• 期刊

【論文摘要】Eccentric Cross-exercise Intervention for Arthrogenic Quadriceps Inhibition After Posterior Cruciate Ligament Reconstruction: A Case Report

Background and Purpose: A 42-year-old female patient, who underwent arthroscopic reconstruction for her left posterior cruciate ligament (PCL) tear, was referred to physical therapy four weeks after surgery for post-operative rehabilitation, and arrived to the physical therapy center in a wheelchair. The patient reported that she could not actively contract her thigh muscle at all. Extensor lag during straight-leg raise and weakened quadriceps activity during quadriceps setting were noted during exercise training. The patient exhibited arthrogenic quadriceps muscle inhibition (AMI), an ongoing neural activation deficit that occurs across many knee joint pathologies. These changes in afferent discharge alter reflex pathways at the spinal and supraspinal levels, leading to inhibition of the quadriceps muscle. Although it is less often seen in patients following PCL injury or reconstruction, AMI was seen in our case, as observed in the extensor lag sign and inability to activate the quadriceps during weight-bearing and ambulation. Eccentric exercise has been discovered to facilitate neuromuscular changes in muscle fibers, improving recruitment and firing rate of alpha motor neurons, as well as induce greater excitability at the supraspinal level in the motor cortex. Since eccentric exercise of the affected limb of this case was contraindicated due to her being in the acute post-operative stage, the eccentric-cross exercise was considered. The aim of this case report was to illustrate the capability of eccentric-cross exercises in enhancing neural adaptations and neuroplasticity in patients with AMI. Methods: The main treatment goals were to improve the patient's left quadriceps activation ability, overall lower extremity muscle strength, and to improve ambulation ability. Our program was based on the postoperative rehabilitation protocol for PCL reconstruction. We included the novel eccentric cross-exercise training (5 sets of 6 repetitions at 80% of one repetition maximum) for 30 minute per session, 2 sessions per week, while the affected limb executed quadriceps setting. Results: After two weeks of intervention, although extensor lag was still noted, active quadriceps muscle contraction was observed. The patient could walk using a quadricane with partial weight-bearing, and reported that she could exercise with better activation and control over the quadriceps muscle. Conclusion: Eccentric cross-exercise is suitable and safe for patients with AMI in the acute post-operative stage, utilizing the unaffected limb to increase quadriceps activation and strength in the affected limb. From our literature review, increasing an intervention program of eccentric cross-exercise to 3 days a week for 8 weeks may facilitate greater improvement in neuromuscular control. Clinical Relevance: Our results provide an updated understanding of AMI and the potential of eccentric exercise or eccentric cross-exercise interventions in treatment programs designed for patients suffering from knee pathology.

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【論文摘要】Effects of Post-surgery Physical Therapy on Functional Recovery for Patient With Infantile Blount Disease Undergoing the Osteotomy& Taylor Spatial Frame Surgery: A Case Report

Background and Purpose: Blount disease is a disorder of the posteromedial proximal tibial physis which causes a progressive varus deformity of the tibia. External fixation using the Taylor spatial frame (TSF) allowing gradual safe correction of multiplanar deformities is a well-tolerated technique by those patients. Application of an external fixator would result in joint stiffness and functional loss after surgery. The purpose of this case report was to explore the benefits of physical therapy for a patient with infantile Blount disease undergoing the osteotomy& TSF surgery. Methods: A 5 y/o female child with Blount's disease who suffered from progressive bowing leg and always fell down while going up/down stairs underwent surgery correction. She received inpatient physical therapy initiated from postoperative day 2 for 2 weeks, 30 mins/3 times/week. The programs included 1) tilting table for 20 mins: provide weight-bearing in an upright vertical position 2) early ROM and strengthening exercise: enhance mobility and regain lost strength. Afterward, the outpatient programs started and focused on lower extremity ROM exercise, balance and gait training (learning how to walk properly with assistive device) for 6 weeks, 30 mins/once/week. Assessments were performed at post-surgery day 2, week 2 (discharge), week 4, and week 8. The assessments before discharge included ROM, Manual Muscle Testing, and functional activity. The functional outcomes after discharge were measured by the Numeric Pain Rating Scale (NPRS), the Lower Extremity Functional Scale (LEFS), and IKDC- 2000 knee subjective evaluation form. Results: After 2-week inpatient intervention, the patient was able to tolerate ambulation with walker for few steps. The patient improved scores on NPRS from 5 to 1, LEFS from 10 to 76 and IKDC-2000 from 8 to 58 after 6-week outpatient care. Conclusions: The results of this case report revealed that early intervention helps the patient improving her walking abilities and getting great improvement in pain and functional outcome scores after discharge. Clinical Relevance: This report demonstrates the positive effects of post-surgery physical therapy on functional recovery for patient with infantile Blount disease undergoing the osteotomy & TSF surgery.

