(3.235.245.219) 您好!臺灣時間:2021/05/10 01:01
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:蔡維陽
研究生(外文):Wei-YangTsai
論文名稱:等速離心訓練對於外側肌腱病變患者的效果
論文名稱(外文):Effect Of Isokinetic Eccentric Training On Patients With Lateral Epicondylar Tendinopathy
指導教授:蘇芳慶蘇芳慶引用關係
指導教授(外文):Fong-Chin Su
學位類別:碩士
校院名稱:國立成功大學
系所名稱:生物醫學工程學系
學門:生命科學學門
學類:生物化學學類
論文種類:學術論文
論文出版年:2016
畢業學年度:104
語文別:英文
論文頁數:54
中文關鍵詞:等速收縮肌力訓練手腕伸直肌肘外側肌腱病變
外文關鍵詞:Isokinetic contractionStrength trainingWrist extensorsLateral epicondylar Tendinopathy
相關次數:
  • 被引用被引用:0
  • 點閱點閱:81
  • 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
肘外側肌腱病變是手腕伸肌在抗阻力收縮的過程中如抓握或手腕伸直時導致肘關節外側疼痛的疾病。目前為止,已經有一些使用在網球肘的治療的等速離心復健規程被提出。雖然等速肌力儀可以提供慢性肌腱炎等速離心訓練,但是等速肌力訓練對肌肉力量和功能性活動的效果還沒有被廣泛研究。
這項研究的目的是用一台創新的等速肌力儀,它能調節不同的手腕姿勢和不同角速度來提供肘外側肌腱病變的患者進行肌力訓練。並進一步透過評估前臂肌肉活化程度、肘外側肌腱的力學特性、握力、等長及等速收縮時腕伸肌肌力和功能性活動下的肌力來驗證肘外側肌腱病變的患者經過等速離心訓練後的治療效果。實驗組的參與者需要使用一台專門設計的等速肌力儀進行為期4週的力量訓練,每週兩次或三次。訓練初期為次最大肌肉收縮和慢的角速度,在肌力訓練規程期間均逐步增加肌肉收縮的強度和角速度。控制組的參與者則只接受電療,並無加入肌力訓練。實驗中招募了二十一位參與者並將其分為兩組,一組為實驗組,一組為控制組,並分別測試兩次,包括訓練前和訓練後或前測和後測,測驗內容為利用等速肌力儀同時使用肌電圖來測量等長與等速收縮下手腕伸肌的肌力與肌肉活化程度及功能性活動的肌力,利用握力器量測握力,以及利用超音波量測在等長收縮下的肌腱位移並同時量測手腕伸肌的肌力。肌力訓練的效果是透過量測握力以及等長與等速收縮下手腕伸肌的肌力及肌肉活化程度與功能性活動下的肌力,以及肌腱的力學特性,問卷調查和疼痛/失能評分的來評估。結果顯示,等長收縮下手腕伸肌肌力增加8.68%、等速收縮下手腕伸肌上升5.2%與功能性活動的肌力上升6.5%和握力增加2.62%,而在手腕伸直時疼痛經過等速肌力訓練後明顯降低了56.2%,握力時的疼痛則降低了47.3%。肌肉力量的改善會導致減少失能狀態35.65%。目前的研究資料可以提供臨床人員通過等速肌力訓練治療網球肘病人的一項依據。

Lateral epicondylitis is featured by pain at lateral elbow during contraction of wrist extensor such as grip and wrist extension with resistance. Few isokinetic eccentric rehabilitation protocols have been promoted for the treatment of tennis elbow. Although dynamometers could provide isokinetic eccentric training in patients with chronic tendinitis, the effect of isokinetic strength training on muscle strength and performance of functional task has not been widely investigated.
