臺灣博碩士論文加值系統

本研究主要目的在探討不同鞋跟高度(3公分、5.5公分、7.6公分)在下階梯時對人體運動學與動力學參數之影響。研究對象:10位有穿著高跟鞋經驗且下肢無任何病史之健康女性，年齡28.2±4.6歲、身高163.1±4.9公分、體重54.7±6.0公斤。方法與步驟：以Mega Speed 25k高速攝影機(100Hz)與一台AMTI測力板(1000Hz)以同步方法擷取不同鞋跟高度下階梯之動作。影片以Kwon3D動作分析軟體處理，原始資料經人體肢段參數建置、直接線性轉換(DLT)及量化後取得重心垂直位移、著地瞬間下肢關節角度、最大角位移、最大角速度與產生時間等運動學參數。測力板原始訊號透過DASYLab6.0分析軟體，經濾波、模組校正得到三維分力，並以體重倍率來表示，再經由積分運算取得衝量。資料處理則以重複量數單因子變異數（α=.05）進行統計分析。結果:(一)超過3公分的鞋跟，人體下階梯時的重心垂直位移會變大，膝關節最大角速度加快，著地瞬間的膝關節角度變小，踝關節角度變大。(二)垂直地面反作用力和最大負荷率也受到鞋跟高度的影響，鞋跟高度愈高，所造成的垂直地面反作用力和最大負荷率就愈大，促使垂直地面反作用力產生時間提前。結論:穿著超過3公分的鞋跟下階梯會增加垂直地面反作用力、最大負荷率、重心垂直位移與加快膝關節最大角速度，因此女性選擇鞋子時應注意到鞋跟的高度。

The purpose of this study was to examine stair descent performed at three different high heels heights. Ten healthy female adults with high heels experienced (height=163.1±4.9cm；weight=54.7±6.0kg；age=28.2±4.6years) participated in this study. Methods: One high-speed video cameras (Mega Speed 25k)) and ATMI force plateform (1000 Hz) were used to sample the stair descent motion. By adopting Kwon 3D movement analysis software to process the film with Direct Linear Transformation (DLT), kinematical parameters such as body center-of-gravity position, the contact joint angle, the maximal joint angle displacement, the maximal joint velocity and time to maximal joint velocity of three lower extremity could be obtained . By adopting DASY LAB6.0 software to process original signals with correction modular and low-pass filtering (10 HZ), three dimension ground reaction force could be obtained. Then, using body weight (B.W) as standardization basis, force and impulse values of ground reaction force could be worked out. The parameters were compared by one-way ANOVA, the level of significance was set at .05. Results:(1)When females wears high-heel shoes which is more than 3cm , vertical movement of the center body mass , knee maximal joint velocity and the contact joint angle of ankle all increase as people step down from stairs, while the touchdown angle of knee on the contrary .(2)Systematic increases in the vertical ground reaction force and maximal loading rate as heel height increased, shortern the time to maximal vertical ground reaction force. Conclusions: It appears that females wearing high-heeled shoes more than 3 cm increases the vertical ground reaction force , maximal loading rate, vertical movement of the center body mass, and knee maximal joint velocity. Therefore, women should be aware of the high-heeled problems when choosing shoes.