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【論文摘要】Effects of Myofascial Release on Gastrocnemius Muscle-tendon Unit-A Preliminary Study

Background and Purpose: Tightness of the gastrocnemius muscle-tendon unit (GAS-MTU) was commonly noted in athletes, resulting in limitation of ankle dorsiflexion. Myofascial release was developed to reduce tightness of the GAS-MTU. Previous studies found that myofascial release improved angle of maximal ankle dorsiflexion. Less is known in morphology changes in the GAS-MTU because of lack of appropriate evaluation tools. Thus, this study was aimed to explore effects of myofascial release on changes in length of the GAS-MTU using panoramic ultrasonography. Methods: Five healthy participants (3M 2F; 24.5 ± 0.5 years; 1.690 ± 0.100 m; 63.4 ± 8.9 kg) participated in this study. Myofascial release was executed by a 2-year-experienced physical therapist for 3-5 min. All participants were examined before and after myofascial release by the same examiner. Length of the muscle belly, fascia and tendon of the GAS-MTU were examined using panoramic ultrasonography. Passive maximal ankle dorsiflexion was measured in the prone position for the non-weight-bearing condition using an electrogoniometer while the modified weight-bearing lunge test was used for the weight bearing condition. Paired t-tests were used for statistical analyses of outcome variables. Results: The mean time for myofascial release was 4.1 ± 0.5 min. The fascia of the GAS-MTU was the only structure to be lengthened significantly after myofascial release (119.10 ± 17.64 mm vs. 127.24 ± 15.84 mm, p ＜ 0.005). On the contrary, length of the muscle belly was shortened after myofascial release (211.19 ± 13.69 mm vs. 203.83 ± 12.64 mm, p ＜ 0.005) while that of the tendon was no significant change. Maximal ankle dorsiflexion angle with knee extended (6.6 ± 3.0° vs. 10.9 ± 2.6°, p ＜ 0.005) improved after myofascial release in the non-weight-bearing condition. However, there were no differences in results of the modified weight-bearing lunge tests. Conclusions: Results of this study revealed that myofascial release might be effective to improve tightness of the GAS-MTU. However, small sample size was the limitation of this study. Further studies need to recruit more participants to ensure the stability of effects of myofascial release. Clinical Relevance: Myofascial release is perhaps an alternative method to increase flexibility of the GAS-MTU.

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【論文摘要】物理治療合併疼痛諮詢對於肌肉骨骼系統疼痛患者短期效益之初探

背景與目的：根據世界衛生組織資料顯示全球有20～33%的人患有肌肉骨骼傷病，在臺灣，2018年健保資料若以疾病別分析，肌肉骨骼系統及結締組織疾病為西醫門診就診件數第二名。該疾病通常會造成疼痛及功能受限。顯見不論在國內或國外受此困擾或就醫者相當多。在過去該疾病所造成之疼痛大多以生理角度解釋其成因，但Engel學者則認為疼痛是大腦綜合生理、心理及社會等三個面向之因素相互影響後所產生之判斷結果。Curtin等學者在2017年研究顯示對於慢性肌肉骨骼疼痛病人而言，疼痛的負面認知或焦慮感越多，則其疼痛程度或嚴重度將越顯著，該學者建議正念（mindfulness）是打破慢性疼痛循環的有效策略。Darlow等學者在2013年研究發現醫療專業人員的建議會顯著改變下背痛病人對於疼痛來源的認識與信念，甚至其影響會長達數年。Simon學者認為肌肉骨骼疼痛患者治療時除了徒手或運動介入外，更應給予病人正確疼痛來源認知及正念提升的疼痛諮詢（pain counseling skills）。但過去在臺灣由於臨床治療時間、人力等因素的考量，鮮少利用疼痛諮詢介入該族群及成效探討。故本篇研究目的為針對肌肉骨骼系統疼痛病人利用物理治療合併疼痛諮詢的短期效益之初探。方法：本研究收取自花蓮慈濟醫院復健部經醫師診斷肌肉骨骼系統疾病需接受物理治療之患者。介入內容為由物理治療師執行物理治療及疼痛諮詢。其中，疼痛諮詢包括仔細問診、帶領病人重新認識疼痛來源及安全的挑戰、發現身體改變等部分。於介入前、後記錄舒服指數（comfortable rate）、信心指數（confidence rate）、角度變化量之比例及病患自覺功能量表（Patient-Specific Functional Scale）。利用Wilcoxon signed rank test比較前後改變之差異，p值＜ 0.05即達統計顯著差異。結果：共收錄12位患者，6位女性，年齡47.1 ± 18.3歲，介入次數3.3 ± 1.8次。發病到第一次介入時間為10.8 ± 14.4月。各項參數之Z檢定值為-2.95～-3.07，檢定統計量p值均小於0.05，達顯著差異。結論：物理治療合併疼痛諮詢對於肌肉骨骼疼痛之患者有短期效益，包含舒服程度、自身信心程度、關節活動度及自覺功能改善。惟個案數較少或長期效益仍需後續研究探討。臨床意義：對於肌肉骨骼疼痛之患者，除物理治療介入外，建議可再合併疼痛諮詢，以期待患者有更全面的助益。

