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研究生:朱俊榮
研究生(外文):Chun-Jung Chu
論文名稱:腰椎穩定性運動對下背痛棒球野手之療效
論文名稱(外文):Effects of Lumbar stabilization for Baseball Fielders with Low Back Pain
指導教授:陳文英陳文英引用關係王子娟王子娟引用關係
指導教授(外文):Wen-Yin ChenTzyy-Jiuan Wang
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:物理治療學系暨研究所
學門:醫藥衛生學門
學類:復健醫學學類
論文種類:學術論文
論文出版年:2006
畢業學年度:94
語文別:中文
論文頁數:93
中文關鍵詞:下背痛腰椎穩定性棒球野手腰椎骨盆控制身體功能表現
外文關鍵詞:low back painlumbar stabilitybaseball fielderslumbo-pelvic controlphysical performance
相關次數:
  • 被引用被引用:8
  • 點閱點閱:659
  • 評分評分:
  • 下載下載:96
  • 收藏至我的研究室書目清單書目收藏:2
背景與研究目的:台灣的棒球野手的下背痛發生率很高,往往會影響到臨場表現。守備時除了需要快速的軀體動作之外,還得有適當的腰椎穩定。因此要改善下背痛棒球野手守備表現,腰椎穩定度的訓練是重要的。過去的研究顯示,腰椎穩定訓練不但可以有效改善下背痛患者的疼痛及失能狀況,還可以減少下背痛發生率。不過,尚無研究探討這類訓練對於下背痛棒球野手功能表現的影響。本研究目的為探討腰椎穩定訓練對於下背痛棒球野手身體功能表現的影響。研究方法:採用單一組別重複測試的實驗設計。共計收取了十三位下背痛棒球野手並施予各六週的第一階段 (包括牽拉運動及傳統式腹背肌訓練) 和第二階段訓練 (包括牽拉運動及特定式腰椎穩定運動)。並在介入前、六週訓練後及十二週訓練後,評估其疼痛、腰椎骨盆控制力以及包括折返跑等六項身體功能表現。統計方式:以重複測試變異數分析 (repeated measures ANOVA) 檢定疼痛程度在三次測量時的差異;並用重複測試多變項變異數分析 (repeated measures multivariate ANOVAs) 檢定三次測量時腰椎骨盆控制力、以及身體功能表現的差異,顯著差異水準定為0.01。 研究結果:經過第二階段訓練後,與第一階段訓練後相比,無論是自覺疼痛、腰椎骨盆控制力、以及身體功能表現,都呈現顯著進歩 (P<0.01)。 討論與結論:特定式腰椎穩定訓練可以有效改善疼痛、失能、及腰椎不穩定的狀況;也可促進下背痛的棒球野手身體功能的表現。
Background and purpose: Occurrence of low back pain (LBP) in baseball fielders is high In Taiwan. The players need rapid and repeated trunk movements for optimal performance on the field; this requires proper stabilization of the lumbar spine. Deficits in the trunk muscle function have been identified to cause impaired lumbar stability, which often result in recurrent or chronic LBP. Lumbar stabilization is essential for improving function and performance of the baseball fielders, especially for those with LBP. Previous studies suggested lumbar stabilization programs could reduce pain and disability in back pain sufferers and decrease back pain occurrence in athletes. However, no study has evaluated the effect of lumbar stabilization in physical performance of baseball fielders with LBP. The purpose of the study is to investigate the effects of a lumbar stabilization program on physical performance of the baseball fielders with LBP. Design: One group repeated measures design. Method: Thirteen baseball fielders with LBP were recruited and received six weeks of phase I training (stretch + general trunk muscles strengthening) and six weeks of phase II training (stretch + lumbar stabilization exercise). Outcome was based on self-reported pain , lumbopelvic control test (leg loading test), and physical performance tests (the timed 20-m shuttle runt, timed up and go, timed repeated trunk flexion, loaded reach, Sorensen fatigue, vertical jump tests) measured immediately before, six weeks and twelve weeks after the intervention starts. Statistical Analysis: One-way analysis of variances with repeated measures were used to compare differences of lumbopelvic control test and the physical performance tests between the two phases of training (p<0.01). Result: The phase II intervention showed significant improvement in self reported level of pain, lumbopelvic control, and most of the physical performance tests (p<0.01). Discussion and Conclusion: The specific lumbar stabilization program could reduced pain, disability and lumbar instability in baseball fielders with LBP. Furthermore, it could help baseball players with LBP to regain physical performance.
目 錄
授權書..............................................................i
謝誌...............................................................ii
目錄..............................................................iii
表目錄..............................................................v
圖目錄.............................................................vi
中文摘要..........................................................vii
英文摘要...........................................................ix
第一章 緒論........................................................1
第一節 研究背景................................................1
第二節 研究重要性..............................................2
第三節 研究目的................................................3
第四節 研究假設................................................4
第二章 研究背景....................................................5
第一節 棒球與野手簡介.........................................5
第二節 棒球守備的軀體動作.....................................5
一、 投手....................................................6
二、 捕手....................................................7
三、 內野手..................................................7
四、 外野手..................................................8
第三節 軀體的肌肉作用對於守備動作的重要性.............9
第四節 脊椎穩定系統..........................................11
一、 被動支持系統...........................................12
二、 主動支持系統...........................................12
三、 神經控制系統........................ ..................14
第五節 腰椎穩定性異常與下背痛的關係..........................15
一、 腹肌的功能異常.........................................15
二、 背肌的功能異常.........................................16
三、 神經肌肉的控制異常.....................................18
第六節 評估腰椎穩定性的臨床測試..............................19
第七節 脊椎穩定性運動對於下背痛患者的療效....................21
第八節 綜合探討..............................................24
第三章 研究方法....................................................26
第一節 研究設計.................... ..........................26
第二節 研究對象..............................................26
一、 收案條件...............................................26
二、 排案條件...............................................27
第三節 評估項目與步驟........................................27
一、 疼痛程度的評估.........................................27
二、 腰椎骨盆控制力.........................................28
三、 身體功能表現............................ ..............29
第四節 治療介入..............................................33
一、 基礎期.................................................33
二、 進階期.............. ..................................34
三、 特殊訓練期.............................................34
第五節 研究流程............ ..................................34
第六節 資料統計與分析........................................35
第四章 研究結果...................................................36
第一節 研究對象...............................................36
第二節 疼痛...................................................36
第三節 腰椎骨盆控制力.........................................37
第四節 身體功能表現...........................................38
第五章 討論............................. .........................40
第一節 下背痛棒球野手之疼痛情形...............................40
第二節 腰椎骨盆控制能力之探討.................................42
第三節 身體功能表現之探討.....................................44
第四節 臨床應用...............................................45
第五節 研究限制...............................................46
第六節 未來研究方向...........................................47
第六章 結論.......................................................49

