熱身方法影響阿基里斯腱的生物力學比較

Biomechanical Comparison of Warm-up Methods for Achilles Tendon

沈雅珣(Ya-Hsun Shen)

指導教授 ： 陳祥和

臺北醫學大學/醫學院/醫學科學研究所/碩士(2017年)

摘要

隨著時代的進步，國人對健康日漸重視，近年來運動人口比率逐漸提高。依教育部體育署104年統計結果顯示，13歲以上國人有運動者占83％，規律運動人口占33.4％。以路跑運動為例，美國路跑者調查從2010年開始女性比例已高於男性，2015年女性路跑人數接近六成，代表越來越多女性熱愛休閒運動，幾乎已成為一種流行趨勢。但運動傷害也隨之增加，其主要原因之一是熱身不足。根據文獻，熱身方式分為被動熱身和主動熱身，最常使用的主動熱身方式為慢跑；被動熱身則是對運動部位進行加熱。阿基里斯腱銜接比目魚肌和腓腸肌與跟骨，主要作為傳遞力量的角色。它的力學性質在運動過程中極為重要，最大受力在跑步及跳躍可達六到八倍體重以上，反覆的拉伸影響阿基里斯腱產生疲勞甚至發炎，嚴重則會斷裂。本研究特別針對女性探討熱敷及慢跑兩種不同熱身方式對阿基里斯腱力學性質的影響，希望提出較好的運動熱身策略，以預防運動傷害。研究招募共三十位成年女性，分為對照組與兩種熱身方式總共三組，進行交叉試驗。受試者於不同時間進行無熱身、慢跑十五分鐘和熱敷十五分鐘三種條件；為了解溫度變化情況，其中七例在熱身過程中使用紅外線熱像儀量測體表溫度。阿基里斯腱分為二個區段，由跟骨至比目魚肌交會點視為自由肌腱(Free tendon)；由跟骨至腓腸肌交會點視為全肌腱(Gastrocnemius tendon)。參考受試者之50%MVC，利用蹠屈等長收縮控制器進行蹠屈作用，施加27N•m 的等長收縮受力維持3秒。使用超音波掃描組織平面影像，並利用斑點追蹤演算法取得阿基里斯腱的伸長量和應變率。結果顯示在成對T檢定下，兩種熱身方式與對照組做比較自由肌腱的伸長量皆有統計學的顯著差異；但在全肌腱皆無統計學差異。在應變率方面，自由肌腱在慢跑組與對照組比較有統計學的顯著差異；全肌腱在熱敷組與慢跑組和對照組比較皆有統計學上顯著差異。在溫度變化方面，同樣的熱身時間控制下，熱敷升溫幅度較高，僅需加熱7-8分鐘即可達到與慢跑相同溫度。自由肌腱在熱敷與慢跑不同熱身方式下，伸長量變大、變較柔軟代表短時間勁度較低或較均勻，說明熱敷和慢跑造成自由肌腱的力學性質改變相近，全肌腱由於一部份與比目魚肌並聯存在，力學效應與自由肌腱相比明顯不同。本篇研究提出熱敷的熱身方式某程度下可代替慢跑熱身，但無法達一致效果，可提供教練或運動員在運動前選擇熱身方式之策略參考。

關鍵字

阿基里斯腱 ； 熱身 ； 應變 ； 生物力學

並列摘要

With the development of the society, leisure activities and exercises, especially jogging, are becoming more popular. More and more females participate in sports, virtually evolving into a trend. However, many people are busy and warm up exercises can be ignored easily, which may result in sports injuries. Achilles tendon (AT) is located in the back of the calf. At the end of the gastrocnemius, it tapers off and becomes tendon tissue connecting to the calcaneus, serving as the connection between muscle and bone. Its flexibility is critical during exercise, as it can withstand 8 times the body’s weight while running and jumping. Repeated stretching causes the AT to become fatigued, leading to rupture. This study focuses on the effects of two different warm up routines, jogging and hot compressing for 15 minutes, on the AT of females. Thirty untrained female amateurs volunteered to participate in this study. During the two-week period of the experiment, we conducted trials on the first, the fourth, and the eleventh day. Mechanical testing and ultrasound scanning were performed immediately after warm-up routines. Deformation data of the free tendon, tissue between the calcaneal notch and Soles muscle-tendon junction, and the Gastrocnemius tendon, tissue between the calcaneal notch and muscle-tendon junction, were recorded. A spring pedal was designed to conduct the isometric planta flexion of the ankle with a torque of 27N-m. To investigate the temperature elevation of tendon tissues, the temperature probe remained at the tendon area throughout the warm-up process in 7 subjects. Tissue speckle tracking using the Echopac software was used to determine displacement and strain rate of two tendon tissues. In displacement, the free tendon showed that both warm-up conditions were different from the control condition significantly. But, the difference among three groups was not significant for the Gastrocnemius tendon. In strain rate, only the jogging group was different from the control one for the free tendon, and both warm-up groups were different from the control group for the Gastrocnemius tendon. In temperature elevation, the hot compressing increased the temperature of the AT area to a same level as the jogging in 7 or 8 minutes. The results indicate that mechanical properties of both tissues were significantly different between situations without warm-up and with both warm-up routines, flexibility especially. The hot compressing method can bring a similar effect on AT to the jogging method in certain aspects. However, the similarity of both methods is not identical and needs further verification. This study provides an insight into differences of two warm-up methods and may help players to better protect Achilles tendon during exercising.

並列關鍵字

Achilles tendon ； Warm up ； Strain ； Biomechanics

參考文獻

2. 國立臺北師範學院學報。第十六卷第一期。(2003)。79-96。

13. 祁葉榮、莊恆澤、張又文。（2004）。籃球熱身暖和運動對生理與傷害的影響。中華體育，18(2):102-6。

50. 洪俊安、張立羣、周桂名。(2008)。踢擊動作的慣用腳與非慣用腳之探討。國立臺灣體育大學競技運動學系。第十卷第一期。

3. Maffulli N, Sharma P, Luscombe KL (2004) Achilles tendinopathy: aetiology and management. J R Soc Med, 97 (10):472-6.

4. Bradley JP, Tibone JE (1990) Percutaneous and open surgical repairs of Achilles tendon ruptures. A comparative study. Am J Sports Med, 18 (2):188-95.