(3.230.143.40) 您好!臺灣時間:2021/04/21 06:13
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果

詳目顯示:::

我願授權國圖
: 
twitterline
研究生:李冠廷
研究生(外文):Kuan-Ting Lee
論文名稱:探討肩胛骨位置對於斜方肌延遲放鬆與反應時間之影響
論文名稱(外文):Influence of scapular position on the delayed relaxarion and latency times of the trapezius muscle region
指導教授:莊炯承
指導教授(外文):Chiung-Cheng Chuang
學位類別:碩士
校院名稱:中原大學
系所名稱:生物醫學工程研究所
學門:工程學門
學類:生醫工程學類
論文種類:學術論文
論文出版年:2011
畢業學年度:99
語文別:中文
論文頁數:50
中文關鍵詞:斜方肌疲勞表面肌電圖肩胛骨
外文關鍵詞:ElectromyographyFatigueTrapeziusScapular
相關次數:
  • 被引用被引用:0
  • 點閱點閱:270
  • 評分評分:系統版面圖檔系統版面圖檔系統版面圖檔系統版面圖檔系統版面圖檔
  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:0
肩關節是人體中活動度最大的關節之一,其中肩胛骨是負責協調肩部其他骨骼與肌肉相關位置的重要骨骼,當肩胛骨位置不當會導致肩部發生病變,因此找出一個簡易方法評估肩胛骨是否正常運作,和準確辨別出肩胛骨運動位置就顯得相當重要。
本研究針對正常年輕族群探討肩胛骨位置較低時對於靜止時與聳肩後上、下斜方肌的壓力疼痛閥值(Pressure Pain Threshold, PPT)與肌肉基本狀態,分析表面肌電圖在連續三次最大自主聳肩時肌肉延遲時間(Muscle Latency Time, MLT)及每次聳肩時最大中位頻率(Median Frequency, MF),並利用線性回歸法計算出連續三次最大自主MF的變化斜率(Hz/ms),作為肌肉疲勞指標。
本研究臨床收案有效樣本共20人,包含正常12人(男生5人、女生7人)與肩胛骨位置較低8人(男生5人、女生3人),經由統計分析後發現肩胛骨位置較低者,其上、下斜方肌確實都有明顯較低的PPT值(P<0.05),肌肉基本狀態沒有顯著差異(P>0.05),在聳肩時上斜方肌MLT有明顯延遲的現象發生(P<0.05),MF的斜率變化上無顯著差異。因此推測在肩部未患有任何症狀且活動正常的年輕人中,肩胛骨位置較低者,其上、下斜方肌深層的肌肉確實都有較低的壓力耐受值,但還是能維持正常的基本特性。運動時上斜方肌徵召運動單元時會需要較長的時間,但不影響肌肉緩解疲勞能力。



The shoulder joint is one of the most freely movable joint in the body. It possesses specialized structure and motion. Scapular is stabilised in or moved into a certain position to coordinate shoulder function during the movement of shoulder and arm and to achieve a ways movement of joint in athletic and daily activities. An alteration in the scapular position at rest or during arm movement is commonly associated with shoulder injury on dysfunction. Therefore, it is necessary to quantify and identify scapular dysfunction accurate by easily implemented clinical tests and measures.
The purpose of this study was to assess the influence of scapular with depressed position through the values of pressure pain threshold (PPT) and muscle properties of the up and lower trapezius muscles in a young healthy population. By using surface electromyography to evaluate muscle fatigue instructed to a sequence of three maximal shoulder shrugs with each held for 5s. Calculating each shrug’s muscle latency time (MLT) and a slope of the regression line (Hz/ms) that fits the maximum values of median frequency (MF) in a least-square sense was used as a fatigue index.
Twenty volunteers participated in this study, they were divided into normal shoulder (NS group, n=8, 5 men and 3 women) group and depressed shoulder (DS group, n=12, 5 men and 7 women) group. The results revealed significant difference between groups, with the DS group demonstrated lower mean PPT values(P&lt;0.05) when compared to NS group. Significant delayed in latency time(P&lt;0.05) of the upper trapezius muscle during the shoulder shrugs were observed. Although there were no significant difference(P&gt;0.05) in muscle properties and the slope of the regression line (P&gt;0.05) among the 2 section of the trapezius muscle.
Our results showed that healthy young subjects with depressed scapula position had significant lower PPT value than subjects with normal scapular position both in the up and lower trapezius muscle. There is no difference in muscle properties of upper and lower trapezius muscle in subjects with normal and depressed scapular position.



