簡易檢索 / 詳目顯示

研究生: 邱藍億
Chiu, Lan-Yi
論文名稱: 動態貼紮對慢性踝關節不穩定族群在單腳著地的影響
The influences of dynamic taping on single leg landing in CAI
指導教授: 李恆儒
Lee, Heng-Ju
學位類別: 碩士
Master
系所名稱: 體育學系
Department of Physical Education
論文出版年: 2019
畢業學年度: 107
語文別: 中文
論文頁數: 56
中文關鍵詞: 外踝扭傷韌帶撕裂運動傷害動態貼布
英文關鍵詞: lateral ankle sprain, ligament tear, sports injury, dynamic tape
DOI URL: http://doi.org/10.6345/NTNU201900814
論文種類: 學術論文
相關次數: 點閱:102下載:19
分享至:
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報
  • 踝關節扭傷佔運動傷害的大宗,多數會造成反覆扭傷,其中四成會演變成慢性踝關節不穩定,進而影響生活品質或運動表現,過去文獻建議除本體覺、肌力與神經肌肉控制等運動治療外,另外配合外在支撐可達到保護與預防的效果,其中採用的方式包括護具與貼紮,由於貼紮輕薄貼附皮膚,更廣泛使用於運動場上。一般貼紮包括不具彈性的運動貼布與具彈性的肌內效貼布,基於不同貼布特性,帶來效用亦有所不同,其中機轉包括限制踝關節動作的生物機械效用、減緩疼痛、改變肌肉收縮時序的神經生理效用、與心理層面安慰劑效用。動態貼布由於材質的特殊性,回彈力高,主要效益為機械效益,調整關節肌肉負荷、改善動作控制。目的:本研究探討慢性踝關節不穩定族群進行動態貼紮後,在動作策略上與能量吸收的改變,以利臨床應用。方法:招募23位實驗參與者,以坎伯蘭踝關節不穩定問卷為依據,分別納入踝關節不穩定組與健康控制組。動作測試為單腳著地動作,要求實驗參與者非測試腳站在40公分高台上垂直落地,以測試腳單腳著地平衡4~6秒。實驗過程使用Kistler測力板 (2000 Hz)、Vicon紅外線攝影機 (250 Hz) 與Delsys無線肌肉電訊號 (2000 Hz) 同步收集下肢運動學、動力學與肌電參數資料。統計方法以混合設計二因子變異數分析進行統計考驗,顯著水準訂為 α=.05。結果:研究發現動態貼紮可以顯著減少慢性踝關節不穩定族群踝關節與髖關節的能量吸收。結論:動態貼紮不會限制踝關節動作,且可以減少踝關節做為主要緩衝關節的程度,可成為慢性踝關節不穩定族群進行運動時,踝關節貼紮的另一項選擇。

    Ankle sprains are the most frequent injuries sustained by athletes, and most of them would turn into recurrent ankle sprains. Unfortunately, there was forty percent of ankle sprain becoming chronic ankle instability (CAI), which influenced quality of life or exercise performance. Past studies suggested that people with CAI need external support to achieve protection and prevention, as well as exercise therapies such as proprioception, strengthening, and neuromuscular control. There were two kinds of external support, including brace and taping. However, taping was used more frequently by athletes because of light and thin which can contact to skin. Non-elastic exercise tape and kinesio-tape were two kinds of popular tapes. The effects of taping were different according to different characteristic of tapes, such as biomechanical effect of limiting ankle mobility, neurophysiological effect of decrease pain threshold and changing timing of muscle activation, and psychological effect of placebo. There was a new tape, dynamic tape (DT), and the main effect was providing mechanical support which can adjust muscle loading and improve motor control because of high elastic characteristic. Purpose: The purpose of the study was to assess the changes of movement strategy and shock absorption after dynamic taping applying onto ankles in CAI. Methods: We enrolled 13 CAI and 10 control participants according to Cumberland ankle instability tool. All participants performed single leg drop landing protocol. They were asked to stand on a 40 cm platform by un-tested leg, landed on floor by test leg, and kept balance for 4~6 seconds. Kistler force platform (2000 Hz), Vicon infared camera (250 Hz), and Delsys wireless EMG sensors (2000 Hz) were used for collecting kinematic, kinetic, and muscle activation parameters during experiments. Two-way ANOVA was conducted to compare the difference of biomechanical parameters among groups (CAI and Control) and interventions (Pre-tape and Post-tape). The significant level was set at α=.05. Results: The main finding of this study was dynamic taping could significantly decrease the shock absorption of ankle and hip joints in CAI. Conclusion: Dynamic taping would not limit ankle mobility and could decrease impact of ankle joint during landing. It could be another choice of ankle taping for CAI group.