The purpose of this study was to use a novel dynamometer, which provides modulating different wrist posture and angular velocity, to train patients with lateral epicondylar tendinopathy. This study further determines the training effects of isokinetic eccentric training on patients with lateral epicondylitis through the measurement of muscle activation, tendon mechanical properties, gripping force, isometric and isokinetic force of wrist extensors and muscle force of functional tasks. Participants in training group were asked to perform a 4-week strength training with two or three times per week by a custom-designed dynamometer. The exercise initially started with submaximal muscle contraction at slow speed. The strength training protocol was prescribed with progressively increased intensity of muscle contraction and speed of movement during the period of training. Participants in the control group only received regular physical therapy. Twenty-one participants were recruited. Then, they were separated into two groups: one was the control group, while the other was training group, and the experimental test was measured two times including pre-training and post-training or pre-test and post-test. The test includes the measurement of muscle force in isometric and isokinetic force of wrist extensors and force of functional tasks through the dynamometer; meanwhile, the measurement of muscle activation through electromyography system, tendon mechanical properties with ultrasound apparatus, gripping force with Jamar dynamometer. The effect of strength training was assessed through measurement of muscle force in isometric and isokinetic contraction of wrist extensors and force of functional tasks, muscle activity of forearm muscles, tendon mechanical properties and measurement of pain/disability score by questionnaire. The results showed that muscle strength increased 8.68% in all isometric conditions and 5.2% in all isokinetic conditions, functional task increased 6.5%, gripping force increased 2.62% and pain had reduced 47.3% after isokinetic strength training. The improvement of muscle strength could lead to reducing the disability status 35.65%. The information of current study could provide for clinicians to treat patients with tennis elbow by isokinetic strength training.

中文摘要 I
Abstract II
致謝 IV
Chapter 1 Introduction 1
1.1 BACKGROUND 1
1.2 TENDON 1
1.3 LATERAL EPICONDYLITIS (TENNIS ELBOW) 2
1.4 ECCENTRIC TRAINING 5
1.5 TENDON MECHANICAL PROPERTIES 8
1.6 ELECTROMYOGRAPHY OF FOREARM MUSCLES 9
1.7 WRIST POSTURE 10
1.8 SPECIAL AIMS 12
Chapter 2 Methods 13
2.1 SUBJECTS 13
2.2 APPARATUS 14
2.2.1 Wrist isokinetic dynamometer 14
2.2.2 Ultrasound 15
2.2.3 Surface electromyography 16
2.3 EXPERIMENTAL PROCEDURE 17
2.4 TREATMENT PROTOCOL 18
2.5 CALCULATION OF TENDON FORCE 19
2.6 CALCULATION OF TENDON FDR (FORCE-DISPLACEMENT RATIO) 20
2.7 MUSCLE ACTIVATION 21
2.8 INTERACTION OF FORCE AND MUSCLE ACTIVATION (FE) 21
2.9 PAIN SCORE 21
2.10 DISABILITY QUESTIONNAIRE 22
2.11 STATISTICAL ANALYSIS 22
Chapter 3 Results 24
3.1 Effect of training and wrist posture on muscle strength 24
3.1.1 INTERACTION OF TRAINING ON ANGULAR VELOCITY AND WRIST POSTURE 25
3.1.2 TRAINING EFFECT 26
3.1.3 TRAINING EFFECT ON FUNCTIONAL TASK 26
3.1.4 TRAINING EFFECT ON GRIPPING FORCE 27
3.1.5 TRAINING EFFECT ON MUSCULAR ACTIVITIES 28
3.1.6 MUSCULAR ACTIVITIES OF CONTROL GROUP 32
3.1.7 INTERACTION OF FORCE AND MUSCLE ACTIVATION 36
3.2 Effect of training on tendon stiffness 38
3.3 Effect of training on pain and questionnaire 39
3.3.1 VAS OF TRAINING AND CONTROL GROUP 39
3.3.2 DASH OF TRAINING AND CONTROL GROUP 41
Chapter 4 Discussion 42
4.1 Training effect 42
4.1.1 MUSCLE STRENGTH 42
4.1.2 MUSCLE ACTIVITY 44
4.1.3 TENDON MECHANICAL PROPERTIES 45
4.1.4 PAIN SCORE AND DISABILITY QUESTIONNAIRE 47
4.2 Limitations 48
Chapter 5. Conclusion 49
References 50

1.Chourasia, A.O., et al., The effect of lateral epicondylosis on upper limb mechanical parameters. Clinical Biomechanics, 2012. 27(2): p. 124-130.
