中文摘要
近紅外光光譜儀以非侵入方式測量肌肉組織內血液之含氧血紅素濃度、去氧血濃度。透過觀察血液中血氧濃度之變化，就可間接瞭解肌肉代謝狀況。同時，無論是在靜態或動態運動過程中測量血氧濃度變化，近紅外光光譜儀都能精準的收集相關血氧資料，不因動作或運動的干擾而影響資料的收集。正因如此，近紅外光光譜儀被廣泛應用評估急性運動或長期運動介入下，肌肉代謝的適應狀況。
本研究第一階段，主要嘗試調查規律阻力訓練對於肌肉氧合之影響，研究中招募11位長期規律阻力訓練之老年男性、11位長期規律阻力訓練之年輕男性、11位無阻力訓練習慣之老年男性、11位無阻力訓練習慣之年輕男性共四組進行比較。研究中將調查四組在等長肌肉收縮時以及恢復階段之肌肉氧合之變化，同時也透過頻譜分析瞭解規律阻力訓練對於組織氧合振盪之影響。結果顯示規律阻力訓練者，無論是年輕人或老年人，皆能有效提高肌肉收縮時的氧需求，也表示規律訓練能改善肌肉代謝。然而這樣的訓練效益並沒有改善肌肉的有氧代謝，規律訓練之老年人能呈現較長時間的肌肉氧合恢復。另外我們也發現，規律阻力訓練改善了組織氧合振盪，而此影響似乎在老年人上較為顯著。
本研究第二階段，主要調查12週短期複合式運動訓練對肌肉氧合之影響，研究中有17位年輕人與18位老年人參與12週運動訓練介入。兩組在訓練前、後將在等長自主收縮與電刺激下進行肌肉氧合資料的收集。同時，兩組的肌力與肌電圖資料也納入評估。研究結果顯示，12週複合式運動訓練會使得年輕人肌肉力量的提高，但此肌力之提升並沒有伴隨明顯的肌肉氧合變化。研究結果也指出該肌力之提高可能是由於肌肉的神經適應。另外，相對於年輕人而言，老年人的肌力提升較不明顯，但在訓練後卻加快了肌肉氧合的恢復，這代表肌肉有氧能力的提高。以上結果顯示，年輕人在複合式運動訓練後傾向提高肌肉力量，老年人則傾向提高肌肉有氧能力。顯示相同的訓練介入，對於不同族群可能產生不同的正向訓練效益。
本研究第三階段則是評估19位男性成年人在不同類型等長肌肉收縮之刺激下，大腦活化情況及肌肉代謝。其中等長肌肉收縮之類型可分為:1. 自主收縮 2. 電刺激收縮3. 混合性肌肉收縮(電刺激加上自主收縮)。其中混合性肌肉收縮又依電刺激參與電量分為三種情況。研究中將嘗試了解不同刺激下大腦活化之變化與肌肉代謝之影響。同時也探討在不同條件下之混合性肌肉收縮對於感覺運動皮質區、前運動皮質區、輔助運動皮質區之活化影響。研究結果顯示，在混合性肌肉收縮的方式中增加電刺激電量能明顯提升肌肉收縮時的氧需求，也意味著電刺激的介入會加速肌肉之代謝表現。另一方面，在大腦的活化表現上，相較於自主收縮，在電刺激僅引發較小的大腦活化，無論在感覺運動皮質區、前運動皮質區、輔助運動皮質區皆是如此。但研究也發現混合性肌肉收縮(自主收縮加上30mA電刺激)，能有效提高大腦感覺動作區域活化狀態。而混合性肌肉收縮提升大腦活化的程度不僅受到參與電刺激電量之影響，也受到大腦各動作感覺區塊之特殊性的影響。最後，該研究結果指出混合性肌肉收縮確實能有效刺激肌肉代謝和大腦活化程度，而電刺激介入的電量可能是重要關鍵。
最後，本研究結果顯示，無論年輕人或老年人，長期阻力訓練能增加收縮中肌肉的氧需求和組織氧合震盪，但在肌肉有氧能力的改善上較不明顯。然而，相較於長期阻力訓練，短期整合式運動訓練在兩族群的訓練適應上則產生了不同的適應效果。年輕人偏向肌肉力量的提升，而老年人則偏向肌肉有氧能力的改善。此外，本研究中也發現混和性肌肉收縮能有效刺激肌肉代謝、促進大腦活化，而決定混和性肌肉收縮之刺激效果之關鍵在於電刺激介入的電量。

Abstract
Near-infrared spectroscopy (NIRS) is a non-invasive optical technique that has been extensively used to evaluate tissue oxygenation in terms of oxygenated and deoxygenated hemoglobin concentrations. The advantage of NIRS is its ability to measure the instantaneous oxygenation response in a less restrict environment, which is suitable for exercise tasks involving static and dynamic exercise. Moreover, NIRS has been applied for observing the alteration in muscle oxygenation and brain cortical activity during immediate or chronic effects of exercise training. The aim of this is first to compare the adaptation of muscle oxygenation to regular resistance training between young and elderly subjects. The second aim is to investigate the influences of multi-component exercise training on muscle oxygenation between young and elderly subjects. The NIRS was further extended to characterize the cortical excitability and muscle oxygenation during knee extension task in volitional contraction, electrical stimulation-induced contraction, and hybrid activation, i.e. volitional contraction combining with electrical stimulation tasks.
