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研究生:黃彙茵
研究生(外文):Hui-Yin Huang
論文名稱:踝關節功能性不穩定患者落地時踝關節穩定肌群活化情形之探討
論文名稱(外文):The Electromyography of Ankle Stabilizers during Landing in Subjects with Functional Ankle Instability
指導教授:傅麗蘭傅麗蘭引用關係
指導教授(外文):Li-Lan Fu
學位類別:碩士
校院名稱:國立體育大學
系所名稱:運動保健學系碩士班
學門:民生學門
學類:運動科技學類
論文種類:學術論文
論文出版年:2012
畢業學年度:100
語文別:中文
論文頁數:77
中文關鍵詞:踝關節不穩定落地動作預先活化
外文關鍵詞:Ankle instabilitylandingpre-activity
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研究背景:踝關節功能性不穩定(FAI, Functional Ankle Instability)是指腳踝扭傷後反覆出現無力感或不穩定的症狀,但是在醫學相關檢查卻沒有發現不正常的情形,而且可能因為踝關節的無力感造成反覆性扭傷。之前的研究指出踝關節扭傷後,可能由於受傷關節傳入訊息改變,導致傳出至肌肉產生動作的訊息減少,最後因為肌肉活化不完全及活化延遲,造成關節的不穩定,但確實之機轉仍未有定論。
研究目的:本研究之目的為探討踝關節功能性不穩定患者落地於傾斜地面時,肌電活化情形及角度變化與控制組是否有差異。
研究方法:本研究招募26名自願參與實驗的受試者,包含13位有FAI症狀者及13位無FAI症狀者。請受試者跳躍落地於內翻傾斜30度的木板上,以Biopac system搭配雙極電極前置放大器收集雙側下肢脛前肌、腓骨長肌、外側比目魚肌及腓腸肌外側頭在落地前100毫秒到落地後200毫秒的肌電訊號,以Motion Analysis Corp收集關節角度變化之情形。以成對樣本t檢定比較不穩定者傷側與健側腳之間的差異,再用獨立樣本t檢定比較兩組間的差異。
結果:落地前FAI患者傷側腳腓腸肌的活化(M=52.04,SD=24.26)較健側腳(M=38.00,SD=17.94)來的多(p<.01),而脛前肌、腓骨長肌與比目魚肌的活化在傷側腳及健側腳間則無顯著差異;而FAI患者雙側腳踝關節穩定肌群在落地後活化雖未達顯著差異,但傷側腳腓骨長肌(M=99.47,SD=63.72)有比健側腳(M=149.61,SD=117.29)活化較少的趨勢;FAI患者與控制組間在落地前後穩定肌群活化皆未達顯著差異。在角度變化方面,落地前FAI患者傷側腳矢狀面的平均角度位移(M=13.72,SD=5.39)與健側腳(M=10.61,SD=3.68)有顯著差異(p=.02),落地後則無顯著差異。
結論:FAI患者利用腓腸肌預先活化的方式幫助緩衝落地的反作用力,表示FAI患者在外踝受傷之後會利用其他踝關節穩定肌群的活化協助達到動態平衡。

Background:Functional ankle instability has been defined as a tendency to “give way” during activities after ankle sprain, but no detectable abnormality could be found during examination. Repeated sprains might be caused by the subjective feeling of weakness or “give way.” According to previous researches, the decrease of afferent input after ankle sprain impact the efferent output to the muscles. Functional ankle instability may be due to incompletement and delay of muscle activation, but the underlining mechanism is still unclear.
Purpose:To identify the difference of EMG activity and angular displacement of ankles between subject with and without FAI during landing on an inclined 30° surface.
Method:Twenty six volunteers participated in this study, including 13 with and 13 without FAI . The EMG amplitude of tibia anterior, peroneal longus, lateral gastrocnemius, and soleus muscles during landing were collected with Biopac system. And the angular displacements of joints were collected with Motion Analysis Corp. Paired t-test was used to compare datas of FAI subjects between sound side and affected side. Independent t-test was used to compared datas between subjects with and without FAI.
Result:The pre-landing EMG activity of affected side(M=52.04,SD=24.26) lateral gastrocnemius was higher than sound side(M=52.04,SD=24.26 vs. M=38.00,SD=17.94, p<.01 ) in the subjects with FAI. No significant differences were found between limbs for the pre-landing EMG activity of tibia anterior, peroneal longus, and soleus. Although there was no significant differences in EMG activity after landing between limbs of the subjects with FAI, there was a decreasing mean EMG activity in peroneal longus for the affected limbs (M=99.47,SD=63.72) than unaffected limbs (M=149.61,SD=117.29). Both before and after landing, no significant differences in EMG activity between groups were detected. As for the the angular displacements of joints, the FAI subjects had more mean angular displacements in sagittal planes for affected limbs (M=13.72,SD=5.39) than unaffected limbs (M=10.61,SD=3.68) before landing (p=.02).
Conclusion:In order to absorb the shock during landing, the subjects with FAI had more pre-landing EMG activity in lateral gastrocnemius. It might indicate that the subjects with FAI tend to use other ankle stabilizers to help achieve dynamic joint stability.

第壹章 緒論 1
第一節 研究背景 1
第二節 研究目的 3
第三節 研究假設 4
第四節 操作性定義 4
第五節 研究限制 5
第貳章 文獻探討 6
第一節 踝關節功能性不穩定形成機制與病因 6
第二節 踝關節功能性不穩定評估方式 9
第三節 踝關節功能性不穩定對表現的影響 15
第四節 文獻總結 25
第參章 研究方法 27
第一節  研究對象 27
第二節  實驗時間與地點 28
第三節  儀器與設備 28
第四節  實驗流程與步驟 32
第五節 資料處理及統計方法 37
第肆章 研究結果 40
第一節  受試者基本資料 40
第二節  落地前肌電預先活化振幅之比較 41
第三節  落地後肌電活化振幅之比較 44
第四節  落地前後踝關節角度變化之比較 46
第伍章 討論 51
第一節  落地前肌電預先活化振幅之探討 51
第二節  落地後肌電活化振幅之探討 53
第三節  落地前後平均角度變化之探討 56
第陸章 結論與建議 61
參考文獻 62
附錄 69



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