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【論文摘要】The Effects of Non-specific Neck Pain on the Neuromuscular Control of Temporomandibular Joint

Background and Purpose: Previous studies have shown the relationships between neck and temporomandibular joint (TMJ) from the anatomical and functional perspectives. The neck pain may be relating to the disability of TMJ and vice versa. However, few studies addressed the early effect of the impaired neck on TMJ function. In addition, the proprioception of TMJ was less discussed and evaluated to represent the disability of neuromuscular control. Therefore, this study aimed to evaluate the disturbance of neuromuscular control of TMJ in the patients with non-specific neck pain and compared with the healthy group. Methods: Subjects divided into two groups by using Neck Disability Index. Ten subjects with mild neck disability were recruited into the neck pain group and another ten subjects without neck pain were allocated into the healthy group. Both groups received the kinematic evaluation of neck and TMJ by IMU sensors (Avanti, Delsys, USA) when performing mouth opening and closing in resting and neutral position to determine the compensatory patterns. A new proposed proprioception evaluation for TMJ was conducted by reproducing the joint positions, which were identified by four increments of the range from mouth closing to full opening and quantified by the distance error between identified and performed positions. Additionally, pain thresholds at trigger points of temporalis, masseter, sternocleidomastoid, suprahyoid muscle, levator scapulae and C1-C7 area were also recorded. These data were analyzed between two groups by independent t-test. Result: There was no significant difference of kinematic performance during mouth opening and closing as well as no difference of proprioception of TMJ between two groups. Pain thresholds on both side of masseter and right side of suprahyoid muscle showed significant difference between healthy group and neck pain group (p ＜ 0.05). Conclusion: The current results pointed out the mild neck disability may not cause to the changes of TMJ performance. The effects of pain may contribute to the compensation of muscle recruitment. The limit of this study was the lack of electromyography recordings for providing the information of muscle control around TMJ. Clinical Relevance: The mild neck pain may not evoke the abnormal patterns on TMJ. The association neck movement during TMJ performing may be relating to the stability of cervical spine and required to be further investigated in the future work.

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【論文摘要】旋轉袖肌腱病變患者的棘上肌肌腱超音波評估：測量信度研究

