臺灣博碩士論文加值系統

本研究主要目的是以特定之功能性疲勞運動和本體感覺測試方法來比較肌肉疲勞前後和恢復時間長短對膝關節本體感覺精確度之影響。本研究以21名年齡層為20~30歲之正常人為研究對象，使用電阻量角器搭配三用電表以及Kistler 9290之Quattro jump測力板作為測量膝關節彎曲角度和進行疲勞運動之儀器，讓所有受試者進行運動疲勞前、後之本體感覺測試，以膝關節彎曲30、45和60度為目標測量角度，膝關節彎曲15度為測量之起始位置，採主動復位模式重複測試受試者承重時之膝關節本體感覺至疲勞運動後60分鐘。以單因子變異數分析法（one-way ANOVA）及杜凱氏最誠實顯著性差異檢定法（Turkey honestly significant difference test；Turkey HSD）分析跳躍運動前與跳躍運動後各個時間點之整體及三個膝關節角度之絕對誤差角度差異情形，以絕對誤差角度平均數圖分別表示整體關節角度位置及各個關節角度位置絕對誤差角度與恢復時間之情形，以皮爾森相關係數雙尾檢定，比較平均肌力疲勞指數與膝關節整體絕對誤差角度之相關性。本研究結果如下：
一、以承重姿勢測量連續垂直跳前後之膝關節整體絕對誤差角度達到顯著差異（p<.05）。
二、目標角度不論為膝關節彎曲30、45或60度，連續垂直跳前後之膝關節絕對誤差角度均達到顯著差異（p<.05），經事後比較發現，目標角度為30和60度時，只有跳躍後5分鐘之數值與跳躍前達顯著差異；目標角度為45度時，則有三個測量時段達顯著差異。
三、平均肌力疲勞指數與膝關節整體絕對誤差角度為中度負相關（r=-.449，p<.05）。

四、連續垂直跳60秒所引起的肌肉疲勞足以降低肌肉受器之精確性，而且整體膝關節本體感覺在連續60秒垂直跳後約5分鐘時為最差。
五、連續垂直跳60秒所引起的膝部肌肉疲勞後，膝關節整體本體
感覺功能至少需要休息50分鐘才會恢復。
由以上總結，連續彎膝垂直跳60秒所引發之肌肉疲勞確實會降低膝關節本體感覺之精確度，因此建議型態相似之運動，應於訓練時增加膝部肌肉之肌耐力，以降低或延緩肌肉疲勞，並給予選手適當且足夠的休息時間，減少運動傷害的發生。



關鍵詞：連續垂直跳、膝關節、肌肉疲勞、本體感覺、恢復時間。

The purpose of the study was to determine the effect of muscle fatigue on knee joint proprioception with specific fatigue protocol and functional weight-bearing position. Twenty-one healthy subjects were participated in this study. Electric goniometer and Kistler 9290 force plate with Quattro Jump program were used to measure knee joint flexion angles and fatigue index. 15 degrees of knee flexion was the starting position, and the target angles were set at 30, 45, and 60 degrees. The target angles were measured pre- and after fatigue exercise. One-way ANOVA and Turkey HSD post hoc were used to analyze mean differences of AAE among total knee joint and three target angles between each testing time in this study. AAE average graphs were used to describe the recovery status of knee joint proprioceptiion after muscle fatigue in this study. The findings demonstrated:
1. Total knee joint proprioception of pre- and after continuous jumps showed significant
difference in functional weight-bearing position (p<.05).
2. All of the target angles showed significant differences of pre- and after continuous jumps (p<.05), but there were three testing times in the mid target angle (45 degrees) showed significant differences when compared with pre-fatigue AAE.
3. Muscle fatigue induced by continuous jumps influenced knee joint proprioception, and the worst of the knee joint proprioception happened at 5 minutes after continuous jumps.
4. The function of knee joint proprioception should rest at least 50 minutes in order to recovery from muscle fatigue induced by continuous jumps.
Based on our findings, we suggested that sports activities which similar to continuous jumps, such as volleyball and basketball, should add muscle strength training programs to knee joint, and to ensure proper rest when encounter muscle fatigue, in order to prevent sports injury.

Key Words: Continuous Jump, knee joint, muscle fatigue, proprioception, recovery time.