    中文摘要 i 英文摘要 ii 目次 iv 表次 vii 圖次 viii 第壹章 緒論 1 第一節 問題背景 1 第二節 研究目的 3 第三節 研究假設 3 第四節 名詞解釋與操作性定義 3 第五節 研究範圍與限制 5 第六節 研究重要性 6 第貳章 文獻探討 7 第一節 慢性踝關節不穩定族群的病因、機轉、治療 7 第二節 慢性踝關節不穩定族群之單腳著地動作分析 10 第三節 慢性踝關節不穩定之不同貼紮效益探討 12 第四節 文獻總結 14 第參章 研究方法 16 第一節 研究對象 16 第二節 實驗儀器與器材 17 第三節 實驗程序 19 第四節 外踝扭傷之動態貼紮 20 第五節 動作任務 21 第六節 資料處理與分析 22 第肆章 結果 24 第一節 實驗參與者基本資料 24 第二節 單腳著地動作的運動學特徵 24 第三節 單腳著地動作的動力學特徵 29 第四節 單腳著地動作的神經肌肉控制特徵 35 第伍章 討論 40 第一節 動態貼布的特性 40 第二節 動態貼紮對著地能量吸收的影響 42 第三節 動態貼紮對於地面反作用力的影響 45 第四節 慢性踝關節不穩定族群著地動作之策略 46 第陸章 結論與臨床建議 49 第一節 結論 49 第二節 臨床建議 50 引用文獻 51 附錄 (附件一) 56

    李書維、黃長福 (1995)。不同高度赤腳著地動作之生物力學分析。中華民國體育學報, 12,213-224。
    林建志、李恆儒 (2018)。評估不同踝關節型態運動員在著地動作的姿勢穩定與神經肌肉 控制 (未出版博士論文)。國立臺灣師範大學,臺北市。 doi:10.6345/DIS.NTNU.DPE.001.2018.F03
    林建志、李育銘、李恆儒 (2015)。前十字韌帶重建後運動員從事躍起著地動作下肢關節 運動與肌肉活化特徵。體育學報,48(1),45-58。doi:10.3966/102472972015034801004
    翁梓林 (2012)。穿戴護具對踝關節內翻之防護效果探討。行政院國家科學委員會補助大 專學生參與專題研究計畫研究成果報告(編號:NSC 100-2815-C-152-005-H),未出 版。
    郭藍遠、楊志鴻、林千芬、吳汶蘭、王靜怡、張志仲 (2006)。踝關節貼紮對平衡和高處 著地緩衝能力的影響。物理治療,31(2),81-86。
    蔡博琳、陳文英、施怡芬 (2017)。功能性踝關節不穩定影響平衡測試中踝關節肌肉活化 的表現。物理治療,42(2),80-87。
    Al-Mohrej, OA & Al-Kenan, NS. (2016). Chronic ankle instability: current perspectives. Avicenna Journal of Medicine, 6(4), 103-108. doi:10.4103/2231-0770.191446
    Bicici, S., Karatas, N., & Baltaci, G. (2012). Effect of athletic taping and kinesiotaping on measurements of functional performance in basketball players with chronic ankle sprains. The International Journal of Sports Physical Therapy, 7(2), 154-166.
    Colville, M. R. (1998). Surgical treatment of the unstable ankle. The Journal of the American Academy of Orthopaedic Surgeons, 6(6), 367-377.
    Chan, K. W., Ding, B. C., & Mroczek, K. J. (1911). Acute and chronic ankle instability in athlete. Bulletin of the NYU Hospital for Joint Disease, 69(1), 17-26.
    Coventry, E., O’Connor, K. M., Hart, B. A., Earl, J. E., Ebersole, K. T. (2006). The effect of lower extremity fatigue on shock attenuation during single-leg landing. Clinical Biomechanics (Bristol, Avon), 21(10), 1090-1097. doi:10.1016/j.clinbiomeh.2006.07.004
    Cordova, M. L., Takahashi, Y., Kress, G. M., Brucker, J. B., & Finch, A. E. (2010). Influence of external ankle support on lower extremity joint mechanics during drop landings. Journal of Sport Rehabilitation, 19(2), 136-148.
