臺灣博碩士論文加值系統

踝關節扭傷後會造成平衡缺失、本體感覺障礙、腓骨長肌收縮反應時間延遲、踝關節角度受限或肌力下降等問題。當腳趾在蹠屈時，最有可能造成扭傷腳踝，然而滑板運動中，基礎的豚跳動作則在雙腳都有蹠屈與內翻的姿態，這表明滑板運動持續著較危險的踝關節活動。本研究目的為探討專業與業餘的滑者踝關節穩定性及脛前肌、腓骨長肌、腓骨短肌的肌肉反應。本研究將招募實驗組16位專業滑板玩家，控制組為16位業餘滑板玩家。透過標準測角器量測關節角度差異，使用Biodex Balance System進行穩定度檢測，以及無線生理訊號紀錄儀配合傾斜踏板測量肌肉反應時間。結果顯示專業的滑者在慣用腳的內翻有顯著小於業餘的滑者，專業滑者在滑板運動中有更好的關節控制能力及安全性。Biodex Balance System測量結果顯示，在極限穩定度項目等級12中專業滑者的平衡能力有顯著高於業餘的滑者，則健康專業滑者的平衡能力顯著高於有舊傷的專業滑者，業餘的滑者也有相同的結果。肌肉反應時間上，專業的滑者與業餘的滑者並沒有顯著差異，而健康的專業滑者相較於有舊傷的專業滑者，透過肌內效貼布貼紮後慣用腳的腓骨長肌與短肌有較快的反應且達顯著差異。

Ankle sprains cause problems such as lack of balance, loss of proprioception, fibularis longus muscle contraction response time delay, limited ankle angle, or decreased muscle strength. When the toes are plantar flexion, they are most likely to cause sprained ankles. However, the ollie have a posture of plantar flexion and varus on both feet in skateboarding, which indicates that the skateboarding continues the dangerous ankle movement. The purpose of this study was to investigate the differences in the ankle joint stability between the professional and amateur skateboarders and the muscle responses of the tibialis anterior, fibularis longus and fibularis brevis muscles. This study will recruit 16 professional skateboarders from the experimental group, and the control group will be 16 amateur skateboarders. Measuring the joint angle through a goniometer, Stability testing with the Biodex Balance System, and BioRadio with the tilt pedal to measure muscle reaction time. The results show that the professional skateboarders has a significantly smaller varus of the conventional foot than the amateur skateboarders, and the professional skateboarders has better joint control ability and safety in the skateboarding. The Biodex Balance System measurement results show that the balance of the professional conversion of the limits of the stability testing level 12 is significantly higher than the amateur skateboarders, the balance of the healthy professional skateboarders is significantly higher than the professional skateboarders with the old injury, amateur skateboarders also has the same result. There is no significant difference between the professional skater and the amateur skater in muscle reaction time. Healthy professional skaters are compared to professional skaters with old injuries., after taping patch comparison result peroneus longus and peroneus brevis muscle and have a fast response of significant differences in dominant leg.