摘要 I
Abstract II
誌 謝 III
目 錄 IV
圖目錄 VII
表目錄 IX
第一章 緒論 1
1.1 前言與背景 1
1.2 文獻回顧 2
1.3 研究動機與目的 6
1.4 論文架構 7
第二章 基礎理論 8
2.1 肩胛骨的解剖學與生物力學機制 8
2.2 斜方肌(Trapezius Muscle) 10
2.3 表面肌電圖(surface Electromyography, sEMG) 11
2.3.1 肌肉延遲時間(Muscle Latency Time, MLT) 12
2.3.2 中位頻率(Median Frequency, MF) 13
2.4 壓力疼痛閥值(Pressure Pain Threshold, PPT) 14
2.5 肌肉機械特性 15
第三章 研究方法與步驟 16
3.1 肩胛骨位置拍攝裝置 16
3.2 壓力疼痛測試計(Pressure Threshold Algometer, PTA) 17
3.3 肌肉基本特性 17
3.4 肌電訊號擷取系統 19
3.4 實驗組別 24
3.5 臨床試驗設計 25
3.5.1 臨床試驗流程 25
3.5.2 受測者之篩選 25
第四章 成果與討論 27
4.1 實驗對象 27
4.2 臨床試驗結果與討論 28
4.2.1壓力疼痛閥值(PPT) 28
4.2.2 肌肉基本特性 29
4.2.3肌肉延遲時間(MLT) 30
4.2.4中位頻率(MF) 31
第五章 結論與未來展望 33
5.1 結論 33
5.2 未來展望 33
5.2.1 臨床收案部分 33
5.2.2 臨床實驗設計 33
參考資料 35
附錄 口試委員建議事項 40

圖目錄
圖 1 肩胛骨位置 3
圖 2 肌肉收縮時間延長與中位頻率、肌肉疲勞之關係[24] 5
圖 3 連續週期性自主收縮之肌電訊號變化[29] 5
圖 4 隨著作用時間延長,斜方肌各部位之中位頻率變化[30] 5
圖 5 右肩胛骨 9
圖 6 背部肌肉[33] 10
圖 7 兩組運動單元與連結之肌肉細胞[41] 12
圖 8 肌電圖訊號產生示意圖[44] 12
圖 9 肌電圖頻譜正規化後中心頻率與持續運動時間長度關係[47] 14
圖 10 肩胛骨拍攝裝置設置 16
圖 11 Pressure Threshold Algometer 17
圖 12 Myoton 肌肉特性量測系統 18
圖 13 myoton 量測圖形[57] 18
圖 14 肌電訊號擷取裝置(Power Lab 15T) 20
圖 15 電極貼片正反面 21
圖 16 肌肉收縮時間示意圖 21
圖 17 MF 分析示意圖 23
圖 18 肩胛骨位置(實際收案) 24
圖 19 臨床詴驗流程圖 25

表目錄
表 1 相關肌肉特性與計算公式[52] 19
表 2 Power Lab 15T 規格 20
表 3 受測者基本資料 27
表 4 壓力疼痛閥值(PPT)(Kg/cm2) 29
表 5 上斜方肌肌肉群基本特性 30
表 6 斜方肌肌肉群聳肩時肌肉延遲時間(MLT)(ms) 31
表 7 斜方肌肌肉群聳肩MF-slope (Hz/ms) 32
表 8 各組之間斜方肌肌肉群聳肩MF-slope (Hz/ms) 32
[1]N. T. Tsai, P. W. McClure, and A. R. Karduna, "Effects of muscle fatigue on 3-dimensional scapular kinematics1," Archives of physical medicine and rehabilitation, vol. 84, pp. 1000-1005, 2003.
[2]R. Carola, J. P. Harley, and C. R. Noback, Human anatomy: McGraw-Hill New York etc, 1992.
[3]D. D. Ebaugh, P. W. McClure, and A. R. Karduna, "Effects of shoulder muscle fatigue caused by repetitive overhead activities on scapulothoracic and glenohumeral kinematics," Journal of electromyography and kinesiology, vol. 16, pp. 224-235, 2006.
[4]K. Saladin, Human Anatomy'2007 Ed: Rex Bookstore, Inc.
[5]H. T. Lin, "Biomechanical Modeling and Dynamic Graphic Simulation for the Shoulder Using Visual Interactive Musculoskeletal System (VIMS)," 2005.
[6]G. Di Giacomo, N. Pouliart, and A. Costantini, Atlas of Functional Shoulder Anatomy: Springer Verlag, 2008.