    Doherty, C., Bleakley, C., Hertel, J., Caufield, B., Ryan , J., & Delahunt, E. (2016). Single-leg drop landing movement strategies in participants with chronic ankle instability compare with lateral ankle injury. Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA, 24(4), 1049-1059. doi:10.1007/s00167-015-3852-9
    Doherty, C., Bleakley, C., Hertel, J., Caufield, B., Ryan , J., & Delahunt, E. (2015a). Single-leg drop landing movement strategies 6 months following first-time acute lateral ankle injury. Scandinavian Journal of Medicine & Science in Sports, 25(6), 806-817. doi:10.1111/sms.12390
    Doherty, C., Bleakley, C., Hertel, J., Caufield, B., Ryan , J., & Delahunt, E. (2015b). Single- leg drop landing motor control strategies following acute ankle sprain injury. Scandinavian Journal of Medicine & Science in Sports, 25(4), 525-533. doi:10.1111/sms.12282
    Delahunt, E., Cusack, K., Wilson, L., & Doherty C. (2013). Joint mobilization acutely improve landing kinematics in chronic ankle instability. Medicine and Science in Sports & Exercise, 45(3), 514-519. doi:10.1249/MSS.0b013e3182746d0a
    Deschamps, K., Dingenen, B., Pans, F., Bavel, I. V., Matricali, G. A., & Staes, F. (2016). Effect of taping on foot kinematics in persons with chronic ankle instability. Journal of Science and Medicine in Sport, 19, 541-546. doi:10.1016/j.jsams.2015.07.015
    Delahunt, E., Monaghan, K., & Caulfield, B. (2006). Change in lower limb kinematics, kinetics, and muscle activity in subjects with functional instability of the ankle joint during a single leg drop jump. Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society, 24(10), 1991-2000. doi:10.1002/jor.20235
    DiStefano, L. J., Padua, D. A., Brown, C. N., & Guskiewicz, K. M. (2008). Lower extremity kinematics and ground reaction forces after prophylactic lace-up ankle brace. Journal of Athletic training, 43(3), 234-241. doi:10.4085/1062-6050-43.3.234
    Devita, P., & Skelly, W. A. (1992). Effect of landing stiffness on joint kinetics and energetic in the lower extremity. Medicine and science in sports and exercise, 24(1), 108-115.
    Hung, Y. J. (2015). Neuromuscular control and rehabilitation of the unstable ankle. World Journal of Orthopedics, 6(5), 434-438. doi:10.5312/wjo.v6.i5.434
    Hertel, J. (2002). Funtional anatomy, pathomechanics, and pathophysiology of lateral ankle instability. Journal of Athletic Training, 37(4), 364-375.
    Holmes, A., & Delahunt, E. (2009). Treatment of common deficits associated with chronic ankle instability. Sports Medicine, 39(3), 207-224. doi:10.2165/00007256-200939030- 0000
    Halseth, T., McChesney, J. W., DeBeliso, M., Vaughn, R., & Lien, J. (2004). The Effects of kinesio taping on proprioception at the ankle. Journal of Sports Science and Medicine, 3, 1-7.
    Hughes, T., & Rochester, P. (2008). The effects of proprioceptive exercise and taping on proprioception in subjects with functional ankle instability: A review of the literature. Physical Therapy in Sport, 9, 136-147. doi:10.1016/j.ptsp.2008.06.003
    Hiller, C. E., Refshauge, K. M., Bundy, A. C., Hervert, R. D., & Kilbreath, S. L. (2006). The Cumberland ankle instability tool: a report of validity and reliability testing. Archives of Physical Medicine and Rehabilitation, 87(9), 1235-1241.
    Konradsen, L. (2002). Sensori-motor control of the uninjured and injured human ankle. Journal of Electromyography and Kinesiology: Official Journal of the International Society of Electromyography and Kinesiology, 12(3), 199-203.
    Kalron, A., & Bar-Sela, S. (2013). A systematic review of the effectiveness of kinesio taping- fact or fashion? European Journal of Physical and Rehabilitation Medicine, 49(5), 699- 709.
    Kannus, P., & Renström, P. Treatment for acute tears of the lateral ligaments of the ankle: operation, cast, or early controlled mobilization. The Journal of Bone and Joint Surgery. American Volume, 73(2), 305-312.
    Kase, K., Tatsuyuki, H., & Tomoki, O. (1996). Development of Kinesio tape. Kinesio taping perfect manual. Kinesio Taping Association, 6-10, 117-118.
    Kuni, B., Mussler, J., Kalkum, E., Schmitt, H., & Wolf, S. I. (2016). Effect of kinesiotaping, non-elastic taping and brace on segmental foot kinematics during drop landing in healthy subjects and subjects with chronic ankle instability. Physiotherapy, 102, 287-293. doi:10.1016/j.physio.2015.07.004
    Levin, O., Vanwanseele, B., Thijsen, J.R., Helsen, W. F., Staes, F. F., & Duysens, J. (2015). Proactive and reactive neuromuscular control in subjects with chronic ankle instability: evidence from a pilot study on landing. Gait & Posture, 41(1), 106-111. doi:10.1016/j.gaitpost.2014.09.005
    McCaw, S. T., & Cerullo, J. F. (1999). Prophylactic ankle stabilizers affect ankle joint kinematics during drop landings. Medicine and Science in Sports and Exercise, 31(5), 702- 707.