First, groups of eleven trained young (TY), untrained young (UTY), trained elderly (TE), and untrained elderly (UTE) were recruited to investigate the influence of regular resistance training on the muscle oxygenation kinetics during muscle contraction and recovery phase. Furthermore, the training effect on tissue oxygenation oscillation was observed from the change in the frequency spectrum of muscle oxygenation data. Our results suggested that regular resistance training can improve muscle metabolism in the trained young and elderly groups. During muscle contraction, trained elderly demonstrated larger O2 demand and better regulation of tissue oxygenation oscillation. In regards to the tissue oxygenation oscillation, it was found that the training effect is different between young and elderly. Elderly groups showed a well regulation in lower frequency tissue oxygenation oscillation after long-term resistance training. In the recovery phase, the resistance training was limited to improve muscle oxidative capacity that older subjects had a longer reoxygenation time.
In addition to subjects with long-term resistance training, the second study was to investigate the effect of 12 weeks multi-component exercise training on muscle oxygenation performance. Seventeen young adults and eighteen healthy elderly participated in the study who received multi-component exercise training under supervision for 12 weeks, 2-3 sessions per week. Muscle strength, muscle oxygenation and electromyography data were collected and compared before and after the training period. Oxygen saturation (SpO2) of the vastus lateralis muscle during isometric knee extension tasks with voluntary contraction (VOL) and electrical stimulation (ES) were observed using NIRS. The SpO2 kinetics was modeled with a tangential model. The median frequencies (MF) of electromyography data were used to indicate the neuromuscular change. The larger ES-induced O2 demand and lower MF in young subjects suggest that the evident neuromuscular adaptation following 12 weeks training. For young subjects, 12 weeks multi-component exercise training could increase muscle strength, which may be due to the neuromuscular changes rather than improvement of muscle metabolism. Although elderly subjects did not have a significant enhancement of O2 demand during muscle contraction, an improvement of oxidative capacity was found by a shorter reoxygenation time. Compared to young subjects, the improvement of muscle oxidative capacity to multi-component exercise training seems to be more significant in elderly subjects.
To investigate ES effect on muscle oxygenation and cortical activity during isometric knee extension tasks, hybrid activation (HA) was included, which patterned ES superimposed on attempted voluntary movement in close synchrony. We compare muscle oxygenation and cortical activity during isometric knee extension tasks with voluntary contraction (VOL) only, ES only, and with HA at three stimulation intensities, namely 10 mA (HA-I), 30 mA (HA-II), and 50 mA (HA-III). A frequency-domain NIRS was employed to assess the muscle oxygenation in the vastus lateralis as well as the cortical activity from the bilateral sensorimotor cortices (SMCs), premotor cortices (PMCs), and supplementary motor areas (SMAs). Our results show that the increased ES contribution during HA significantly increased O2 demand in working muscle, implying that the intervention of ES accelerates the muscle metabolism during muscle contraction. For cortical activation, ES only had a similar cortical activation pattern to that during VOL but with lower activation in SMCs, PMCs, and SMAs. Augmented sensorimotor activation was observed during the HA-II condition. The enhanced level of cortical activation during HA was not only affected by the ES contribution within HA but also related to the functional specificity of cortical areas. Our results suggest that HA can effectively enhance the muscle oxygen demand as well as the activation of cortical regions, and that the ES contribution within HA is a key factor.
In summary, our study showed that long-term resistance training could enhance muscle oxygen demand of working muscle and tissue oxygenation oscillation, but did not improve muscle oxidative capacity. For young subjects, however, the short-term multi-component exercise training enhanced muscle strength without a significant increase of muscle oxygenation, while elderly subjects saw enhanced muscle oxidative capacity after 12 training. Also, our study demonstrated the effect of HA on muscle oxygenation and cortical activity. Muscle oxygen demand and the activation of cortical regions can be increase by HA, and the ES contribution within HA is a key factor.