[7]W. Kibler, "Shoulder rehabilitation: principles and practice," Medicine & Science in Sports & Exercise, vol. 30, p. 40, 1998.
[8]W. Ben Kibler and J. McMullen, "Scapular dyskinesis and its relation to shoulder pain," Journal of the American Academy of Orthopaedic Surgeons, vol. 11, p. 142, 2003.
[9]W. Kibler, P. M. Ludewig, P. McClure, T. Uhl, and A. Sciascia, "Scapular Summit 2009: Introduction," journal of orthopaedic & sports physical therapy, vol. 39, p. a1, 2009.
[10]F. Martini, E. F. Bartholomew, W. C. Ober, C. W. Garrison, K. Welch, and R. Hutchings, Essentials of anatomy & physiology: Prentice Hall, 2000.
[11]D. C. Azevedo, T. de Lima Pires, F. de Souza Andrade, and M. K. McDonnell, "Influence of scapular position on the pressure pain threshold of the upper trapezius muscle region," European Journal of Pain, vol. 12, pp. 226-232, 2008.
[12]A. M. Cools, E. E. Witvrouw, G. A. Declercq, L. A. Danneels, and D. C. Cambier, "Scapular muscle recruitment patterns: trapezius muscle latency with and without impingement symptoms," The American Journal of Sports Medicine, vol. 31, p. 542, 2003.
[13]H. S. J. Picavet and J. Schouten, "Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups, the DMC3-study," Pain, vol. 102, pp. 167-178, 2003.
[14]C. G. M. Meskers, H. M. Vermeulen, J. H. De Groot, F. C. T. Van der Helm, and P. M. Rozing, "3D shoulder position measurements using a six-degree-of-freedom electromagnetic tracking device," Clinical biomechanics, vol. 13, pp. 280-292, 1998.
[15]F. P. Kendall, E. K. McCreary, P. G. Provance, M. M. Rodgers, and W. A. Romani, "2005. Muscles, Testing and Function With Posture and Pain," Williams & Wilkins, Baltimore.
[16]T. R. Swift and F. T. Nichols, "The droopy shoulder syndrome," Neurology, vol. 34, p. 212, 1984.
[17]S. A. Sahrmann, "Diagnosis and treatment of movement impairment syndromes. St. Louis: Mosby," Inc, 2002.
[18]L. J. Clein, "The droopy shoulder syndrome," Canadian Medical Association Journal, vol. 114, p. 343, 1976.
[19]S. Finocchietti, M. Nielsen, C. D. Morch, L. Arendt-Nielsen, and T. Graven-Nielsen, "Pressure-induced muscle pain and tissue biomechanics: A computational and experimental study," European Journal of Pain, vol. 15, pp. 36-44, 2011.
[20]D. T. Barry, S. R. Geiringer, and R. D. Ball, "Acoustic myography: a noninvasive monitor of motor unit fatigue," Muscle & nerve, vol. 8, pp. 189-194, 1985.
[21]F. B. Stulen and C. J. De Luca, "Frequency parameters of the myoelectric signal as a measure of muscle conduction velocity," Biomedical Engineering, IEEE Transactions on, pp. 515-523, 1981.
[22]G. L. Soderberg, Selected topics in surface electromyography for use in the occupational setting: Expert perspectives: US Dept. of Health and Human Services, Public Health Service, Centers for Disease Control, National Institute for Occupational Safety and Health, 1992.
[23]T. Oberg, L. Sandsjo, R. Kadefors, and S. E. Larsson, "Electromyographic changes in work-related myalgia of the trapezius muscle," European journal of applied physiology and occupational physiology, vol. 65, pp. 251-257, 1992.
[24]C. J. De Luca, "Myoelectrical manifestations of localized muscular fatigue in humans," Critical reviews in biomedical engineering, vol. 11, p. 251, 1984.
[25]C. J. De Luca, "The use of surface electromyography in biomechanics," Journal of Applied Biomechanics, vol. 13, pp. 135-163, 1997.
[26]A. M. Cools, E. E. Witvrouw, G. A. De Clercq, L. A. Danneels, T. M. Willems, D. C. Cambier, and M. L. Voight, "Scapular muscle recruitment pattern: electromyographic response of the trapezius muscle to sudden shoulder movement before and after a fatiguing exercise," The Journal of orthopaedic and sports physical therapy, vol. 32, p. 221, 2002.