    Mohamed, M. A., Radwan, N. L., & Azab, A. S. R. (2016). Effect of kinesio-taping on ankle joint stability. International Journal of Medical Research & Health Science, 5(5), 51-58.
    Mostafavifar, M., Wertz, J., & Borchers, J. (2012). A systematic review of the effectiveness of kinesio taping for musculoskeletal injury. The Physician and Sportsmedicine, 40(4), 33- 40. doi:10.3810/psm.2012.11.1986
    Murphy, D. F., Connolly, D. A., & Beynnon, B.D. (2003). Risk factors for lower extremity injury: a review of the literature. British Journal of Sports Medicine, 37(1), 13-29.
    Murry, H., & Husk, L. (2001). Effect of kineio taping on prioprioception in the ankle. Journal of Orthopedic Sports Physical Therapy, 31, A-37.
    McNeill, W., & Pedersen, C. (2016). Dynamic tape. Is it all about controlling load? Journal of Bodywork and Movement Therapies, 20(1), 179-188. doi:10.1016/j.jbmt.2015.12.009
    Mason-Mackay, A. R., Whatman, C., & Reid, D. (2017). The effect of reduced ankle dorsiflexion on lower extremity mechanics during landing: a systematic review. Journal of Science and Medicine in Sport, 20(5), 451-458. doi:10.1016/j.jsams.2015.06.006
    Olsen, O. E., Myklebust, G., Engebretsen, L., Bahr, R. (2004). Injury mechanisms for anterior cruciate ligament injuries in team handball: a systematic videio analysis. The American Journal of Sports Medicine, 32(4), 1002-1012.
    Raymond, J., Nicholson, L. L., Hiller, C. E., & Refshauge, K. M. (2012). The effect of ankle taping or bracing on proprioception in functional ankle instability: a systematic review and meta-analysis. Journal of Science and Medicine in Sport, 15, 386-392. doi:10.1016/j.jsams.2012.03.008
    Riemann, B. L., Schmitz, R. J., Gale, M., & McCaw, S. T. (2002). Effect of ankle taping and bracing on vertical ground reaction forces during drop landings before and after treadmill jogging. Journal of Orthopaedic & Sports Physical Therapy, 32(12), 628-635. doi:10.2519/jospt.2002.32.12.628
    Rosen, A., Swanik, C., Thomas, S., Glutting, J., Knight, C., & Kaminski, T. W. (2013). Differences in lateral drop jumps from an unknown height among individuals from functional ankle instability. Journal of Athletic Training, 48(6), 773-781. doi:10.4085/1062-6050-48.5.05
    Sawkins, K., Refshauge, K., Kilbreath, S., & Raymond, J. (2007). The placebo effect of ankle taping in ankle instability. Medicine and Science in Sports and Exercsie, 39(5), 781-787. doi:10.1249/MSS.0b013e3180337371
    Tashman, S., Collon, D., Anderson, K., Kolowich, P., & Anderst, W. (2004). Abnormal rotational knee motion during running after anterior cruciate ligament reconstruction. American of Journal of Sports Medicine, 32(4), 975-983. doi:10.1177/0363546503261709
    Terada, M., Pietrosimone, B. G., & Gribble, P. A. (2013). Therapeutic interventions for increasing ankle dorsiflexion after ankle sprain: a systematic review. Journal of Athletic Training, 48(5), 696-709. doi:10.4085/1062-6050-48.4.11
    Yi, C. H., Brumt, D., Kim, H. D., & Fiolkowski, P. (2003). Effect of ankle taping and exercise on EMG and kinetics during landing. Journal of Physical Therapy Science, 15(2), 81-85. doi:10.1589/jpts.15.81
    Yeung, M. S., Chan, K. M., So, C. H., & Yuan, W. Y. (1994). An epidemiological survey on ankle sprain. British Journal of Sports Medicine, 28(2), 112-116.
    Yeow, C. H., Lee, P.V., & Goh, J. C. (2009). Effect of landing height on frontal plane kinematics, kinetics and energy dissipation at lower extremity joints. Journal of Biomechanics, 42(12), 1967-1973. doi:10.1016/j.jbiomech. 2009.05.17

    下載圖示
    QR CODE