謝誌 I
中文摘要 II
英文摘要 III
目次 IV
表次 V
圖次 VI
壹、緒論 1
一、問題背景 1
二、研究目的 3
三、研究範圍 4
四、名詞操作型定義 4
貳、文獻探討 6
一、不同鞋跟高度之生物力學影響 6
二、下階梯動作之生物力學影響 11
三、著地動作之相關文獻 15
四、文獻總結 18
參、研究方法與步驟 19
一、研究架構 19
二、研究對象 20
三、實驗日期與地點 20
四、實驗儀器與設備 20
五、實驗方法與步驟 22
六、資料處理與統計分析 29
肆、結果 31
一、不同鞋跟高度下階梯運動學參數分析 31
二、不同鞋跟高度下階梯動力學參數分析 37
三、不同鞋跟高度下階梯運動學與動力學參數分析 41
伍、討論 42
一、不同鞋跟高度下階梯運動學的討論 42
二、不同鞋跟高度下階梯動力學的討論 46
三、不同鞋跟高度下階梯運動學與動力學綜合討論 49
陸、結論 50
參考文獻 51
表次
表3-1、測力板精確度誤差表 25
表4-1、著地瞬間下肢各關節角度變化摘要表 31
表4-2、不同鞋跟高度下階梯人體重心垂直位移摘要表 32
表4-3、不同鞋跟高度下階梯下肢關節最大角位移摘要表 33
表4-4、著地期間下肢關節最大角速度摘要表 35
表4-5、著地期間下肢關節最大角速度產生時間摘要表 35
表4-6、垂直地面反作用力第一、第二峰值、產生時間和站立
期衝量摘要表 37
表4-7、前後方向地面反作用力與衝量摘要表 38
表4-8、50毫秒被動衝量和最大負荷率摘要表 40
圖次
圖1-1、前後方向地面反作用力示意圖示意圖 4
圖1-2、垂直地面反作用力、衝量及負荷率示意圖 5
圖1-3、鞋跟高度示意圖 5
圖2-1、穿著8cm鞋跟身體質量重心軌跡示意圖 7
圖2-2、左腳足底分區示意圖 9
圖3-1、研究架構圖 19
圖3-2、Mega Speed 25k高速攝影機示意圖 20
圖3-3、測力板及相關儀器示意圖 21
圖3-4、階梯示意圖參考架示意圖 21
圖3-5、參考架示意圖 22
圖3-6、實驗場地與儀器布置圖 23
圖3-7、測力板比例模組校正圖 25
圖3-8、實驗流程圖 28
圖4-1、下階梯重心垂直位移圖 32
圖4-2、不同鞋跟高度下階梯膝關節角度曲線圖 34
圖4-3、不同鞋跟高度下階梯踝關節角度曲線圖 34
圖4-4、不同鞋跟高度下階梯垂直地面反作用力圖 38
圖4-5、不同鞋跟高度下階梯前後地面反作用力圖 39
圖4-6、不同鞋跟高度下階梯運動學與動力學曲線圖 41

一、中文部份
王顯智、黃惠貞（2006）。阿基里斯腱的解剖生理功能及可能的傷害因素。大專體育，84，202-206。
李書維、黃長福（1995）。不同高度赤腳著地動作之生物力學分析。中華民國體育學會體育學報，20，213-224。
林欣怡 （2000）。比較老年人與年輕人在下階梯時膝關節的肌電控制與功能性硬度調節。未出版碩士論文。國立體育學院運動科學研究所，桃園縣。
林寶城（1994）。運動鞋結構功能之運動生物力學探討。中華體育，8(3)，60-64。
相子元（1997）。足部運動生物力學研究。財團法人鞋類設計暨技術研究中心委託學術機構研究報告
洪維憲、李永輝、鄧復旦、陳嘉玲、劉文隆、裴育晟(2005)。高跟鞋不適度、解除不適行為及其臨床意涵。台灣復健醫學雜誌，33(1)，11-18。
洪維憲 (2003)。女性高跟鞋及鞋墊的生物力學與傳力機制分析。未出版博士論文。國立台灣科技大學，台北市。
許太彥（1993）。國小學童不同高度赤腳著地動作之生物力學分析。未出版碩士論文。國立師範大學體育研究所，台北市。
許太彥（2003）。國小學童不同軟硬表面著地下肢勁度調節之機轉及其影響。未出版的博士論文。國立師範大學體育研究所，台北市。
姬榮軍 (1999)。動態活動與下階梯動作條件下老年人下肢肌肉勁度調節與肌電圖現象之研究。未出版碩士論文。國立師範大學體育研究所，台北市。
陳雯惠（2003）。不同高度與姿勢的人體著地動作之生物力學分析。未出版的碩士論文。國立體育學院運動科學研究所，桃園縣。
郭金明、張國權、阿布米力提．阿里木江 （2007）。穿高跟鞋對中青年女性腰椎生理曲度的影響。臨床骨科雜誌，10(4)，332-333
張大昌（2003）。國小學童赤腳著地動作之生物力學分析。未出版碩士論文。國立體育學院運動科學研究所，桃園縣。
張英智（1995）。大專男子籃球選手不同高度著地動作之生物力學分析。未出版的碩士論文。國立台灣師範大學，台北市。
張敬德、郝智秀、張宇、周大佛、方新(2007)。鞋跟高度對地面反力和鞋底壓力中心的影響，中國康復醫學雜誌，22(3)，241-243。
黃韻靜（2002）。視障大學生下肢動態肌肉勁度調節能力與肌電現象之研究。未出版碩士論文。中國文化大學運動教練研究所，台北市。
趙峻郁（1999）。老年人著地技能動作之肌電圖分析。未出版博碩士論文，文化大學教練研究所，台北市。

二、英文部份
Adrian, M.J., & Karpovitch, P.V.(1965). Foot instability duringwalking in shoes with high heels. Research Quarterly ,37,168 -175
Alexander, R.M.(1992). The Human Machine. New York:The Columbia University Press.
