神經刺激結合肌力平衡訓練對於踝關節不穩定者其神經肌肉表現的效益

腳踝扭傷一直以來都是運動傷害中居高不下的傷害之一，而患者又容易因照顧不善、肌力不足、本體感覺不佳等因素導致踝關節反覆扭傷，而成為踝關節不穩定(FAI)。近年提出全身性震動訓練可以藉由刺激患者神經肌肉功能改善患者腳踝穩定能力。因此本研究將透過比較一般的徒手運動訓練與搭配全身性震動的徒手運動訓練來探討神經刺激結合肌力和平衡訓練對踝關節不穩的神經肌肉性能的效果。34名踝關節不穩定的男性大學生隨機分配成(1)徒手訓練組(2)震動訓練組(3)控制組進行8周的下肢平衡訓練，並比較訓練前後各組肌力、平衡及動作控制等運動表現。結果發現經過八周的訓練期，震動訓練組在蹠屈的最大肌力與5秒肌力平均值、動態平衡的後方內側方向及閉眼單足立表現有顯著提升。脛前肌在雙腳從高處跳下、星型平衡後方內側方向的肌電活化有顯著下降；腓骨長肌在星型平衡後方內側方向和閉眼單足立的肌電活化有顯著下降；神經傳導反射則在從敲擊到開始反應的時間明顯變長；而評估受測者踝關節功能的CAIT問卷分數在經過訓練後有顯著的上升。本研究結果為搭配全身性震動的徒手運動訓練對於踝關節不穩定者的神經肌肉系統及平衡能力有較明顯的改善。

關鍵字

震動訓練；動作控制；神經肌肉系統；平衡

並列摘要

Ankle is the most frequently injured joints in the human body. After trauma, damage to some or all of these structures may result functional instability of the joint and predispose the ankle to future injuries. Whole body vibration (WBV) training is a new training method that has been linked with improving balance and muscle function. Therefore, the purpose of this study was to compare the effect of general body weight training and the body weight training with whole body vibration to investigate whether training with nerve stimulation could enhance the muscle strength and balance ability to whom with ankle instability. Thirty-four male university students with self reported ankle instability were randomly assigned into three groups including body weight training group, whole body vibration training group, and control group. Both training groups have eight weeks lower limb balance training. Landing, star excursion balance test (SEBT), single leg stand close eyes, muscle power, muscles activation, Cumberland ankle instability tool (CAIT) and joint reposition were measured before and after eight-weeks training intervention. WBV group increased plantar flexion muscle strength both in peak value and contractions for five seconds, increased SEBT posterior-medial reach distances, increased single leg stand close eyes performance, reduced anterior tibia muscle activation at both feet jump from high place and SEBT posterior-medial, reduced fibularis longus muscle contraction at SEBT posterior-medial and single leg stand close eyes, increased the time of Achilles tendon reflex, and increased CAIT score. Traditinal trainging combined with whole body vibration has better training effect in improving balance performance and reduced muscle activation during landing for subjects suffers ankle instability.

並列關鍵字

vibration training ； motor control ； neuromuscular system ； balance

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