不同身體姿勢及負荷重量對於執行肩部外轉運動對肩部肌肉活化之影響

Effect of body positions and weight loads in the shoulder muscles activity during external rotation exercise

陳延昌(Yen-Chang Chen)

指導教授 ： 林槐庭

高雄醫學大學/醫學院/運動醫學系碩士在職專班/碩士(2019年)

摘要

背景：
旋轉肌群損傷是造成肩痛最常見的原因之一，且旋轉肌群對於肩部的靜態及動態穩定扮演了重要的角色，因此復健計畫中常使用肩部外轉運動來增加旋轉肌袖肌力及功能。
目的：
棘下肌是肩部外轉運動中最具有影響力的肌肉，本篇研究藉由觀察棘下肌和肩部周遭肌肉活化情形，期望找出不同復健階段在何種姿勢及重量負荷下執行肩外轉等張運動能達到最適當訓練，以提供早期復健計畫之參考。
方法：
20位年齡介於20~40歲無肩關節病史之健康成年人參與此次研究。肌電圖表面電極放置於上斜方肌、中三角肌、後三角肌、胸大肌、棘下肌，肌電圖訊號用最大自主等長收縮做常規化處理（%MVIC）。受試者隨機分別在坐姿、躺姿、側躺姿下進行測驗，每個姿勢請受試者用慣用側分別於無負重、0.5公斤、1公斤、2公斤啞鈴執行肩外轉等張運動。
結果：
側躺姿勢的棘下肌和後三角肌不管在哪個負重下的活化皆顯著高於坐姿和躺姿，且隨著重量的增加，其活化改變程度較為明顯。躺姿下的棘下肌、後三角肌、中三角肌、上斜方肌活化相較其他兩個姿勢是較低的，但胸大肌的活化則明顯高於其他兩個姿勢。上斜方肌和中三角肌在躺姿下負重2公斤的活化皆顯著高於無負重。
結論：
早期復健計畫中執行肩外轉等張肌肉收縮運動，可先於躺姿下做小幅度活動，再變換至坐姿，最後在側躺姿下訓練，可漸進式訓練棘下肌並避免其他肌肉代償。不同重量間肌肉活化變化也可提供參考與應用。

關鍵字

肩部 ； 肩外轉運動 ； 旋轉肌袖 ； 棘下肌 ； 肌電圖

並列摘要

Background:
Rotator cuff pathology is one of the most common causes of shoulder pain, and the rotator cuff muscles play important roles in the static and dynamic stability of the shoulder. Therefore, external rotation exercise is commonly performed to improve strength and function during rehabilitation.
Purpose:
Infraspinatus acts as the most powerful muscle in shoulder external rotation. In this study, we analyzed the muscles activation of infraspinatus and other major shoulder muscles in 3 different positions, supine, seated and side lying, for purpose of finding a proper position for early rehabilitation after shoulder injury.
Methods:
There are 20 healthy subjects aged between 20 to 40 years (14 males, 6 females) with free of shoulder pathology participated in this study. EMG electrodes were placed on the trapezius, middle deltoid, posterior deltoid, pectoralis major and infraspinatus. The EMG signals were normalized to the MVIC (%MVIC). The subjects were randomly tested in sitting, supine and side lying position. In each position, the subject performed isotonic shoulder external rotation with 0 kg, 0.5 kg, 1 kg, and 2 kg dumbbell.
Results:
The activities of infraspinatus and posterior deltoid in the side lying position were significantly higher than that in the sitting and supine positions, and their activities were increased with loading increased. Generally the activity of infraspinatus, posterior deltoid, middle deltoid and upper trapezius in the supine position was lower than the other two positions, but the activity of pectoralis major was significantly higher. The activities of the upper trapezius and middle deltoid in the supine position with 2 kg load were significantly higher than those with 0 kg load.
Conclusion:
For early rehabilitation of isotonic shoulder external rotation exercise, it was performed first in the supine position, then changed to the sitting position, and finally in the side lying position, the infraspinatus can be train gradually and avoided other muscle compensatory mobility. and the activation changes between different loads in our research can also provide reference and application.

並列關鍵字

shoulder ； external rotation exercise ； rotator cuff muscle ； infraspinatus ； electromyography

參考文獻

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