評估不同踝關節型態運動員在著地動作的姿勢穩定策略與神經肌肉控制

Assessment of Postural Stability Strategy and Neuromuscular Control during Landing among Athletes with CAI, Coper, and Healthy Control

林建志(Lin Jian-Zhi)

指導教授 ： 李恆儒

國立臺灣師範大學/運動與休閒學院/體育學系/博士(2018年)

https://doi.org/10.6345/DIS.NTNU.DPE.001.2018.F03

摘要

目的：本研究目的為評估不同踝關節型態運動員在著地動作的姿勢穩定策略與神經肌肉控制，從中尋找慢性踝關節不穩定 (chronic ankle instability, CAI) 反覆扭傷因子，以及防止潛在族群 (Coper) 發展成CAI的不可逆過程。方法：以Cumberland踝關節不穩定問卷為依據，招募30位大專運動員並以CAIT問卷標準，將每組10人分別納入踝關節不穩定組、潛在組與健康對照組。動作測試為前跳、側向跳與垂直跳著地動作，要求實驗參與者以躍起後單腳著地平衡5秒鐘。實驗過程使用十台Vicon紅外線攝影機 (200 Hz)、3塊Kistler測力板 (1000 Hz) 與8枚無線肌電訊號 (1000 Hz) 同步收集下肢運動學、動力學與肌電圖參數。統計方法以獨立樣本單因子變異數分析進行統計考驗不穩定組、潛在組與健康控制組的比較 (α = .05)，事後比較處理為雪費法。結果：研究發現CAI運動員存在數個不穩定特徵：(一) 踝關節背屈動作受限，影響踝關節矢狀面關節ROM；(二) 踝關節額狀面關節ROM變化較大；(三) 著地瞬間具有較早與較快的踝關節內翻速度；(四) 腓骨長肌與臀中肌活化不足的神經肌肉損傷後遺症；(五) Coper的整體著地動作策略趨向於CAI。結論：踝關節不穩定運動員即便在扭傷復原後，仍舊存在反覆扭傷的不穩定因子，因此，建議針對踝關節活動範圍與神經肌肉控制進行強化與訓練，以避免二次傷害的產生。

關鍵字

踝關節扭傷 ； 單腳著地 ； 韌帶撕裂 ； 不穩定 ； 運動傷害

並列摘要

Purpose: The purpose of this study was to assessment of postural stability strategy and neuromuscular control during landing among athletes with chronic ankle instability (CAI), Coper, and healthy control. To find out what affect stability movement strategy of CAI. And to prevent Coper development to CAI during irreversible process of ankle sprain. Method: All participants had to complete a Cumberland ankle instability tool to define Healthy, Copers and CAI groups. There were 30 collegiate Division I athletes volunteered for this study. All participants needed to complete jump-landing protocol (forward jump, side hop, and bounce drop jump). Participants were asked to perform a jump followed with a single-leg landing. When landing with single-leg, participants were asked to maintain their balance for 5 seconds. Ten Vicon infrared cameras (200 Hz), three Kistler force platform (1000 Hz), and eight Delysis wireless EMG sensors (1000 Hz) were synchronized to acquire the lower extremity kinematic, kinetics, and EMG data. One-way ANOVA was conducted to compare the differences of lower extremity biomechanics data during jump-landing among CAI, Coper, and healthy control groups. The significant level was set at α = .05. Post hoc comparisons were performed using the Scheffe’s test, if statistical significance was found among the groups. Results: The major finding of CAI athletes: 1. The ankle range of motion in sagittal plane was influenced by limited ankle dorsiflexion. 2. The variation of ankle range of motion was obvious in frontal plane. 3. The angular velocity of inversion was earlier and bigger in initial contact. 4. There was neuromuscular control deficit in peroneal longus and gluteus medius muscles. 5. The landing strategy of Coper was similar to CAI. Conclusion: Even though fully healed after ankle sprain, the athletes with CAI still had deficits to repeated occurrence of instability. Therefore, we suggested that training programs of ankle range of motion and neuromuscular control is necessary to prevent recurrent ankle sprain.

並列關鍵字

ankle sprain ； single-leg landing ； ligament tear ； instability ； sport injury

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