Anastasia Protopapadaki , Wendy I. Drechsler , Mary C. Cramp , Fiona J. Coutts , Oona M. Scott .(2007). Hip, knee,ankle kinematics and kinetics during stair ascent and descent in healthy young individuals. Clinical Biomechanics ,22 , 203–210
Andriacchi T, Andersson G, Fermier R et al(1980). A study of lower limb mechanics during stair climbing. J Bone Joint Surg ,62,749-57.
Brown R., & Lingg, C.(1961).Musculoskeletal Complaints in an Industry. Annusl Complaint Rate and Diagnosis, Absenteeism ans Economics Loss, Arthritis Rheum,4,283
Brown M, Rudicel S, & Esquenazi A.(1996). Measurement of dynamic pressures at the shoe-foot interface during normal walking with various foot orthoses using the FSCAN system. Foot Ankle, 17,152-156.
Caroline M. Speksnijder, Rieny J.H. vd Munckhof, Sjors A.F.C.M. Moonen,Geert H.I.M. Walenkamp. The higher the heel the higher the forefoot-pressure in ten healthy women. The Foot ,15 ,17–21
Chang-Min Lee, Eun-Hee Jeong, & Andris Freivalds.(2001). Biomechanical effects of wearing high-heeled shoes. International Journal of Industrial Ergonomics ,28, 321-326
Craik RL, Cozzen BA, & Freedman W.(1982). The role of sensory conflict on stair descent preference in humans. Exp Brain Res,45,399-409.
Corrigan JP, Moore DP, & Stevens MM (1993). Effect of heel height on forefoot loading. Foot Ankle ,14 (3),148–52.
Dawson J,Thorogood M, Marks SA, Juszczak E, Dodd C, Lavis G, & Fitzpatrick R, (2002).The prevalence of foot problems in older women: a cause for concern. J Public Health Med,24,77-84.
Devita, P., & Skelly W.A. (1992). Effect of landing stiffness on joint kinetics and energetics in the lower extremity. Medicine and Science in Sports and Exercise, 24(1), 108-115.
Dufek, J.S., & Bates, B.T. (1991). Biomechanical factor associated with injury during landing in jump sports. Sports Medicine, 12(5), 326-337.
Ebbeling, C.J., Hamill, J., & Crussemeyer, J.A.(1994). Lower extremity mechanics and energy cost of walking in highheeled shoes. Journal of Orthopedics Sports Physical Therapy ,19, 190-196
Eisenhardt JR, Cook D, Pregler I, & Foehl HC(1996). Changes in temporal gait characteristics and pressure distribution for bare feet versus various heel heights. Gait Posture, 4,280–286.
Ernst G, Kawaguchi J, & Saliba E(1999). Effect of patellar taping on knee kinetics of patients with patellofemoral pain syndrome. Journal of Orthopedic and Sports Physical Therapy ,29,661-667.
Gollnick PD, Tipton CM, & Karpovich PV(1964). Electrogoniometric study of walking on high heels. Res Q ,35 (3),370–378.
Hamel KA, Okita N, Bus SA, & Cavanagh PR(2005). A comparison of foot/ ground interaction during stair negotiation and level walking in young and older women. Ergonomics ,48,1047–1056.
Hemenway D, Solnick SJ, Koeck C, & Kytir J. (1994). The incidence of stairway injuries in Austria. Accid Anal Prev,26,675-679.
Hyun, S., & Kim, J.Y.(1997). The study on the effect of the highheel affecting to the back muscle fatigue. The Proceedings of the Ergonomics Society of Korea, Hongik University, Seoul Korea,304-310.
Jang, N., & Kim, Y.(1998). Human Physiology(3th.ed).,Sumunsa, Seoul,Korea,73-80.
Jevsevar, D.S., Riley, P.O., Hodge, W.A., Krebs, D.E.(1993). Knee kinematics and kinetics during locomotor activities of daily living in subjects with knee arthroplasty and in healthy control subjects. Phys. Ther, 73 (4), 229-238.
Jones, K. & Barker, K. (1996).Human Movement Explained.Butterworth-Heinemann. 297-311.
Kerrigan, D.C., Todd, M.K., Riley, P.O.(1998). Knee osteoarthritis and high-heeled shoes. The Lancet ,351 (9),1399–1401
Krebs, D.E.,Wong, D., Jevsevar, D., Riley, P.O., & Hodge,W.A.(1992). Trunk kinematics during locomotor activities. Physical Therapy ,72 (7), 505–514
Krebs DE, Wong DK, & Jevsevsar DS et al(1992).Trunk kinematics during locomotor activities. Phys Ther ,72,505-14.
Lateur, B.J., Giaconi, R.M., Questad, K., Ko, M., & Lehmann, J.F.(1991). Footwear and posture: compensatory strategies for heel height. American Journal of Physical Medicine and Rehabilitation 70, 246-254.