[27]G. F. S. Moraes, C. D. C. M. Faria, and L. F. Teixeira-Salmela, "Scapular muscle recruitment patterns and isokinetic strength ratios of the shoulder rotator muscles in individuals with and without impingement syndrome," Journal of Shoulder and Elbow Surgery, vol. 17, pp. S48-S53, 2008.
[28]M. Cifrek, S. Tonkovi, and V. Medved, "Measurement and analysis of surface myoelectric signals during fatigued cyclic dynamic contractions," Measurement, vol. 27, pp. 85-92, 2000.
[29]V. Srhoj-Egekher, M. Cifrek, and V. Medved, "The application of Hilbert–Huang transform in the analysis of muscle fatigue during cyclic dynamic contractions," Medical and Biological Engineering and Computing, pp. 1-11, 2011.
[30]S. Minning, C. A. Eliot, T. L. Uhl, and T. R. Malone, "EMG analysis of shoulder muscle fatigue during resisted isometric shoulder elevation," Journal of electromyography and kinesiology, vol. 17, pp. 153-159, 2007.
[31]P. V. Komi and P. Tesch, "EMG frequency spectrum, muscle structure, and fatigue during dynamic contractions in man," European journal of applied physiology and occupational physiology, vol. 42, pp. 41-50, 1979.
[32]V. Phadke, P. R. Camargo, and P. M. Ludewig, "Scapular and rotator cuff muscle activity during arm elevation: a review of normal function and alterations with shoulder impingement," Revista Brasileira de Fisioterapia, vol. 13, pp. 1-9, 2009.
[33]F. H. Martini, M. J. Timmons, R. B. Tallitsch, and K. A. Ireland, Human anatomy: Prentice Hall Upper Saddle River, NJ, 2009.
[34]P. M. Ludewig and T. M. Cook, "Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement," Physical Therapy, vol. 80, p. 276, 2000.
[35]A. C. Lukasiewicz, P. McClure, L. Michener, N. Pratt, and B. Sennett, "Comparison of 3-dimensional scapular position and orientation between subjects with and without shoulder impingement," The Journal of orthopaedic and sports physical therapy, vol. 29, p. 574, 1999.
[36]B. J. Cole and J. J. P. Warner, "Anatomy, biomechanics, and pathophysiology of glenohumeral instability," Disorders of the shoulder. Diagnosis and management. Philadelphia Baltimore, pp. 208–219, 1999.
[37]N. K. Poppen and P. S. Walker, "Normal and abnormal motion of the shoulder," The Journal of Bone and Joint Surgery, vol. 58, p. 195, 1976.
[38]D. C. Sobush, G. G. Simoneau, K. E. Dietz, J. A. Levene, R. E. Grossman, and W. B. Smith, "The lennie test for measuring scapular position in healthy young adult females: a reliability and validity study," The Journal of orthopaedic and sports physical therapy, vol. 23, p. 39, 1996.
[39]J. J. P. Warner, L. J. Micheli, L. E. Arslanian, J. Kennedy, and R. Kennedy, "Scapulothoracic Motion in Normal Shoulders and Shoulders With Glenohumeral Instability and Impingement Syndrome A Study Using Moire Topographic Analysis," Clinical orthopaedics and related research, vol. 285, p. 191, 1992.
[40]D. G. Simons, J. G. Travell, and L. S. Simons, Travell & Simons' Myofascial pain and dysfunction: the trigger point manual: Williams & Wilkins, 1999.
[41]E. P. Widmaier, H. Raff, and K. T. Strang, Human physiology: the mechanisms of body function: Mcgraw Hill, 2006.
[42]C. Kirtley, "Muscles," in Clinical Gait Analysis Edinburgh: Churchill Livingstone, 2006, pp. 133-155.
[43]G. Johnson, N. Bogduk, A. Nowitzke, and D. House, "Anatomy and actions of the trapezius muscle," Clinical biomechanics, vol. 9, pp. 44-50, 1994.
[44]L. Ming-I, "Electromyographic Assessment on Muscular Fatigue during the Long-Term Typing Activity," in Institute of Occupational Medicine and Industrial Hygiene. vol. Master Taipei: National Taiwan University, 2002, p. 73.
[45]R. H. T. Edwards, "Human muscle function and fatigue," 1981.
[46]J. Watkins, Structure and function of the musculoskeletal system: Human Kinetics, 2009.
[47]L. Lindstrom and I. Petersen, "Power spectra of myoelectric signals: motor unit activity and muscle fatigue," Clinical Neumphysiology, London, England: Butterwonh & Co (Publishers) Ltd, pp. 66-87, 1981.
