不同跑步機訓練模式對下肢恆定性步態表現之影響

The Influences of Different Treadmill Training Modes on the Lower Extremity Certainty in Gait Performance

陳世銘(Shih-Ming Chen)

指導教授 ： 林昭宏

高雄醫學大學/健康科學院/行為科學研究所/碩士(2004年)

摘要

本研究的目的是探討不同的跑步機訓練模式對正常受試者及中風患者下肢肌群之肌電訊號恆定性(certainty)的影響。本研究徵召10位正常人及5位中風患者為受試者，採用基準(baseline)-介入干擾(intervention)-移除干擾(withdraw)(A-B-A)的實驗方式，介入干擾分別為改變坡度(坡度12%)及改變速度(二倍自選舒適速度)二種訓練模式。二種模式皆個別進行12分鐘，分別包含各4分鐘的基準階段、介入干擾階段及移除干擾階段。過程中連續記錄雙側下肢脛前肌及內側腓腸肌之表面肌電訊號，轉換為近似熵值(Approximate Entropy, ApEn)，用以說明肌肉誘發型態恆定性之意涵並且觀察適應現象。使用單因子多變量變異數分析(one-way MANOVA)之統計方法檢測兩組間不同訓練模式下不同階段和不同肌群之間差異性。在坡度訓練模式中，正常人與中風患者脛前肌與內側腓腸肌恆定性變化的趨勢較為一致，但是過程中各階段的熵值中風患者皆高於正常人且達到統計學上顯著差異；改變速度模式中，則顯示出不同變化的趨勢，中風患者脛前肌肌電訊號熵值變化有增加的趨勢，即肌肉收縮變異性隨速度增加而變大，然而，兩者內側腓腸肌恆定性表現相對穩定。整體而言，內側腓腸肌恆定性和適應現象皆較脛前肌明顯。本研究相關結果可以提供做為探討跑步機步行訓練療效的參考指標。

關鍵字

跑步機訓練 ； 近似熵值 ； 恆定性 ； 步態 ； 半側輕癱

並列摘要

The purpose of this study was to investigate the influences of different treadmill training modes on the lower extremity certainty for normal and hemiparetic subjects in gait performance. Ten healthy subjects and 5 hemiparetic patients were recruited for this baseline-intervention-withdraw (A-B-A) study. The intervention of training modes consisted of the variation of the upgrade 12% inclination and two-fold free comfortable speed. Both modes were individually performed for 12 minutes, including 4 minutes baseline-, 4 minutes intervention-, and 4 minutes withdraw phases. The surface electromyographic (SEMG) profiles of the bilateral anterior tibialis (TA) and medial gastrocnemius (MG) were serially recorded and then converted into Approximate Entropy (ApEn), in terms of the certainty of muscle firing patterns and adaptation phenomenon. One-way MANOVA was used to examine the ApEn differences between muscle groups and phases for the two training modes. At inclination mode, the trends of the certainty variation of TA and MG for stroke patients were consistent with those of normal subjects, but ApEn scores in each phase were significantly higher in stroke subjects. At speed mode, the trends were various between stroke patients and normal subjects. The increase of ApEn of TA for the stroke patients’ indicates that faster speed induced TA variability. However, the trends of the MG certainty variation were relatively stable. In general, the certainty variation and adaptation phenomenon of MG were more substantiality than those of TA. The results may provide the basis of assessment effects on treadmill ambulatory training.

並列關鍵字

Treadmill Training ； Approximate Entropy ； Certainty ； Gait ； Hemiparesis

參考文獻

參考資料

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