2.Altan, L. and E. Kanat, Conservative treatment of lateral epicondylitis: comparison of two different orthotic devices. Clinical rheumatology, 2008. 27(8): p. 1015-1019.
3.Croisier, J.-L., et al., An isokinetic eccentric programme for the management of chronic lateral epicondylar tendinopathy. British journal of sports medicine, 2007. 41(4): p. 269-275.
4.Lin, T.W., L. Cardenas, and L.J. Soslowsky, Biomechanics of tendon injury and repair. Journal of biomechanics, 2004. 37(6): p. 865-877.
5.Tendon. Available from: https://en.wikipedia.org/wiki/Tendon.
6.elbow, S.i.l.; Available from: http://www.beantownphysio.com/pt-tip/archive/strain-sprains.html.
7.Roetert, E., et al., The biomechanics of tennis elbow. An integrated approach. Clinics in sports medicine, 1995. 14(1): p. 47-57.
8.Labelle, H., et al., Lack of scientific evidence for the treatment of lateral epicondylitis of the elbow. An attempted meta-analysis. Bone & Joint Journal, 1992. 74(5): p. 646-651.
9.Nirschl, R., Prevention and treatment of elbow and shoulder injuries in the tennis player. Clinics in sports medicine, 1988. 7(2): p. 289-308.
10.Nirschl, R.P. and F. Pettrone, Tennis elbow. The surgical treatment of lateral epicondylitis. J Bone Joint Surg Am, 1979. 61(6): p. 832-839.
11.Walz, D.M., et al., Epicondylitis: Pathogenesis, Imaging, and Treatment 1. Radiographics, 2010. 30(1): p. 167-184.
12.Baskurt, F., A. Özcan, and C. Algun, Comparison of effects of phonophoresis and iontophoresis of naproxen in the treatment of lateral epicondylitis. Clinical rehabilitation, 2003. 17(1): p. 96-100.
13.Smidt, N. and D.A. van der Windt, Tennis elbow in primary care. Bmj, 2006. 333(7575): p. 927-928.
14.Amin, Q.M., I. Ahmed, and A. Aziz, Autologous blood injection in the treatment of lateral epicondylitis. JPMA. The Journal of the Pakistan Medical Association, 2014. 64(12 Suppl 2): p. S38-43.
15.De Smedt, T., et al., Lateral epicondylitis in tennis: update on aetiology, biomechanics and treatment. British journal of sports medicine, 2007. 41(11): p. 816-819.
16.ortho.
17.Bisset, L., et al., Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. Bmj, 2006. 333(7575): p. 939.
18.Komi, P.V. and E. Buskirk, Effect of Eccentric and Concentric Muscle Conditioning on Tension and Electrical Activity of Human Muscle*. Ergonomics, 1972. 15(4): p. 417-434.
19.Ellenbecker, T.S., G.J. Davies, and M.J. Rowinski, Concentric versus eccentric isokinetic strengthening of the rotator cuff objective data versus functional test. The American journal of sports medicine, 1988. 16(1): p. 64-69.
20.training, e.; Available from: https://en.wikipedia.org/wiki/Eccentric_training.
21.Murtaugh, B. and J.M. Ihm, Eccentric training for the treatment of tendinopathies. Current sports medicine reports, 2013. 12(3): p. 175-182.
22.Croisier, J.-L., et al., Adapted eccentric training in chronic lateral epicondylitis rehabilitation. 2005.