Lee, H.J., & Chou, L.S.(2006). Detection of gait instability using the center of mass and center of pressure inclination angles. Archives of Physical Medicine and Rehabilitation, 87 (4), 569–575.
Livingstone LA, Stevenson JM, & Olney SJ(1991). Stair-climbing kinematics on stairs of differing dimensions. Archives of Physical and Medical Rehabilitation, 72,398–402.
Mandato MG, & Nester E(1999). The effects of increasing heel height on forefoot peak pressure. J Am Podiatr Med Assoc ,89(2),75–80
Mathews, D.K., & Wooten, E.P.(1963). Analysis of oxygen consumption of women while walking in different styles of shoes. Archives of Physical Medicine and Rehabilitation, 99,569-571.
McNitt-Gray, J.L. (1991). Kinematics and impulse characteristics of drop landings from three height. International Journal of Sport Biomechanics, 7, 201-224.
McNitt-Gray, J.L. (1993). Kinetics of the lower extremities during drop landing from three height. Journal of Biomechanics,9, 1037-1046.
Morrison, J.B.(1968). Bioengineering analysis of force actions transmittedby the knee joint. Biomed. Eng, 4, 164-169.
Murray, P.M., Kory, R.C., & Sepic, S.B.(1970). Walking patterns of normal women. Archives of Physical Medicine and Rehabilitation ,51,637.
Nieto, E., & Nahigian, S.H.(1975). Severe ankle injuries while wearing elevated platform shoes. Ohio Medicine 71,137–141
Nilsson, J., & Thorstensson, A.(1989). Ground reaction forces at different speeds of human walking and running. Acta. Physiol.Scand ,136 (2),217–227.
Opila-Correia, K.A.(1990). Kinematics of high heeled gait.Archives of PhysicalMedicine and Rehabilitation ,71,304–309.
Perry, J.(1992). Gait analysis, Normal and pathological function. NJ .Slack Incorporated.
Riener R, Rabuffetti M, & Frigo C.(2002). Stair ascent and descent at different inclinations. Gait Posture ,15,32–44.
Salsich, G.B., Brechter, J.H., & Powers, C.M.(2001). Lower extremity kinetics during stair ambulation in patients with and without patellofemoral pain. Clin. Biomech,16, 906-912.
Scholl, W.(1931).The Human Foot: Anatomy, Physiology,Mechanics, Deformities and Treatment. Charles C.Thomas, Springfield, IL.
Sneyers, C. J .L., Lysens, R., Feys, H., & Andries, R.(1995).Influence of Malalignment of Foot on the Plantar Pressure Pattern in Running. Foot & Ankle International,16(10),624-632.
Snow,R.E., & Williams,K.R.(1990).Effects of gait,posture,and center of mass position in women walking in high heeled shoes.Med Sci Sports Exerc,22,23.
Snow, R. E., Williams, K. R., & Holmes, C. B., Jr.(1992).The effects of wearing high heeled shoes on pedal pressure in women. Foot Ankle, 13, 85-92.
Snow, R.E., & Williams, K.R.(1994). High heeled shoes: their effect on center of mass position, posture, three-dimensional kinematics, rearfoot motion, and ground reaction forces.Archives of Physical Medicine and Rehabilitation ,75,568–576.
Soames RW, & Clark C(1985). Heel height induced changes in metatarsal loading patterns during gait. In Winter DA, Norman RW, Wells RP(Eds). Biomechanics IX-A(pp.446). Champaign, IL: Human Kinetics Publishers.
Startzell JK, Owens DA, Mulfinger LM, & Cavanagh PR. (2000).Stair negotiation in older people. J Am Geriatr Soc,48,567-580.
Stefanyshyn DJ, Nigg BM, Fisher V, O’Flynn B, & Liu W (2000).The influence of high heeled shoes on kinematics ,kinetics,and muscle EMG of normal female gait.J Appl Biomech ,16,309-319
Svantesson U, Osterberg U, Thomee´ R, & Grimby G. (1998). Muscle fatigue in a standing heel-rise test. Scand J Rehabil Med,30,67-72.
Wei Hsien Hong, Yung-Hui Lee, & Hsieh Ching Chen.(2007). The effect of insert on muscle activites during high-heeled gait. Journal of Biomechanics ,40,111
Yoe, H.(1994). A study on the compatibility of women’shoes.Master Thesis, Pusan University, Pusan, Korea.
Zachazewski James E, & Riley Patrick O.(1993). Biomechanical analysis of body mass transfer during stair ascent and descent of healthysubjects. Journal of Rehabilitation Research and Development ,30,412–422