臺灣博碩士論文加值系統

研究背景與研究目的：跑步 (running) 是最常見及最簡易的個人運動。在國內，近幾年來有越來越多的大型慢跑活動及馬拉松比賽 (marathon)，隨著跑步運動盛行，跑步傷害亦不容忽視，然而較少研究探討跑步傷害的相關危險因子。本研究之目的在探討馬拉松跑者的跑步經驗及跑步習慣，了解跑步傷害及其相關因子的分佈，進而分析造成不同部位跑步傷害的相關影響因素。研究對象：本研究調查1116位於2005年ING台北國際馬拉松比賽的馬拉松參賽跑者，包括全程馬拉松 (42.195公里)、半程馬拉松 (21公里)、路跑組 (10公里) 及 Fun Run組 (3公里) 的參賽跑者做問卷調查。研究方法：問卷形式採自行填寫方式，問卷內容包括基本資料、健康狀況、跑步經驗、訓練方式及跑步相關症狀。統計分析：利用卡方檢定及對數迴歸分析來探討跑步傷害的相關影響因素。結果：共1116份問卷回收，排除基本資料缺失及未完成問卷後，有效問卷969份進行分析。在969位參賽選手當中，有583位 (60.2%) 過去曾經在跑步時發生腳扭傷或下肢疼痛情形。其中男性遭受跑步傷害的比例明顯高於女性 (P=0.021)。分析跑者跑步傷害的部位，發現有226位 (23.4%) 的跑者曾經在跑步時有小腿抽筋的情形，另外疼痛部位以膝關節疼痛 (20.7%) 最常見。分析下肢傷害 (腳扭傷、大腿抽筋、小腿抽筋) 及各部位疼痛 (下背、臀部、大腿、膝部、小腿、腳踝、腳底) 在平時跑步訓練、跑鞋使用及是否有骨骼肌肉問題等變項當中，尋找重要的影響因素。發現跑步經驗5-10年的跑者較多膝關節疼痛 (P=0.005)，另外每星期跑步距離及每次跑步時間是重要的影響因子：每星期跑步超過20公里的跑者較容易發生腳踝疼痛，每次跑步時間超過60分鐘的跑者有較多腳底疼痛及大腿抽筋。規律跑步的跑者有較多發生腳底疼痛或腳扭傷的問題。較多腳踝疼痛的跑者選擇在人工跑道跑步，也發現跑步路面的坡度是重要的影響因子。每次跑不同距離的跑者有較多腳扭傷或大腿抽筋。間歇性訓練的跑者有較多小腿疼痛或抽筋的問題。每次跑固定距離可以減少腳底疼痛，暖身運動可以減少腳抽筋。較多膝關節疼痛的跑者選擇穿戴護膝，另外穿一般運動鞋及穿材質較軟的鞋內墊可以減少膝部疼痛。也發現穿內側足弓加高鞋墊的跑者有較多發生腳扭傷。然而，鞋子的鞋齡和傷害之間沒有關係。在骨骼肌肉問題等變項中發現O型腿的跑者有較多腳扭傷，正常的骨骼肌肉結構是避免造成多重傷害的保護因子。結論：本研究發現各部位疼痛及腳扭傷有其不同的影響因素。而研究結果可以提供未來預防醫學及治療方向的依據，並可當作之後預防跑步傷害及傷後復健介入的參考。

Introduction and purposes: Running is one of the most popular exercises. Injuries associated with running therefore attract more attention in recent years. However, limited studies had investigated the risk factors of running injuries The purpose of this study was to investigate the distribution of lower extremity running injuries and to evaluate the possible risk factors linking to the occurence of these injuries. Subjects. A total of 1116 participants of 2005 ING Taipei International Marathon, including full marathon (42.195km), half marathon (21km), 10km, and 3km, were surveyed. Methods. We used a self-developed questionnaire to collect data on personal characteristics running and training conditions, and injury profiles. Statistical analysis. Chi-square statistics and multivariate logistic regression modeling were used to examine the possible relationship between the presence of injuries and various predictor variables. Results. After excluding subjects with incomplete data, 969 questionnaires entered the process of data analysis. Of the 969 entrants, 583 (60.2%) developed lower extremities pain or injuries. More male runners suffered from injures than female runners (p=0.021). The knee was the most commonly painful site (20.7%) while the lower leg cramp was the most popular problem during running (23.4%). Runners with running experiences 5-10 years had more knee pain (P=0.005). Running distances and duration were important risk factors: running more than 20 km/week was linked to more ankle pain and duration of running more than 60 minutes was linked to more foot pain and thigh cramp respectively. Runners of regular running had more sprain and foot pain. More entrants with ankle pain chose artificial lanes. The gradient of the running surface was an important predictor. Uphill path increased the risk of ankle pain. The runners who ran the different distance per time developed more sprain or thigh cramp. Intermittent training was associated with more lower leg pain and shank cramp. The constant running distance was a protective factor of foot pain. The runners who ran regularly and did warm-up exercise developed less shank cramp. More runners with knee pain used knee braces. Runners who wore ordinary running shoes and used soft insoles had less knee pain. Runners who used medial arch support developed more sprains. There was no significant relationship between running shoe age and injuries. Higher rate of sprain was found in runners with genu varum. Normal musculoskeletal structure was a protective factor to prevent multiple injuries. Conclusions. This study disclosed that various risk factors were linked to injuries in the lower extremity. The practitioner could use these information in developing strategies to prevent running associated injury and pain.

目錄 I
表目錄 III
圖目錄 IV
中文摘要 V
英文摘要 VII
第一章 前言 1
第一節 研究背景 1
第二節 研究目的 2
第三節 研究重要性 2
第二章 文獻回顧 3
第一節 跑步運動傷害之流行病學研究 3
第二節 跑步的生物力學 4
第三節 下肢跑步傷害之影響因素 7
第四節 其他影響下肢跑步傷害的因素 16
第五節 常見的傷害部位 20
第三章 研究方法 23
第一節 研究對象 23
第二節 研究工具 24
第三節 資料分析 25
第四章 結果 27
第一節 參賽選手個人基本資料 27
第二節 參賽選手平時訓練狀況 28
第三節 跑步運動穿著的跑鞋 29
第四節 其他描述性資料 30
第五節 規律跑步運動習慣的人口調查 31
第六節 下肢跑步運動傷害之影響因素 31
第七節 造成多重部位傷害之影響因素 35
第五章 討論 36
第一節 參賽跑者基本特性及受傷相關資料探討 36
第二節 跑步傷害相關影響因素分析 38
第三節 多部位傷害影響因素分析 50
第四節 臨床應用 51
第五節 研究限制與未來研究建議 51
第六章 結論 53
參考文獻 55
表、圖 63
附錄一、同意臨床試驗證明書 88
附錄二、2005安泰國際馬拉松比賽運動前健康安全及傷害防護認知評估…….90

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