背景與目的：肌腱的超音波影像可以經由頻譜分析量化，其中空間頻率峰值半徑（peak spatial frequency radius）定義為二維空間頻譜中原點與峰值間的距離，可用來代表肌腱內膠原蛋白纖維束的排列情況，當膠原蛋白纖維束排列愈一致，空間頻率峰值半徑愈大。過去的文獻多使用此分析方式探究阿基里斯腱病變（Achilles tendinopathy）的超音波影像，另外，先前的證據指出使用固定大小的框格方式選取興趣區（region of interest）分析棘上肌肌腱（supraspinatus tendon）的空間頻率峰值半徑，雖然有良好施測者內信度（intra-rater reliability），分析結果卻無法反應整體肌腱退化的程度，因此本研究目的為建立選取自定義多邊形興趣區的新方式，針對有旋轉袖肌腱病變（rotator cuff tendinopathy）患者的棘上肌肌腱超音波影像進行空間頻率峰值半徑分析，並建立此分析的施測者內與施測者間信度（inter-rater reliability）。方法：臨床超音波檢查時取得診斷為旋轉袖肌腱病變患者的棘上肌肌腱靜態縱觀（longitudinal view）超音波影像，並由2位分別有3個月及1年超音波影像判讀經驗的評估者經初步討論後依受試者順序進行3回評估。每位評估者3回的分析結果做為施測者內信度分析，3回分析結果的平均則為施測者間信度分析。結果：施測者內信度ICC_(3,1)分別為0.977、0.982，測量標準誤（standard error of measurement）為0.043、0.035（mm^(-1)），95%信賴區間的最小可偵測變化值（minimal detectable change of 95% confidence interval）為0.118、0.098（mm^(-1)）。施測者間信度ICC_(2,3)為0.979，測量標準誤為0.039（mm^(-1)），95%信賴區間的最小可偵測變化值為0.109（mm^(-1)）。結論：旋轉袖肌腱病變患者的棘上肌肌腱超音波影像，以自定義多邊形興趣區分析的空間頻率峰值半徑有良好的施測者內與施測者間信度。臨床意義：超音波影像檢查結合頻譜分析可以協助辨別旋轉袖肌腱是否發生肌腱病變，以及輔助判斷肌腱退化的嚴重程度。

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【論文摘要】探討單側骨盆前傾對於行走時足底壓力的影響

背景與目的：骨盆前傾與腰椎前突(lumbar lordosis）、下背痛等都有相關性，因此在整個腰椎－骨盆力學複合體（lumbo-pelvic mechanical complex）中，經常被視為下背痛症候群的致病機轉。骨盆因介於下肢與中軸骨骼之樞紐，在承重動作中扮演重力與地面反作用力傳輸的角色，因此在承重下可能產生一系列的代償動作。學者指出，單側骨盆前傾可能造成該側髖內轉、股骨內轉，並導致足部旋前。由於足部旋前可能進一步衍生出更多下肢疾病，且因過去較少文獻佐證此說法，因此本實驗目的即在驗證單側骨盆前傾對於足底壓力的影響。方法：本研究徵召36位受試者參與實驗，所有受試者均須經過站姿及坐姿的軀幹前屈檢查，並被評估具單側骨盆前傾症狀者。而排案條件為下肢具結構性扁平足、骨盆或下肢曾接受外科手術者，以及下肢有神經肌肉病變者。首先測量受試者患側足弓的高度，畫出費斯線（Feiss line）後，量測坐姿非承重時舟狀骨的高度；再請受試者站起，量測承重時舟狀骨的高度。接著讓受試者在分布壓力感測器的跑步機上進行自然速度行走，並收集30秒的足底壓力資料。為求穩定資料，取中間10秒鐘的壓力資料進行分析。結果：在患側的舟狀骨高度方面，非承重和承重時的平均高度分別為4.3 ± 0.85、3.4 ± 0.91cm，兩者有顯著的差異（p ＜ 0.001）。在足底壓力資料部分，患側和健側的前足平均壓力分別為379.14 ± 67.38，429.52 ± 64.67 N/cm^2（p ＜ 0.001）；患側和健側的中足平均壓力分別為156.85 ± 66.93、184.06 ± 79.07 N/cm^2（p ＜ 0.001）；患側和健側的後足平均壓力分別為291.16 ± 71.38、295.66 ± 76.36 N/cm^2（p =0.47）。結論：本研究結果顯示，單側骨盆前傾症狀造成該側的舟狀骨於承重時有明顯塌陷的情形，與過去結果相符。然而，根據足底壓力分析的結果顯示，反而健側的前足和中足在步態中承受明顯較大壓力，而兩側的後足壓力則無顯著差異。未來可以再針對這類單側骨盆前傾患者的健側足部進行研究，是否有其他因過多壓力造成的肌肉骨骼系統疾病；亦可嘗試以物理治療方式處理骨盆前傾問題，並研究後續對於足底壓力的影響。臨床意義：單側骨盆前傾問題可能不僅造成下背痛，根據本實驗結果，亦可能造成在自然步態中，健側的前足和中足相對於患側有較大的足底壓力。本實驗結果可以提供未來研究以及臨床治療決策之參考。