第一章、緒　論-----------------------------------1
一、研究動機-------------------------------------1
二、研究目的-------------------------------------5
三、研究範圍與限制-------------------------------6
四、研究假定-------------------------------------7
五、名詞解釋及操作性定義-------------------------8
第二章、文獻探討--------------------------------11
一、本體感覺受器的分類與功能------------------11
二、不同膝關節角度位置與本體感覺功能之關係------19
三、不同誘發膝關節肌肉疲勞之方法----------------21
四、不同測量膝關節本體感覺之方法----------------23
五、肌肉疲勞前後對本體感覺功能之影響------------25
六、利用垂直跳與測力板推算出肌力----------------27
七、文獻總結------------------------------------28
第三章、研究方法--------------------------------29
一、研究對象------------------------------------29
二、實驗儀器與設備------------------------------31
三、實驗流程與步驟------------------------------35
四、資料處理與統計方法--------------------------37
第四章、結果------------------------------------38
一、連續跳躍前後對膝關節整體絕對誤差角度之差異-------------------------------- 38
二、連續跳躍前後對各個時間點間三個膝關節角度之絕對誤差角度差異情形---------------------------- 42
三、整體膝關節角度位置及各個膝關節角度位置絕對誤差角度與恢復時間之情形------------------------54
四、平均肌力疲勞指數與膝關節整體絕對誤差角度之相關性----------------------------------------------63
第五章、討論------------------------------------64
一、連續跳躍前後對膝關節整體絕對誤差角度之差異----------------------------------------------64
二、連續跳躍前後對各個時間點間三個膝關節角度之絕對誤差角度差異情形---------------------------66
三、整體膝關節角度位置及各個膝關節角度位置絕對誤差角度與恢復時間之情形-----------------------68
四、平均肌力疲勞指數與膝關節整體絕對誤差角度之相關性----------------------------------------------71
第六章、結論與建議------------------------------72
一、結論----------------------------------------72
二、建議----------------------------------------73
三、未來研究方向--------------------------------74
參考文獻----------------------------------------75
附錄--------------------------------------------80
附錄一、受試者基本資料--------------------------80
附錄二、受試者須知------------------------------81
附錄三、受試者同意書----------------------------83
附錄四、膝關節本體感覺實驗紀錄表----------------84
附錄五、膝關節本體感覺實驗原始資料--------------85
附錄六、疲勞指數與膝關節整體絕對誤差之原始資料--98

參考文獻

一、中文部分
林正常、黃勝裕、陳重佑（民國88）：蹲踞跳與下蹲跳之垂直跳躍指標與等速肌力之相關探討。體育學報。27，91-98頁。
張曉昀、蔚順華（民國90）：肩關節肌肉疲勞後本體感覺功能恢復情形之探討。物理治療。26（3），141-146。
張曉昀、蔚順華（民國88）：肌肉疲勞對本體感覺之影響。中華體育。12（5），69-75頁。

二、外文部分
Anderson, M.K., and Hall, S.J. (1995). Sports injury management, Media, USA, Williams & Wilkins.
Barrack, R.L., Lund, P.J., and Skinner, H.B. (1994).
Knee Joint Proprioception Revisited. Journal of Sport Rehabilitation, 3, 18-42.
Barrack, R.L., Skinner, H.B., and Buckley, S.L. (1989). Proprioception in the anterior cruciate deficient knee. The Physician and Sportsmedicine, 11(6), 1-6.
Barrack, R.L., Skinner, H.B., and Cook, S.D. (1984). Proprioception of the knee joint: paradoxical effect of training. American Journal of Physical Medicine, 63(4), 220-226.


Barrack, R.L., Skinner, H.B., Cook, S.D., and Haddad J.R. (1983). Effect of articular disease and total arthroplasty on knee joint position sense. Journal of Neurophysiology, 50, 684-687.
Borsa, P.A., Lephart, S.M., Kocher, M.S., and Lephart, S.P. (1994). Functional assessment and rehabilitation of shoulder proprioception for glenohumeral instability. Journal of Sport Rehabilitation, 3, 84-104.
Bosco, C., and Komi, P.V. (1980). Influence of Aging on the Mechanical Behavior of Leg Extensor Muscles. European Journal of Applied Physiology, 45, 209-219.
Bosco, C., Komi, P.V., Tihanyi, J., Fekete, G., and Apor, P. (1983). Mechanical Power Test and fiber Composition of Human Leg Extensor Muscles. European Journal of Applied Physiology, 51, 129-135.
Bosco, C., Luhtanen, P., and Komi, P.V. (1983). A Simple Mathod for Measurement of Mechanical Power in Jumping. European Journal of Applied Physiology, 50, 273-282.
Bosco, C., Tihanyi, J., Latteri, F., Fekete, G., Apor, P., and Ruska H. (1986). The effect of fatigue on store and re-use of elastic energy in slow and fast types of human skeletal muscle. Acta Physiologica Scandinavica, 128(1), 109-117.
Bullock-Saxon, J.E., Wong, W.J., and Hogan, N. (2001). The influence of age on weight-bearing joint reposition sense of the knee. Experimental Brain Research, 136, 400-406.