參考文獻...........................................................50
附錄一 人體試驗計劃同意書.........................................80
附錄二 特定性腰椎穩定運動訓練計畫.................................82
附錄三 受試者同意書...............................................91

表目錄

表一、受試者基本資料之平均值(標準差)和範圍..........................63
表二、疼痛表現之重複測試變異數分析..................................64
表三、訓練前、第二階段訓練後和第二階段訓練後之三次下肢負重測試
(毫米汞柱)平均值(標準差)和範圍........................65
表四、下肢負重測試之重複測試多變項變異數分析........................66
表五、訓練前、第二階段訓練後和第二階段訓練後之三次身體功能表現平均
值(標準差)和範圍.............................................67
表六、身體功能表現測試之重複測試多變項變異數分析....................68


圖目錄

圖一、棒球野手的守備位置圖..........................................69
圖二、壓力生物回饋儀................................................70
圖三、研究流程圖................................. ..................71
圖四、訓練前、第一階段訓練後和第二階段訓練後之疼痛測試結果......72
圖五、訓練前、第一階段訓練後和第二階段訓練後之負重0、1、2.5、3.5及5
公斤之腰椎骨盆穩定測試結果...........................73
圖六、訓練前、第一階段訓練後和第二階段訓練後之二十公尺折返跑測試結
果........................................... .............74
圖七、訓練前、第一階段訓練後和第二階段訓練後之快速坐到站並行走測試結
果............................................... ...........75
圖八、訓練前、第一階段訓練後和第二階段訓練後之反覆站姿體前彎測試結
果...........................................................76
圖九、訓練前、第一階段訓練後和第二階段訓練後之負重前驅測試結果.......77
圖十、訓練前、第一階段訓練後和第二階段訓練後之背肌耐力測試結果.......78
圖十一、訓練前、第一階段訓練後和第二階段訓練後之垂直跳測試結果.......79
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