視障按摩師按摩時肌肉疲勞之評估

按摩行業中作業時需要較大的體力付出，因此按摩作業人員，因工作所導致的肌肉骨骼傷病問題也日趨嚴重。目前與按摩相關的研究，大多著重於按摩之療效探討，而較少探討造成按摩人員肌肉骨骼傷病有關之過度施力及肌肉疲勞等研究。為了避免按摩從業人員發生職業性肌肉骨骼傷病，本研究目的為評估按摩作業之上肢及下背肌肉施力及疲勞程度。本研究使用肌電訊號量測模組，收集 12 位視障按摩師及 6 位美容師共計 18 位按摩從業人員之12條肌肉肌電訊號(Electromyography, EMG)，計算肌群施力及使用頻譜與振幅聯合分析方法(Joint analysis of EMG spectrum and amplitude，JASA)，比較不同按摩作業類型(按摩床作業、按摩椅作業及美容作業)之肌肉疲勞程度。研究結果顯示，按摩床作業中男性及女性肌肉施力介於4.67%MVC~32.17%MVC之間及6.67%MVC~44.00%MVC之間。按摩床作業及按摩椅作業之肌肉施力介於8.60%MVC~38.10%MVC之間及9.67%MVC~43.00%MVC之間。美容作業肌肉施力介於8.83%MVC~36.00%MVC之間。各作業有按摩床作業3條、按摩椅作業2條及美容作業3條肌肉施力小於15%MVC。視障按摩師在進行按摩床作業時，JASA象限分佈大多落在第一(28.86%~30.56%)及第四象限(25.69%~26.39%)中，顯示肌肉處於力量增加和疲勞的狀態。進行按摩椅作業時，JASA象限分佈則落在第二(38.89%~41.67%)及第三象限(30.56%~36.11%)中，顯示肌肉處於力量恢復(適應)，及力量減少的狀態。美容師在進行美容作業時，JASA象限分佈約平均分佈在四個象限內，肌肉疲勞比例(第四象限)介於23.61%~27.78%之間。按摩從業人員在作業時，多數肌肉之肌肉施力過高。另外，按摩床作業及美容作業之肌肉疲勞比例亦較高，可透過介入方式(如輔具或增加休息時間)來減輕其肌肉施力及疲勞程度。

關鍵字

按摩；肌肉骨骼傷病；肌肉施力；肌肉疲勞

並列摘要

Massage occupations are physically demanding tasks and can cause an increase in work-related musculoskeletal disorders (WMSDs). Currently, most of the research focuses on the therapeutic effects of massage, but less on the excessive force exertions and muscular fatigue issues related to musculoskeletal injuries caused by massage personnel. To avoid musculoskeletal injuries on the masseur, this research evaluates the loads and fatigue levels of the upper limb and lower back muscles during massage operations. This research used the Electromyography (EMG) module to collect EMG signals of 18 massage personnel (12 visually impaired masseurs and 6 beauticians) to measure the muscular demands of 12 muscles. Besides, JASA (Joint analysis of EMG spectrum and amplitude) analysis is performed to evaluate muscular fatigue levels for different massage operations (table massage, chair massage, and beauty massage). The results show that the muscular demands for table massages ranged from 4.67 %MVC to 32.17 %MVC for male massage therapists and from 6.67 %MVC to 44.06 %MVC for female massage therapists. When performing table massages and chair massages, the muscular demands ranged from 8.60 %MVC to 38.10 %MVC and from 9.7 %MVC to 43.0 %MVC. For beauty massage, the muscular demands ranged from 8.83%MVC to 36.00%MVC. The muscular demands of 3, 2, and 3 muscles are less than 15%MVC for table massage, chair massage, and beauty massage. According to the JASA analysis result, the coordinate of 12 muscle groups falls on the I (28.86%~30.56%) MDF and IV (25. 69%~26.39%) quadrants when performing table massages for visually impaired massage therapists indicating increasing power and fatigued status for these 12 muscle groups. When performing chair massages for visually impaired massage therapists, the coordinate of 12 muscle groups falls on the II (38.89%~41.67%) and III (30.56%~36.11%) quadrants indicating recovery power and reduction power status for these 12 muscle groups. Also, 13.89% to 15.28% of muscles fall on quadrant IV indicating muscular fatigue levels. When performing beauty massage, coordinate of 12 muscle groups evenly falls on the I to IV quadrants for beauticians where 23.61% to 27.78% falls on quadrant IV indicating the fatigued status for these 12 muscle groups. The results of this study show that higher muscular demands for most of the muscles are required during massage operations. Also, the muscular fatigue levels are high for table and beauty massaging tasks. Interventions (e.g. massage assistive devices, longer break time, etc.) could be provided to lower muscular demands and muscular fatigue levels during massage operations.