與慢性處置），針對12名一般自行車騎乘者，於公路車款安裝車輛功率輸出量測裝置，以自選最適騎乘姿勢在30分鐘的騎乘過程中，結合肌肉骨骼模擬系統量化肌肉活化、關節力矩、及關節受力，提出綜合評估騎乘自行車可能遭遇傷害的踩踏位置。研究結果顯示，踩踏過程時的髖、膝關節的近端與遠端皆無較大的關節受力，位於踩踏位置上死點至40°時，膝關節承受30%體重、髖關節則承受25%體重(40°-100°)，而踝關節則有前後方向承受60%體重(40°-100°)。在長時間騎乘下，位於20°- 60°時外旋動作增加、40°-80°時肌肉活化提升、同時形成膝屈曲、髖外旋與髖關節表現，進而產生較大的關節力矩，導致脛骨股骨關節疼痛的發生。60°-140°時股內、外側肌群活化過大，形成膝外旋(rotation)造成膝蓋鷹喙內壓力過大，提高髕骨股骨關節疼痛的發生，此兩者為以抽樣方式推估母群體(group results)騎乘自行車可能造成傷害的踩踏範圍。根據研究結果，本研究利用模擬改善前述騎乘策略，針對一般騎乘自行車的民眾騎乘時，降低膝屈曲與足外旋發生、增加足底踩踏在邁向下死點前的用力情形轉移的滑移，能夠改善股內、外側肌的活化情形，同時降低關節受力與力矩的輸出。針對個體騎乘策略的修正(individual results)，本研究利用關節角度驅動肌肉骨骼模擬系統作為視覺化改善騎乘策略的改善與預防，期提供臨床人員針對動態診斷與因應，並輔以開發設計訓練器器材加以積極訓練、降低受傷，促進運動過程中傷害預防與降低。

In clinical practices, sports injuries are assessed using pain-related inquiries, palpations, or radiographic examinations, after which prescriptions are prescribed to patients. In the repetitive sport of cycling, when muscles resisting environment, the physiological soft tissue must continually accumulate and anticipate fatigue toward direction. By combining anatomy, musculoskeletal simulations, and the concept of sports training, this study developed a system for assessing sports injuries and thus improve cycling strategies and prevent related injuries. All measurements were made during one full cycle of pedaling. We measured the following: 1) normalized (for body weight) reaction force of the hip, ankle, and hip joint before and after simulation strategies, 2) joint moments of hip adduction, and knee and plantar flexion before and after simulation strategies, 3) joint moments of knee, hip, and plantar flexion, 4) joint moments of hip adduction and ankle eversion, 5) joint moments of hip external rotation, and 6) activity of the soleus, rectus femoris, gastrocnemius, biceps femoris, vastus medialis, vastus lateralis, and tibialis anterior muscles. We assessed participant perception of pain and identified possible injuries induced by the accumulated reaction force, observed at the proximal–distal locations of the hip and knee joints during pedaling.We employed musculoskeletal simulation systems and external power output measurement methods to collect quantitative data on acute and chronic cycling. Complete pedal and crank reaction force data were input into a simulation software in which muscle activity was included as a cause of cycling injuries. Musculature performances were simulated for different individuals to identify musculature associated with the various cycling conditions as well as the causes of and adaptive measures for injuries for all crank locations. Next, a method that effectively quantified cycling-induced injuries was derived using data such as muscle coordination, activity, and joint stability. We identified possible injuries induced by the accumulated reaction force, observed at the proximal–distal locations of the hip and knee joints during pedaling. During prolonged cycling, the muscle activities and joint moments increased while the knee flexion and hip external rotations generated potential injuries. In addition, excessive vastus lateralis and medialis activities led to repetitive external rotations of the knee and extreme pressure on the knee joints at 60°-140° crank angles, thus increasing the occurrence of patellofemoral and tibiofemoral pain. Conversely, simulated cycling strategies reduced knee flexion and external rotations of the feet, increased the force application in the plantar flexion toward the bottom dead center, and improved muscle activities at 80°–120° angles, and avoiding excessive slippage improved the VL and VM activities and prevented excessive reaction force in the joints and moment output. The system was used to lower the possibility of injuries by providing improved cycling strategies and encouraging training as well as facilitating sports and training performance. Overall, the developed system assigned to provide the prevented injuries of Lower limbs.

中文摘要 I
ABSTRACT III
INDEX ii
LIST OF TABLES iv
LIST OF FIGURES v
CONCEPTUAL DEFINITION vii
Chapter 1. Introduction 1
1.1 Overview 1
1.2 Background and Motivation 1
1.3 Research Construction and Objectives 3
Chapter 2. Literature Review 6
2.1 Characteristics of Cycling Injuries 6
2.1.1 Acute Injuries 7
2.1.2 Chronic Injuries 8
2.2 Influence of External Factors 12
2.3 Influence of Internal Factors 14
Chapter 3. Research Content and Methods 23
3.1 Injury Trajectory 23
3.1.1 Joint Reaction Force 24
3.1.2 Joint Stability and Muscle Coordination 24
3.2 Adaptive Measures for Injuries 27
3.2.1 Building an Cycling Diagnosis System 28
3.2.2 Trajectory Assessments of Acute and Chronic Injuries 48
3.2.3 Assistive Bicycle Design and Assessment Technology 50
3.2.4 Use and Assessments of Musculatures Training Apparatuses 52
3.3 Statistical Verification 54
Chapter 4. Results and Discussion 56
4.1 Injury Trajectory Results 57
4.1.1 Angles and Causes Leading to Acute Injuries 57
4.1.2 Times and Performance Associated with Chronic Injuries 60
4.2 Data Simulation Method 66
4.2.1 Building an Assessment System and Subsequent Results 66
4.2.2 Riders’ Performance after Simulated Cycling Strategies Using the Bicycle Design 75
4.2.3 Results Obtained Using the Training Apparatus 80
Chapter 5. Conclusion and Recommendations 82
5.1 Conclusion 82
5.2 Innovativeness and Applicability 85
5.3 Limitations and Development 86
References 88
Appendix A:Patent certification of Taiwan Intellectual Property 95
Appendix B: Cycling Diagnosis System Report Example 96

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