[48]R. J. S. Giesbrecht and M. C. Battie, "A comparison of pressure pain detection thresholds in people with chronic low back pain and volunteers without pain," Physical Therapy, vol. 85, p. 1085, 2005.
[49]A. Blikstad and H. Gemmell, "Immediate effect of activator trigger point therapy and myofascial band therapy on non-specific neck pain in patients with upper trapezius trigger points compared to sham ultrasound: A randomised controlled trial," Clinical Chiropractic, vol. 11, pp. 23-29, 2008.
[50]J. Ylinen, "Pressure algometry," Aust J Physiother, vol. 53, p. 207, 2007.
[51]A. A. Fischer, "Pressure algometry over normal muscles. Standard values, validity and reproducibility of pressure threshold," Pain, vol. 30, pp. 115-126, 1987.
[52]G. Gavronski, A. Veraksit, E. Vasar, and J. Maaroos, "Evaluation of viscoelastic parameters of the skeletal muscles in junior triathletes," Physiological Measurement, vol. 28, p. 625, 2007.
[53]J. Lewis, A. Green, Z. Reichard, and C. Wright, "Scapular position: the validity of skin surface palpation* 1," Manual Therapy, vol. 7, pp. 26-30, 2002.
[54]H. Gemmell and J. Bagust, "Can surface electromyography differentiate muscle activity between upper trapezius muscles with active versus latent trigger points?: A cross-sectional study," Clinical Chiropractic, vol. 12, pp. 67-73, 2009.
[55]C. R. Hou, L. C. Tsai, K. F. Cheng, K. C. Chung, and C. Z. Hong, "Immediate effects of various physical therapeutic modalities on cervical myofascial pain and trigger-point sensitivity* 1," Archives of physical medicine and rehabilitation, vol. 83, pp. 1406-1414, 2002.
[56]C. T. Leonard, J. U. Stephens, and S. L. Stroppel, "Assessing the spastic condition of individuals with upper motoneuron involvement: validity of the myotonometer," Archives of physical medicine and rehabilitation, vol. 82, pp. 1416-1420, 2001.
[57]M. Veldi, V. Vasar, A. Vain, and M. Kull, "Obstructive sleep apnea and ageing:: Myotonometry demonstrates changes in the soft palate and tongue while awake," Pathophysiology, vol. 11, pp. 159-165, 2004.
[58]J. R. Cram and E. Criswell, Introduction to surface electromyography: Jones & Bartlett Learning, 2011.
[59]H. J. Hermens, B. Freriks, C. Disselhorst-Klug, and G. Rau, "Development of recommendations for SEMG sensors and sensor placement procedures," Journal of electromyography and kinesiology, vol. 10, pp. 361-374, 2000.
[60]D. Treaster, W. S. Marras, D. Burr, J. E. Sheedy, and D. Hart, "Myofascial trigger point development from visual and postural stressors during computer work," Journal of electromyography and kinesiology: official journal of the International Society of Electrophysiological Kinesiology, vol. 16, p. 115, 2006.
[61]J. W. Clark and J. G. Webster, Medical instrumentation: application and design vol. 2: Wiley, 1998.
[62]E. W. Kamen and B. S. Heck, Fundamentals of signals and systems using the web and matlab: Prentice-Hall, Inc. Upper Saddle River, NJ, USA, 2006.
[63]S. K. Powers and E. T. Howley, "Exercise Physiology: Theory and Application to Fitness and Performance 2004," McGraw Hill, 2004.
[64]L. S. Chesterton, P. Barlas, N. E. Foster, G. D. Baxter, and C. C. Wright, "Gender differences in pressure pain threshold in healthy humans," Pain, vol. 101, pp. 259-266, 2003.
[65]D. A. Jones, D. J. Newham, and C. Torgan, "Mechanical influences on long-lasting human muscle fatigue and delayed-onset pain," The Journal of Physiology, vol. 412, p. 415, 1989.
[66]R. A. Ekstrom, R. W. Osborn, A. D. Robert, PhD, Pt, and Ocs, "Muscle Length Testing and Electromyographic Data for Manual Strength Testing and Exercises for the Shoulder," in Physical Therapy of the Shoulder (Fourth Edition) Saint Louis: Churchill Livingstone, 2004, pp. 435-463.
[67]L. Arendt-Nielsen, N. Gantchev, and T. Sinkjar, "The influence of muscle length on muscle fibre conduction velocity and development of muscle fatigue," Electroencephalography and Clinical Neurophysiology/Evoked Potentials Section, vol. 85, pp. 166-172, 1992.

QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top
系統版面圖檔 系統版面圖檔