摘 要 II
致 謝 IV
目 次 V
圖目錄 VII
表目錄 IX
第一章　緒論 1
1.1 研究背景與動機 1
1.2 研究目的 3
1.3 研究範圍 4
1.4 研究架構 4
第二章　文獻探討 7
2.1 滑板運動現況 7
2.2 踝關節扭傷 9
2.3 肌肉骨骼傷病 10
2.3.1 運動傷害 10
2.3.2 肌電圖檢查 11
2.4 踝關節扭傷治療 11
2.5 本體感覺 13
2.6 肌內效貼布 14
第三章　研究方法 16
3.1 研究對象 16
3.2 實驗設計 16
3.3 臨床病史及調查 17
3.4 研究工具與流程 18
3.4.1 基本資料訪談 19
3.4.2 Romberg’s test 19
3.4.3 肌肉骨骼超音波 20
3.4.4 標準測角器 22
3.4.5 Biodex Balance System 23
3.4.6 傾斜踏板 28
3.4.7 攝影機 29
3.4.8 無線生理訊號紀錄儀 30
3.5 資料收集與分析 33
第四章　研究結果與分析 35
4.1 臨床病史與調查 35
4.2 踝關節活動度測量 36
4.3 BIODEX BALANCE SYSTEM穩定度測試 37
4.3.1專業與業餘滑者穩定度極限項目比較 37
4.3.2專業滑者穩定度極限項目比較 38
4.3.3業餘滑者穩定度極限項目比較 39
4.3.4專業與業餘滑者運動員單腳項目比較 41
4.4 肌肉反應時間 42
4.4.1 專業與業餘滑者比較 42
4.4.2 健康與有舊傷的專業滑者比較 43
第五章 結論與建議 45
5.1 討論 45
5.1.1 臨床病史與調查 45
5.1.2 踝關節活動度測量 45
5.1.3 Biodex Balance System穩定度測量 46
5.1.4 肌肉反應時間 47
5.2 建議 48
參考文獻 49

1.李雪楨、林姵君、周嫚君、黃裕淨、利怡慧、林慧敏、洪禎雯、張谷州（2011）。看人員肌肉骨骼傷害盛行率及危險因子回顧探討。物理治療，36（2），55-66。
2.邱玠勻、王佩凡與傅麗蘭（2017）。不同貼紮對於慢性踝關節不穩定患者效益之比較。中原體育學報，10，20-27。
3.連任章 & 邱文信，2012。以肌電模式分析兒童過肩投擲訓練前後之差異。華人運動生物力學期刊，7，P122-124。
4.郭大成（2012）。某電信公司客服人員肌肉骨骼傷害之調查。嘉南藥理科技大學產業安全衛生與防災研究所碩士論文。
5.楊玉鈴、張光華、趙偉丞與王乾勇（2013）。肌內效貼紮對於踝關節扭傷患者在動態穩定度的影響。物理治療，38（2），137-143。
6.黎俊彥、林威秀、黃啟煌（2004）。規律運動訓練對踝關節本體感覺的影響。體育學報，37，57-68。
7.American Academy of Orthopaedic Surgeons. “Sprain Ankle.” in http://www.sportsinjuryclinic.net/sport-injuries/ankle-achilles-shin-pain/sprained-ankle
8.American Orthopaedic Foot & Ankle Society. “How to Care for a Sprained Ankle.” In http://www.aofas.org/footcaremd/how-to/foot-injury/Pages/How%20to%20Care%20for%20a%20Sprained%20Ankle.aspx
9.Bicici, S., Karatas, N. & Baltaci, G.(2012). Effect of athletic taping and kine siotaping on measurements of functional performance in basketball players with chronic inversion ankle sprains. Int J Sports Phys Ther, 7, 154-66.
10.Bleakley, C. M., O'Connor, S. R., Tully, M. A., Rocke, L. G., Macauley, D. C., Bradbury, I., Keegan, S., McDonough, S. M. (2010). Effect of accelerated rehabilitation on function after ankle sprain: randomised controlled trial. BMJ, 340, c1964.
11.Digiovannl, B. F., Partal, G., & Baumhauer, J.(2004). Acute ankle injury and chronic lateral instability in the athlete. Clin Sports Med, 23, 1-19.
12.Everett, W. W. (2002). Skatepark injuries and the influence of skatepark design: a one year consecutive case series. The Journal of Emergency Medicine, 23(3), 269–274.
13.Fong, D. T., Chan, Y.-Y., Mok, K. M., Yung, P. S., & Chan, K.-M. (2009). Understanding acute ankle ligamentous sprain injury in sports. Sports Medicine Arthroscopy Rehabilitation, 1(1), 14.
14.Fridlund, AJ., Cacioppo JT. (1986). Guidelines for Human Electromyographic Research. Psychophysiology, 23(5), 567-589.
15.Glenn Keays & Alex Dumas(2014). Longboard and skateboard injuries. Injury, INJ-5678, 1-5.
16.Hassan, S., Mohammad, N. H., Tengku, A. H., Saidon, B. A., Mohsen, R., Mohammadreza, F., Elham S. (2017). The effect of exergaming on knee proprioception in older men: A randomized controlled trial. Archives of Gerontology and Geriatrics, 69, P144-150.
17.Hertel, J.(2002). Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability. J Athl Train, 37, 364–375.