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【論文摘要】探討肌筋膜放鬆腓骨長肌對於功能性扁平足患者在行走時足底壓力的立即效果

背景與目的：過去學者曾指出脛前肌和腓骨長肌的相對張力將會影響足弓旋前、旋後的活動度與施力，因此功能性扁平足內側的脛前肌可能是處於較為延長的狀態，而足部外側的腓骨長肌則是處於較為縮短的狀態，如此的張力不平衡可能導致扁平足在步態時的足底壓力分佈異常，而造成如足底筋膜或其它足部肌肉的不正常受力而受傷。因此本研究的目的即在探討以肌筋膜鬆動術的方法，將功能性扁平足受試者的外側腓骨長肌之筋膜放鬆，並觀察其足底壓力的立即變化。方法：本研究徵召30位受試者參與實驗，收案條件為其舟狀骨位置在非承重時於費斯線（Feiss line）上，而承重時則陷下且低於費斯線。排案條件為（1）身體質量指數（BMI）大於30者（可能影響足弓塌陷），（2）結構性扁平足者（非承重時其舟狀骨即已陷落於費斯線之下）。治療介入為肌筋膜鬆動術手法，以腓骨長肌為施作目標，先尋找較為緊繃的區域或緊帶（taut band）的位置，以拇指指腹針對該位置進行4分鐘的肌筋膜放鬆，再輔助受試者進行2分鐘的腳踝主動幫浦運動，治療時間總共6分鐘。足底壓力評估部分則是讓受試者在分布壓力感測器的跑步機上，進行自然速度的行走，並收取30秒的足底壓力資料進行分析。此外，以肌肉張力測定儀偵測腓骨長肌之硬度等相關資料。在治療前、治療後立即各進行一次評估。並為求足底壓力資料之穩定，擷取中間10秒鐘的資料進行分析。結果：在肌張力的資料方面，僅應力鬆弛（stress-relaxation）在治療前、後有顯著差異，分別為：18.45±1.87，18.90±2.09 ms（p=0.043）；其他包括硬度、蠕變（creep）等參數在治療前後均無顯著差異。在足底壓力資料部分，於治療前，健側與患側的前足平均壓力分別為：434.24±74.58，396.12±65.57 N/cm^2（p＜0.001）；於治療後，健側與患側的前足平均壓力分別為：442.51±64.90，441.23±64.37 N/cm^2（p=0.828）；比較治療前後，患側腳前足的平均壓力分別為396.12±65.57，441.23±64.37 N/cm^2（p＜0.001）。結論：本實驗結果顯示，功能性扁平足患者之腓骨長肌接受6分鐘的肌筋膜鬆動術處理後，其立即效果可見其應力鬆弛有顯著的提高，表示其肌肉彈性變得較好。而表現在行走步態中，患側的前足平均壓力有顯著的提高，而健側的前足平均壓力降低，顯示有效的改善患側足推進期的動作。臨床意義：本實驗結果可提供功能性扁平足臨床治療在足底壓力與肌張力改善之佐證。

• 期刊

【論文摘要】Effect of Pilates-based Core Muscle Strengthening Exercises on Muscle Recruitments During Forward Bending Movement in Patients With Chronic Nonspecific Low Back Pain: A Pilot Study