Carpenter, J.E., Blasier, R.B., and Pellizzon, G.G. (1998). The effects of muscle fatigue on shoulder joint position sense. The American Journal of Sports Medicine, 26(2), 262-265.
Clark, F.J., and Burgess, P.R. (1975). Slowly adapting receptors in cat knee joint: ca they signal joint angle? Journal of Neurophysiology, 38, 1448-1463.
Clark, F.J., Burgess, R.C., Chaplin, J.W., and Lipscomb, W.T. (1985). Role of intra-musculareceptors in the awareness of limb position. Journal of Neutophysiology, 54, 1529-1540.
Gandevia, S.C. (1992). Some central and peripheral factors affecting human motoneuronal output in neuromuscular fatigue. Sports Medicine, 13(2), 93-98.
Good, L., Roos, H., Gottlieb, D.J., Renstrom, P.A., and Beynnon, B.D. (1999). Joint position sense is not changed after acute disruption of the anterior cruciate ligament. Acta Physiologica Scandinavica, 70(2), 194-198.
Guyton, A.C. (1992). Human physiology and mechanisms of disease (5th ed.), Pennsylvania: W.B. Saunders Company.
Hagbarth, K.E., and Macefield, V.G. (1995). The fusimotor system: it’s role in fatigue. Advances in Experimental Medicine Biology, 384, 259-70.
Hiemstra, L.A., Lo, K.Y., and Fowler, P.J. (2001). Effect of Fatigue on Knee Proprioception: Implications for Dynamic Stabilization. Journal of Orthopaedic & Sports Physical Therapy, 31(10), 598-605.

Hubley, C.L., and Wells, R,P. (1983). A Work-Energy Approach to Determine Individual Joint Contributions to Vertical Jump Performance. European Journal of Physiology, 50, 247-254.
Isaacs, L.D., and Pohlman, R.L. (1991). Effects of exercise intensity on an accompanying timing task. J. Hum. Stud., 20, 121-131.
Kramer, J., Handfield, T., Kiefer, G., Forwell, L., and Birmingham, T. (1997). Comparisons of Weight-Bearing and Non-Weight-Bearing Tests of Knee Proprioception Performed by Patients with Patello-Femoral Pain Syndrome and Asymptomatic Individuals. Clinical Journal of Sport Medicine, 7, 113-118.
Lantanzio, P.J., Petrella, R.J. (1998). Knee Proprioception: A Review of Mechanisms, Measurements, and Implications of Muscular Fatigue. Orthopedics, 21(4), 463-470.
Lattanzio, P.J., Petrella, R.J., Sproule, L.R. and Fowler, P.J. (1997). Effects of fatigue on knee proprioception. Clinical Journal of Sport Medicine, 7, 22-27.
Lephart, S.M., Pincivero, D.M., Giraldo, J.L., and Fu, F.H. (1997). The role of proprioception in the management and rehabilitation of athletic injuries. The American Journal of Sports Medicine, 25(1), 130-137.



Marks, R., and Quinney, H.A. (1993). Effect of fatiguing maximal isokinetic quadriceps contractions on ability to estimate knee position. Perceptual and Motor Skills, 77, 1195-1202.
McMorris, T., and Keen, P. (1994). Effects of exercise on simple reaction times of recreational athletes. Perceptual and Motor Skills, 78, 123-130.
Newton, R.A. (1982). Joint receptor contributions to reflexive and kinesthetic responses. Physical Therapy, 62(1), 22-29.
Pincivero, D.M., Bachmeier, B., and Coelho, A.J. (2001). The effects of joint angle and reliability on knee proprioception. Medicine & Science in Sports & Science, 33(10), 1708-1712.
Rowinski, M.J. (1997). Neurobiology for orthopedic and sports physical therapy. In T.R. Malone, T.G. McPoil, & A.J. Nitz (3rd ed.), Orthopedic and Sports Physical Therapy, St. Louis: Mosby, Inc.
Saxton, J.M., Clarkson, P.M., James, R., Miles, M., Westerfer, M., Clark, S., and Donnelly, A.E. (1995). Neuromuscular dysfunction following eccentric exercise. Medicine and Science in Sports Exercise, 27(8), 1185-1193.
Schwendner, K.I., Mikesky, A.E., Wigglesworth, J.K., and Burr, D.B. (1995). Recovery of dynamic muscle function following isokinetic fatigue testing. International Journal of Sports Medicine, 16, 185-189.

Sharp, M.H., and Miles, T.S. (1993). Position sense at the elbow after fatiguing contractions. Experimental Brain Research, 94, 179-182.
Skinner, H.B., Barrack, R.L., and Cook, S.D. (1984). Joint position sense in total knee arthroplasty. Journal of Orthopaedic Research, 1, 276-283.
Skinner, H.B., Wyatt, M.P., Hodgdon, J.A., Conard, D.W. and Barrack, R.L. (1986). Effects of fatigue on joint position sense of the knee. Journal of Orthopaedic Research, 4, 112-118.
Sterner, R.L., Pincivero, D.M., and Lephart, S.M. (1998). The effects of muscular fatigue on shoulder proprioception. Clinical Journal of Sport Medicine, 8, 96-101.
Tomporowski, P.D., and Ellis, N.R. (1986). Effects of exercise on cognitive processes: a review. Psychol Bull, 99, 338-346.
Voight, M.L., Hardin, J.A., Blackburn, T.A., Tippett, S., and Canner, G.C. (1996). The effects of muscle fatigue on and the relation of arm dominance to shoulder proprioception. The Journal of Orthopedic and Sports Physical Therapy, 23(6), 348-352.