23.Young, M., et al., Eccentric decline squat protocol offers superior results at 12 months compared with traditional eccentric protocol for patellar tendinopathy in volleyball players. British journal of sports medicine, 2005. 39(2): p. 102-105.
24.Fahlström, M., et al., Chronic Achilles tendon pain treated with eccentric calf-muscle training. Knee surgery, sports traumatology, arthroscopy, 2003. 11(5): p. 327-333.
25.Alfredson, H., et al., Heavy-load eccentric calf muscle training for the treatment of chronic Achilles tendinosis. The American journal of sports medicine, 1998. 26(3): p. 360-366.
26.contraction, e.; Available from: http://steadystrength.com/glossary/eccentric-contraction/.
27.Tyler, T.F., et al., Addition of isolated wrist extensor eccentric exercise to standard treatment for chronic lateral epicondylosis: a prospective randomized trial. Journal of Shoulder and Elbow surgery, 2010. 19(6): p. 917-922.
28.Walmsley, R.P., N. Pearson, and P. Stymiest, Eccentric wrist extensor contractions and the force velocity relationship in muscle. Journal of Orthopaedic & Sports Physical Therapy, 1986. 8(6): p. 288-293.
29.Ichinose, Y., et al., Morphological and functional differences in the elbow extensor muscle between highly trained male and female athletes. European journal of applied physiology and occupational physiology, 1998. 78(2): p. 109-114.
30.Wang, H.K., et al., Effects of tendon viscoelasticity in Achilles tendinosis on explosive performance and clinical severity in athletes. Scandinavian journal of medicine & science in sports, 2012. 22(6): p. e147-e155.
31.Seliger, V., et al., Adaptation of trained athletes' energy expenditure to repeated concentric and eccentric muscle contractions. Internationale Zeitschrift für angewandte Physiologie einschließlich Arbeitsphysiologie, 1968. 26(3): p. 227-234.
32.Arya, S. and K. Kulig, Tendinopathy alters mechanical and material properties of the Achilles tendon. Journal of Applied Physiology, 2010. 108(3): p. 670-675.
33.Kowalczuk, Z., Advanced and Intelligent Computations in Diagnosis and Control. 2016: Springer.
34.Rojas, M., et al. Activation of forearm muscles for wrist extension in patients affected by lateral epicondylitis. in 2007 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society. 2007. IEEE.
35.Thorstensson, A., et al., Effect of strength training on EMG of human skeletal muscle. Acta Physiologica Scandinavica, 1976. 98(2): p. 232-236.
36.Hägg, G.M., J. Öster, and S. Byström, Forearm muscular load and wrist angle among automobile assembly line workers in relation to symptoms. Applied Ergonomics, 1997. 28(1): p. 41-47.
37.Barr, A.E. and M.F. Barbe, Pathophysiological tissue changes associated with repetitive movement: a review of the evidence. Physical therapy, 2002. 82(2): p. 173-187.
38.Shiri, R. and E. Viikari-Juntura, Lateral and medial epicondylitis: role of occupational factors. Best practice & research Clinical rheumatology, 2011. 25(1): p. 43-57.
39.Mogk, J. and P. Keir, The effects of posture on forearm muscle loading during gripping. Ergonomics, 2003. 46(9): p. 956-975.
40.Bozic, P.R., et al., Evaluation of novel tests of neuromuscular function based on brief muscle actions. Journal of strength and conditioning research/National Strength & Conditioning Association, 2013. 27(6): p. 1568.
41.Delp, S.L., A.E. Grierson, and T.S. Buchanan, Maximumisometric moments generated by the wrist muscles in flexion-extension and radial-ulnar deviation. Journal of biomechanics, 1996. 29(10): p. 1371-1375.
42.Finsen, L., et al., Activity patterns of wrist extensor muscles during wrist extensions and deviations. Muscle & nerve, 2005. 31(2): p. 242-251.
43.biodex. Available from: http://www.fysiomed.cz/eng/rehabilitation-equipment/diagnostics/biodex-system-4-pro/.