Background and Purpose: Pilates-based core muscle strengthening exercises have been considered as an effective intervention for patients with chronic nonspecific low back pain (LBP). However, seldom of previous publications have described the muscle recruitments during specific tasks or the comparison to the healthy subjects after interventions. Thus, the purposes of this study were to evaluate the effectiveness of Pilates-based exercises on the muscle recruitments during forward bending movements in patients with chronic non-specific LBP and to compare the muscle recruitments with healthy controls. Methods: Six students of Tzu Chi university, 3 for healthy controls and 3 patients with non-specific LBP, aged from 18 to 25 year were recruited in this study with inform consent. Healthy subjects were those without any experience of pain in the spinal region. The inclusion criterion in the LBP group was having pain in the lower back region in recent 3 months. The exclusion criteria were musculoskeletal pain of any other part of human body in recent 3 months or any other diagnostic musculoskeletal diseases. Pilates-based strengthening exercises were applied to the participants in the LBP group by a senior physiotherapy student under the supervision of a licensed physical therapist for 4 weeks with 2 sessions of 1-hour intervention per week. Wireless electromyography (EMG) system was used to exam the muscle activities of the erector spinae at the level of first lumbar spine (L1) and the multifidus just lateral to the fifth spinous process of lumbar spine. Minimal cross talk EMG signal was found from erector spinae on the multifidus based on this method in previous publications. The EMG signals were collected while forward bending movement with the set speed. All EMG data was normalized by the signals of maximal voluntary isometric contraction (MVIC) of the target muscle which produced by trunk extension. A force gauge was used to measure the pressure pain threshold (PPT) on the erector spinae muscle. The comparison among healthy control, baseline data of LBP group and LBP group after intervention were determined by Mann-Whitney U test and Wilcoxon single rank test. The significant level was set at p ＜ 0.025. Results: The LBP group demonstrated lower PPT comparing to the healthy control (4.15 ± 0.71 vs. 9.70 ± 0.59 kg/cm^2, p ＜ 0.001) and the PPT was significantly increased (4.15 ± 0.71 vs. 5.88 ± 0.74 kg/cm^2, p = 0.023) after 4 weeks' intervention. Regarding to the muscle recruitments, the LBP group demonstrated higher level of muscle recruitment at erector spinae and lower level of multifidus muscle recruitment compared to healthy subjects during forward bending (56.33 ± 6.18 vs. 43.02 ± 3.35 % of MVIC, p = 0.011 and 21.33 ± 6.55 vs. 57.67 ± 7.59 % of MVIC, p ＜ 0.001). The muscle activation was significantly changed in the multifidus after 4 weeks' intervention (21.33 ± 6.55 vs. 43.21 ± 7.30 % of MVIC, p = 0.009). Conclusion: Four weeks of Pilates-based intervention could significantly change the muscle recruitments and PPT status for patients with non-specific LBP. Clinical Relevance: Our results suggested that muscle recruitment strategies could be re-educated by Pilates-based core muscle strengthening.

• 期刊

【論文摘要】足部姿勢對行走中足部動作表現之影響：初步實驗

背景與目的：足弓賦予足部吸震的功能，正常足弓在行走過程中會產生形變，不僅能夠吸震也能提升行走中效率。過低的足弓及過高的足弓則無法像正常足弓擁有良好的形變。過去曾有研究指出低足弓及高足弓在靜態站立及行走時，腿部肌肉活化表現不同於正常足c弓。前人的研究結果使我們推測不同足部姿勢在行走過程中可能也有不同的動作表現。因此，本研究目的為：探討足部姿勢對行走中足部動作表現之影響。方法：本研究收錄3名健康女性為受試者（平均年紀：23 y/o），正常足弓組（Rectus foot, RF）1名，低足弓組（Planus foot, PF）1名，高足弓組（Cavusfoot, CF）1名。分組方法採用Redmond學者等人的足部姿勢指數（Foot posture index-6, FPI6）及Nilsson學者等人的縱弓角度（Longitudinal arch angle, LAA）。每位受試者在研究人員指示下靜態站立10秒，並在8公尺的走道上行走5次。足部動作由6台動作捕捉攝影機進行紀錄，並參考Leardini學者等人的方法將其劃分為前、中、後足，由Visual 3D進行角度分析。Matlab則用於分析出步態中站立期的時間。結果：RF的FPI6為+2，LAA為140°，PF的FPI6為+7，LAA為120°，CF的FPI6為0，LAA為148°。結果CF在站立期時，前、中、後三足的最大外翻角度比RF及PF大，RF三足的最大外翻角度雖然最小但與PF差異不大。而從觸地期開始CF三足的外翻範圍比另外兩組偏大。CF在站立期時，前、中三足的最大外轉角度比RF及PF大。而從觸地期開始CF三足的外轉範圍比另外兩組偏大。結論：本篇實驗初步證實我們的推論，正常足弓、低足弓、高足弓在行走時有著不一樣的動作表現，尤其是高足弓相對正常足弓及低足弓在冠狀面及橫切面的動作。未來研究可以對這三種不同足部姿勢進行更大採樣，並同時對其肌肉活性的變化深入探討。臨床意義：本篇實驗結果能提供訊息給足踝領域研究人員，進行足部或運動表現的研究時需要考量到受試者的足部姿勢可能會影響到動作表現。同時，也能提供訊息給臨床治療師，當受試者有足部問題時，可以考慮足部姿勢對於運動學的影響。