太極拳旋腰轉脊動作對動態姿勢穩定之影響

太極拳係由許多生理、認知與心理等多元成分所構成，而太極拳其中一項核心原則，在於大部分動作中保持立身中正之體姿。誠如太極拳經所言，維持身體中軸脊柱「對拉拔長」能有效增進身體的最大潛能，並確保動作安全性、鬆柔與優雅的姿勢。太極拳係一種螺旋纏繞動作的力量，所有太極拳動作皆源自於纏絲勁的三項要素：放鬆、伸展與轉動，故纏絲勁的發展攸關促進健康養生與武術技能之運用。本文旨在探討太極拳旋腰轉脊動作對動態姿勢穩定之影響。方法：經由招募26位健康且自願的男女性，採隨機分配到實驗組（n=13）與控制組（n=13）。依據台灣受試者保護協會研究倫理之規範，受試者必須是自願參加，並事前告知前、後測及訓練介入之內容等相關事宜。實驗組對象以未具陳式太極拳基礎為主，施以每週乙次每次120分鐘的太極拳纏絲勁與精要十八式套路練習，實驗期程為12週；控制組對象則以從事一般休閒活動的上班人士為主。採修正版的星型擺幅平衡測驗（mSEBT)評估方式，以倒Y字型 (前方、外後、內後) 三個方向的最大延伸距離量測，並施以腿部長度常值化以計算其最大延伸距離（%MAXD），以及測量核心肌耐力的軀幹屈曲與伸展能力。統計分析採前、後測量數據進行比較，以SPSS for windows 22.0套裝統計軟體進行描述統計分析，並以混合設計二因子多變量變異數分析 (two-way mixed design MANOVA) 分別對mSEBT的左腳及右腳三個方向延伸距離、核心肌耐力進行組別（實驗組、控制組）、時間（訓練前、訓練後）的檢驗，統計顯著水準定為α=.05。結果：右腳延伸測驗前方向交互作用達顯著 (F3, 22= 41.37; p＜.05; ηP2 = .85),實驗組後測顯著長於前測，右腳延伸測驗外後方達顯著為 (F1, 24= 43.42; p＜.05; ηP2 =.64)，右腳延伸測驗內後方達顯著則為 (F1, 24= 106.69; p＜.05; ηP2=.82)；相反地，控制組則呈現前測顯著長於後測。左腳延伸測驗及核心肌耐力的軀幹屈曲與伸展，均未達顯著。結論：太極拳纏絲勁之旋腰轉脊動作，透過肢體的螺旋伸縮運動與維持脊柱的中位體姿，能增進穩定中移動與肌力的承重鍛鍊，進而提升腰脊穩定與動態姿勢控制之表現。

關鍵字

星型擺幅平衡測驗 (SEBT) ；動態姿勢穩定；本體感覺；核心穩定

並列摘要

Tai Chi is made up of multiple components, including many physical, cognitive, and psychosocial ingredients. One of the core principles of the Tai Chi relates to posture and alignment that inform most Tai Chi movements is verticality. Building on phrases from the Tai Chi classics-“Suspend the spine like a string of pearls from heaven”- Tai Chi trains practitioners to maximize their body’s physical potential and find alignments that afford safe, unstrained, and graceful postures. Tai Chi provides a spiral force and all Tai Chi movements are achieved through silk-reeling energy containing the three components of relaxation, extension and turning or twisting. The development of silk-reeling energy, therefore, is necessary if the maximum health and martial benefits are to be realized. The purpose of this study was to investigate the effects of Tai Chi rotating the movement of waist and spine on dynamic postural stability. Methods: Twenty-six health volunteers male and female subjects participated in this study and were randomized into either exercise （EX; n=13） or control （CON; n=13）groups. All participants prior to the study signed a voluntary consent form that was approved by the Human Subject Protection Association in Taiwan (HuSPAT), which included an explanation of the study and any possible risks or discomfort the subject may encounter. The Tai Chi intervention involved one 120-minute session, one time per week for 12 weeks. Subjects were taught the Silk-Reeling Energy and the 18-form of Chen’s Tai Chi style designed for the experiment group, whereas the control group abstained from any new exercise. Subjects participated in two test sessions for pre-test and post-test assessments of dynamic postural control using the modified SEBT test Star Excursion Balance Test (mSEBT) as well as the trunk flexor/extensor endurance tests before and after 12-week intervention or control period. Reach distances on mSEBT （For the test, each participant stands in single-limb stance on the test limb and performs maximal reaches with the nonstance limb in the anterior, posterolateral, and posteromedial directions.） was normalized to limb length by calculating the maximized reach distance (%MAXD) using the formula (Reach distance/limb length) ×100=% MAXD.SPSS 22.0 was used for all statistical analyses with a significance level set atα=.05. The two-way mixed design MANOVA repeated measures was used for the statistical analysis of the data. Results: After 12 weeks of intervention of Tai Chi practice, the exercise group showed significant improvement in the maximum excursion 3 distances of right leg in the mSEBT, compared with the control group. For the anterior direction of right leg in the mSEBT was significant Group by Time interaction (F3, 22= 41.37; p＜.05; partial eta squared = .85). MAXD was greater at the post-test (75.0±6.1%) compared to the pre-test (72.0±6.9%). For the posterolateral direction (F1, 24= 43.42; p＜.05; partial eta squared =.64) and For the posteromedial direction (F1, 24= 106.69; p＜.05; partial eta squared=.82). There was no significant effect on the left leg in the mSEBT and the trunk flexor/extensor endurance tests. No serious adverse events were observed during the study period. In conclusion, our results suggest that 12 weeks of intervention of the Tai Chi practice may provide efficient load-bearing exercise for muscle strength and mobility superimposed on stability, leading to an increase in improving lumbar stability and dynamic postural control. This result justifies the hypothesis that the silk-reeling energy of practice and Tai Chi rotating the movement of the waist and spine can improve dynamic balance and dynamic postural stability.