18.Kase, K., Wallis, J., & Kase, T. (2003). Clinical therapeutic applications of the kinesio taping method. Tokyo, Japan: Kinesio Taping Association.
19.Khasnis, A. & Gokula, R. M.(2003). Romberg’s test. J Postgrad Med, 49, 169–72.
20.Lephart, S., Pincivero, D., Giraldo, J., Fu, F. (1997). The role of proprioception in the management and rehabilitation of athletic injuries. Am J Sport Med, 25(1), P130-137.
21.Lynch SA & Renstrom PA. (1999). Treatment of acute lateral ankle ligament rupture in the athlete. Conservative versus surgical treatment. Sports Med, 27(1), P61–71.
22.Lynch, S.A. & Renström, P.A. (1999). Treatment of acute lateral ankle ligament rupture in the athlete. Conservative versus surgical treatment. Sports Med, 27, 61–71.
23.McKay, G. D., Goldie, P. A., Payne, W. R. & Oakes, B. W. (2001). Ankle injuries in basketball: injury rate and risk factors. Sports Med, 35, 103-108.
24.Mohammad, K., Christoph, K., Lucas, L., Martin, P., Tanya, S., Richard, C. (2010). Skateboarding Injuries in Vienna: Location, Frequency, and Severity. PM&R, 2(7), 619-624.
25.Pamela, L. (2015). “Ankle sprain.” in http://www.aofas.org/PRC/conditions/Pages/Conditions/Ankle-Sprain.aspx
26.Perry, S., Housh, T., Johnson, G., Ebersole, K., Bull, A. (2001). Mechanomyography, electromyography, heart rate, and ratings of perceived exertion during incremental cycle ergometry. Journal of sports medicine and physical fitness, 41, P183-188.
27.Rethnam, U., Yesupalan, RS., Sinha, A. (2008). Skateboarders: Are they really perilous? A retrospective study from a district hospital. BMC Res Notes, 1:59.
28.Rowinski, M. (1997). Neurobiology for orthopedic and sports physical therapy. In Orthopedic and Sports Physical Therapy, St. Louis; Mosby, Inc.
29.Sian, A., Leo, N., Nathan, S., Nardia, K., Catherine, W. (2018). Effect of prophylactic ankle taping on ankle and knee biomechanics during basketball specific tasks in females. Physical Therapy in Sport, 32, P200-206.
30.Smith, R. W., Reischl, S. F. (1986). Treatment of ankle sprains in young athletes. Am J Sports Med, 14, 465-471.
31.Sterner, R., Pincivero, D., Lephart, S. (1998). The effects of muscular fatigue on shoulder proprioception. Clin J Sport Med, 8, P96-101.
32.Susanne, R., Tobias, F., Hans, Z., Stefan, R., Stefan, W. (2011). Postural control and functional ankle stability in professional and amateur dancers. Clinical Neurophysiology, 122, 1602-1610.
33.The Tokyo Organising Committee of the Olympic and Paralympic Games. (2016). Re: "Tokyo 2020 New Sport Support Kickoff Event" Held as Part of the Tokyo 2020 Official Programme. Retrieved from https://tokyo2020.jp/en/news/event/20161011-03.html
34.Voight, M., Hardin, J., Blackburn, T., Tippett, S., Canner, G. (1996). The effects of muscle fatigue on and the relationship of arm dominance to shoulder proprioception. JOSPT, 23(6), P348-352.
35.Waterman, BR, Owens, BD, Davey, S, Zacchilli, MA, Belmont, Jr, PJ. (2010). The epidemiology of ankle sprains in the United States. J Bone Jt Surg, 92(13), P2279–2284.
36.Wikstrom, E.A., Tillman, M.D., Chmielewski, T.L. & Cauraugh, J.H. (2007). Dynamic postural stability deficits in subjects with self-reported ankle instability. Med Sci Sports Exerc, 39, 397-402.
37.Witchalls, J., Blanch, P., Waddington, G., Adams, R. (2012). Intrinsic functional deficits associated with increased risk of ankle injuries: a systematic review with meta-analysis. Br J Sports Med, 46(7), P515-23.