44.Wen, D.Y., et al., Eccentric Strengthening for Chronic Lateral Epicondylosis A Prospective Randomized Study. Sports Health: A Multidisciplinary Approach, 2011. 3(6): p. 500-503.
45.Wallerstein, L.F., et al., Effects of strength and power training on neuromuscular variables in older adults. J Aging Phys Act, 2012. 20(2): p. 171-85.
46.Staron, R., et al., Muscle hypertrophy and fast fiber type conversions in heavy resistance-trained women. European journal of applied physiology and occupational physiology, 1990. 60(1): p. 71-79.
47.Jones, D. and O. Rutherford, Human muscle strength training: the effects of three different regimens and the nature of the resultant changes. The Journal of physiology, 1987. 391: p. 1.
48.Tennis Elbow, ed. J.M. Wolf. 2015: Springer US.
49.Finestone, H.M. and D.L. Rabinovitch, Tennis elbow no more: Practical eccentric and concentric exercises to heal the pain. Can Fam Physician, 2008. 54(8): p. 1115-6.
50.Smoliga, J.M., Kinematic and electromyographic analysis of the legs, torso, and arms during an exhaustive run. 2007: ProQuest.
51.Kannus, P., et al., Effects of training, immobilization and remobilization on tendons. Scandinavian journal of medicine & science in sports, 1997. 7(2): p. 67-71.
52.Griffin, L., et al., Muscle vibration sustains motor unit firing rate during submaximal isometric fatigue in humans. J Physiol, 2001. 535(Pt 3): p. 929-36.
53.Taylor, J.L. and S.C. Gandevia, A comparison of central aspects of fatigue in submaximal and maximal voluntary contractions. Journal of Applied Physiology, 2008. 104(2): p. 542-550.
54.Vila-Chã, C., et al., Eccentric exercise and delayed onset muscle soreness of the quadriceps induce adjustments in agonist–antagonist activity, which are dependent on the motor task. Exp Brain Res, 2012. 216(3): p. 385-95.
55.Bogdanis, G.C., Effects of physical activity and inactivity on muscle fatigue. Frontiers in Physiology, 2012. 3: p. 142.
56.Schenck, R.C., Athletic training and sports medicine. 1999: Jones & Bartlett Learning.
57.Kubo, K., H. Kanehisa, and T. Fukunaga, Effects of different duration isometric contractions on tendon elasticity in human quadriceps muscles. The journal of physiology, 2001. 536(2): p. 649-655.
58.Burgess, K.E., P. Graham‐Smith, and S.J. Pearson, Effect of acute tensile loading on gender‐specific tendon structural and mechanical properties. Journal of Orthopaedic Research, 2009. 27(4): p. 510-516.
59.Fukutani, A., J. Misaki, and T. Isaka, Influence of preactivation on fascicle behavior during eccentric contraction. Springerplus. 2016;5(1):760. doi:10.1186/s40064-016-2550-5.
60.Strickler, T., T. Malone, and W.E. Garrett, The effects of passive warming on muscle injury. The American Journal of Sports Medicine, 1990. 18(2): p. 141-145.
61.Croisier, J.-L., et al., Delayed onset muscle soreness induced by eccentric isokinetic exercise. Isokinetics and exercise science, 2003. 11(1): p. 21-29.
62.Öhberg, L. and H. Alfredson, Effects on neovascularisation behind the good results with eccentric training in chronic mid-portion Achilles tendinosis? Knee Surgery, Sports Traumatology, Arthroscopy, 2004. 12(5): p. 465-470.

連結至畢業學校之論文網頁點我開啟連結
註: 此連結為研究生畢業學校所提供,不一定有電子全文可供下載,若連結有誤,請點選上方之〝勘誤回報〞功能,我們會盡快修正,謝謝!
QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top
無相關論文
 
無相關期刊
 
無相關點閱論文
 
系統版面圖檔 系統版面圖檔