Contents
中文摘要……………………………………………………………………………….I
Abstract……………………………………………………………………………...III
誌謝…………………………………………………………………………………VII
Lists of Figures……………………………………………………………………….XI
Lists of Tables……………………………………………………………………...XIV
Chapter 1 Introduction………………………………………………………………1
1-1 Age-associated alteration of muscle oxygenation and muscle composition……....1
1-2 Tissue oxygenation oscillations…………………………………………………...2
1-3 The adaptation of muscle to resistance training…………………………………...4
1-4 The beneficial effects of multi-component exercise training……………………...5
1-5 Muscle oxygenation during neuromuscular electrical stimulation………………..6
1-6 Hybrid activation modality………………………………………………………..8
1-7 Brain activation during electrical stimulation and hybrid activation……………...8
1-8 Near-infrared spectroscopy for evaluating tissue oxygenation…………………..10
1-9 Motivation and the aims of the study…………………………………………….12
Chapter 2 Methods…………………………………………………………………15
2-1 Adaptation of muscle oxygenation to resistance training......................................15
2-1-1 Evaluation of muscle oxygenation using near-infrared spectroscopy………15
2-1-2 Muscle oxygenation measurement during isometric contraction…………16
2-1-3 Subjects……………………………………………………………………...17
2-1-4 Data analysis and statistical analyses………………………………………18
2-2 Training effects of multi-component exercise training on muscle oxygenation…20
2-2-1 Evaluation of muscle oxygenation using near-infrared spectroscopy………21
2-2-2 Muscle oxygenation measurement during voluntary and ES-induced isometric contraction………………………………………………………………22
2-2-3 Surface electromyography measurement during voluntary isometric contraction…………………………………………………………………………24
2-2-4 Subjects……………………………………………………………………25
2-2-5 Multi-component exercise training program………………………………25
2-2-6 Data analysis and statistical analyses………………………………………26
2-3 Muscle oxygenation and cortical activity under various isometric contraction modalities……………………………………………………………………….27
2-3-1 Evaluation of muscle oxygenation and cortical activity using near-infrared spectroscopy…………………………………………………………………...27
2-3-2 Measurements of muscle oxygenation and cortical activity during knee extension……………………………………………………………………….29
2-3-3 Data analysis of muscle oxygenation using NIRS signals…………………..31
2-3-4 Observation of cortical activities using NIRS signals………………………32
2-3-5 Subjects……………………………………………………………………...33
2-3-6 Statistical analysis…………………………………………………………...34
Chapter 3 Results…………………………………………………………………35
3-1 Adaptation of muscle oxygenation and tissue oscillations to resistance training..35
3-1-1 Subject characteristics………………………………………………………35
3-1-2 Oxygen saturation kinetics during contraction phase and recovery phase
……………………………………………………………………………………36
3-1-3 Frequency domain analysis of oxygen saturation…………………………38
3-2 Neuromuscular alteration to multi-component exercise training………………...41
3-2-1 Subject characteristics……………………………………………………41
3-2-2 Oxygen saturation kinetics during VOL and ES-induced contraction……42
3-2-3 Median frequency of surface electromyographic frequency spectrum……46
3-3 Muscle oxygenation and cortical activity during various isometric contraction modalities………………………………………………………………………...48
3-3-1 Muscle SpO2 kinetics……………………………………………………….48
3-3-2 Cortical activation observed from NIRS……………………………………51
Chapter 4 Discussion………………………………………………………………55
4-1 Adaptation of muscle oxygenation to resistance training for elders and young men……………………………………………………………………………….55
4-1-1 ΔSpO2 in isometric contraction phase………………………………………55
4-1-2 IF in isometric contraction and recovery phases……………………………57
4-1-3 Tissue oxygenation oscillation during muscle contraction…………………59
4-2 Effect of 12 weeks multi-component exercise training on muscle strength, muscle
oxygenation and neuromuscular adaptation……………………………………61
4-2-1 ΔSpO2 in VOL and ES-induced contraction phases………………………62
4-2-2 IF in VOL and ES recovery phase…………………………………………64
4-3 Muscle oxygenation and cortical activity during various muscle contraction modalities……………………………………………………………………………66
4-3-1 Muscle SpO2 kinetics during VOL, ES and HA……………………………66
4-3-2 Cortical activity during electrical stimulation………………………………68
4-3-3 Activation of contralateral side SMC during various HA modalities………69
4-3-4 Activation of contralateral side PMC during various HA modalities………70
4-3-5 Activation of contralateral side SMA during various HA modalities………70
4-3-6 Activation of ipsilateral side brain areas during various HA modalities……71
Chapter 5 Conclusions……………………………………………………………73
References…………………………………………………………………………76

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