本研究目的為健康年輕人穿著新型後足複合式內側楔型鞋款，於行走過程中下肢關節運動學、力動學等重要步態參數之變化。同時驗證不同組合材料與軟硬度複合式設計鞋款，藉由與穿著無楔型設計之控制組鞋款之動態生物力學參數比較，探討楔型設計之生物力學效應。受測者為十一位健康男性，穿著四款新型後足複合式內側楔型角度約為7度之鞋款，基底為較硬之材質，將楔型處用不同軟硬度材質彈性填平，及無楔型設計之控制組鞋款，進行步態分析及統計分析。實驗鞋款與控制鞋相比之結果，於鞋具冠狀面之腳跟著地時之角度，於單腳著地期之角度峰值，以及鞋具冠狀面之運動範圍皆無差異，但有顯著較小鞋具外翻力矩峰值。此外，膝關節有較小的內旋角度、外側地面反作用力峰值及其負載率；肌肉活化程度上，於雙腳著地期及單腳著地期皆有顯著較小的膝外側肌及腓骨長肌積分肌電，於雙腳著地期並有較大的膝內側積分肌電。穿著本研究之楔型鞋款在鞋具額狀面角度參數皆無顯著改變，可能是本研究之複合式楔型鞋款，雖不會像過去楔型鞋墊造成冠狀面的運動學參數之顯著改變，但能使得雙腳著地期鞋具外翻力矩顯著降低，這可能與此時期向外之地面反作用力顯著較小有關，此較小的向外之地面反作用力來自於此鞋款下層硬度相對高的楔型，留有的傳統楔型鞋墊之效應。此雙腳著地期與對照鞋款相比，楔型鞋墊對腓腸肌活化沒有顯著改變，卻能顯著降低腓骨長肌活化，所以楔型效應可使踝關節外翻力矩的峰值變小，有助於降低踝關節的負擔。穿著新型後足複合式楔型時，在無改變鞋子外翻發生的情況下，顯著減少膝關節內旋，有助於髕骨外側表面的壓力減少。健康受測者穿著楔型鞋墊於主觀與客觀生物力學參數皆有正向結果，建議以本研究為藍圖，在未來的研究中評估下肢肌肉骨骼疾病患者穿著此鞋款之步態。

The purpose of our study was to evaluate the effects of four types of rearfoot midsole with varus wedge on joint kinematics and kinetics of lower extremity during walking by comparing with control shoes without rearfoot wedge design. The eleven healthy asymptomatic males were recruited to perform gait analysis during walking while wearing testing shoes which were designed with 7 degrees varus wedge on bottom layer and control shoes. Subjective comfort and objective biomechanical indices, namely joint angles and moments at hip, knee, and ankle as well as ground reaction force and EMG variables during gait were calculated and compared between shoes conditions. When wearing varus wedge shoes, subjective hardness during walking is higher than that during CON (p=0.015). For the ankle joint kinetics, this first peak shoes evertor moment infer to the demand at the ankle joint which was associated with the abrupt eversion angular displacement occurs during the loading response. Despite of the non-significant changes of frontal plan joint kinematic variables, smaller peak ankle evertor moment were found while wearing varus wedge shoes, which may be associated with the smaller lateral ground reaction force and its loading rate. The results also showed that when wearing varus wedge shoes, without significant shoe condition effect on shoes kinematics variables, significantly decreased knee internal rotation was found, which may be help for decreased loading on lateral aspect of patella. In addition, varus wedge shoes seem to favorite the firing of muscle on the medial side of the knee compared with those on the lateral side. Lower peroneal longus muscle activation was also found. Finding in the current tend to support some previous researches which reported smaller significant differences of joint kinematic than joint kinetic when wearing VW. As indicated by several positive subjective and objective findings when wearing varus wedge in healthy adults, the design is encouraged for the use of footwear markets and for evaluating biomechanical effects for patients with musculoskeletal disorders such as patella femoral pain syndrome in future studies.

中文摘要 I
ABSTRACT II
致謝 III
目錄 IV
圖目錄 VII
表目錄 VIII
第一章 緒論 1
1.1 文獻回顧 1
1.1.1 驗證楔型鞋墊之相關生物力學參數 1
1.1.1.1 立即影響 1
1.1.1.1.1 跑步 1
1.1.1.1.2 走路 5
1.1.1.2 長期影響 8
1.1.1.2.1 跑步 8
1.1.1.2.2 走路 9
1.1.2 髕股骨疼痛症候群(Patellofemoral Pain Syndrome)之臨床表徵及生物力學成因 13
1.1.2.1 髕股骨疼痛治療方法 13
1.1.2.2 髕股骨疼痛症候群於動作過程中之生物力學研究 14
1.2 研究目的 17
1.3 研究假設 18
第二章 實驗設計及方法 19
2.1 實驗對象 19
2.2 實驗設備 20
2.2.1 動作分析系統 20
2.2.2 肌電系統 20
2.2.3 中底後足內側楔型鞋墊 21
2.3 實驗流程 24
2.3.1 實驗室硬體系統校正 24
2.3.2 受試者準備與校正 24
2.3.3 受試者資料擷取 24
2.3.4 實驗問卷 25
2.4 步態週期定義 27
2.4.1 正常步態週期介紹 27
2.4.2 實驗步態週期定義 29
2.5 定義各關節名稱及關節在各平面活動名稱 29
2.6 資料分析 30
2.7 統計分析 32
第三章 研究結果 34
3.1 下肢關節角度 34
3.2 下肢關節力矩 44
3.3 地面反作用力 51
3.4 其他參數 55
第四章 討論 59
結論 67
參考文獻 68
附錄 77

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