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  • 學位論文

彈性貼紮對脛腓聯合關節動作之限制效應

Effect of Elastic Taping on Motions of Ankle Syndesmosis Joint

指導教授 : 林居正
共同指導教授 : 柴惠敏
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摘要


脛腓聯合關節傷害約佔每年發生的腳踝扭傷個案的1%~ 18%,比其他的腳踝扭傷需要較長的休息時間與較多的治療時間。脛腓關節傷害的治療目前多採用運動貼紮或彈性貼紮,而以後者較受運動員的喜愛。然而貼紮對脛腓聯合關節的限制效應,卻未有實證研究。因此本研究欲探討彈性貼紮對於脛腓聯合關節的限制效應。 本研究共徵召30名健康成年人,男女各半,其年齡為24.3 ± 3.1 (20~ 29)歲。受試者於下肢關節黏貼微型接收器,以FASTRAK運動追蹤系統分析全蹲動作。測試狀況有三種,分別為沒有貼紮、彈性貼紮、運動貼紮等。測試次序是隨機的。測試動作為腳跟不離地的全蹲動作,受試者從靜止站立迅速蹲下,再迅速站起,為一個測試動作,每個測試狀況共進行3次測試動作。計算3次雙踝間距的平均值來分析脛腓聯合關節的活動度。每種貼紮狀況結束時,使受試者填寫貼紮時進行全蹲、墊腳尖、單腳站、步行、跑步等五項動作之舒適程度分數。以受試者全蹲時的腳踝角度作為共變數,進行混合式模型統計分析,來比較不同貼紮狀況站立與全蹲時雙踝間距變化的差異;並以魏克森符號排序檢定,分析不同貼布在全蹲、墊腳尖、單腳站、步行、砲步等五項動作的舒適度。 本研究發現在站立或全蹲時FASTRAK運動追蹤系統皆有高的ICC值(ICC= .88~ .99),低SEM%(SEM%<1%)與低SRD%(SRD%<1.5%)。未貼紮之雙踝間距變化為4.8 ± 1.3 mm,彈性貼紮之雙踝間距變化為4.4 ± 1.3 mm,運動貼紮之雙踝間距變化為4.8 ± 1.5 mm,彈性貼紮後雙踝間距雖然有減少的趨勢,但未能達到統計學上的差異(p= .084)。在全蹲、墊腳尖、單腳站、步行、跑步等五個動作的舒適度統計,運動貼紮的舒適度都比彈性貼紮為低(所有p<0.001)。本研究為世界首度使用活體量測脛腓聯合關節動作之研究。本研究之研究對象為健康成年人,或許是無法達到統計差異的主因,未來將進行脛腓聯合關節傷害者的限制效應。此外,彈性貼紮對脛腓聯合關節的限制效應雖然與運動貼紮無統計上的差異,但因其舒適度優於運動貼紮,在臨床治療是一個較佳的選擇。

並列摘要


Ankle syndesmosis injury has been reported approximately 1%~ 18% of patients with ankle sprain. Compared with patients with other ankle sprains, ankle syndesmosis injury takes more period of time to get recovery. The common intervention of ankle syndesmosis injury is to apply either athletic or elastic taping onto the injured joint in order to bind the tibia and the fibula together. Although the confinement effect of such taping is appreciated by the injured athletes, there are no solid evidences provided yet. Therefore, the purpose of this research was to examine the effect of either athletic or elastic taping on motion of the ankle syndesmosis joint. Thirty young healthy adults were recruited in this study, 15 men and 15 women with mean age of 24.3 ± 3.1 (20~ 29) years. Two sensors were attached onto bilateral malleoli of the ankle to be tested in order to analyze the deep squat task using an electromagnetic device. All participants were tested in three conditions: non-taping, elastic taping, and athletic taping in a random order. The participant was asked to perform deep squat from quiet stance with the fastest speed, and then to stand up immediately with the fastest speed. Three trials were collected for each condition. An average of three trials of bilateral malleoli distance was used to represent the mobility of the ankle syndesmosis, and the ankle angle at the deep squat moment served as a covariate. After completing the test of each condition, all participants were asked to point out the degree of comfortability during performing deep squat, heel rise, one-leg stance, walking, and running when either elastic or athletic taping was applied. For statistical analyses, A mixed model ANOVA was used to compare the differences of the changes of bilateral malleoli distance from quiet stance to deep squat among three different conditions. Additionally, the Wilcoxon signed ranks test was used for examining the comfortability in performing deep squat, heel rise, one-leg stance, walking, and running between two taping conditions. The results showed that measurement of ankle syndesmosis using the electromagnetic system presented high ICC values(ICC= .88~ .99), lower SEM%( SEM%<1%), and SRD% value (SRD%<1.5%), indicating an excellent intrarater reliability. Changes in bilateral malleoli distance from quiet stance to deep squat was 4.8 ± 1.3 mm for the non-taping condition, 4.4 ± 1.3 mm for elastic taping, and 4.8 ± 1.5 mm for athletic taping, respectively. Although the mean value of change in bilateral malleoli distance tended to be less in the elastic taping condition than the other two conditions, there was no significant differences among these three condition (p= .084). Comfortability in performing deep squat, heel rise, one-leg stance, walking, and running were lower for the athletic taping condition as compared to the elastic taping one (p<0.001). This research is the first study to quantify the ankle syndesmosis motion during deep squat test using FASTRAK motion analysis system and to compare the confinement effect of taping for ankle syndesmosis motion. Since this research recruited healthy adults only, the effect of elastic taping to restrict ankle syndesmosis motion is not visible. However, using elastic taping in syndesmosis provides more comfortability than using athletic taping, indicating another better treatment alternative in clinic.

參考文獻


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被引用紀錄


李文浩(2016)。肌貼貼紮對脛腓聯合關節關節功能的即時影響〔碩士論文,國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342%2fNTU201610135

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