研究背景:膝關節在舞蹈的技巧中扮演著支撐髖關節與身體動作的角色,而這種運動的型態我們稱之為閉鎖運動鏈。同時,閉鎖運動鏈的運動型態也促進了踝關節及足部的本體知覺。膝關節的韌帶在支持膝蓋的穩定度上扮演了非常重要的角色,但是有些舞蹈動作會在膝關節形成一個剪力進而造成了韌帶的過度牽張。在學舞孩童的骨科理學檢查中,我們發現了學舞孩童產生膝關節疼痛的比例較未學舞孩童來的高。什麼樣的原因造成了學舞孩童的膝關節疼痛?研究目的:本篇的研究目的是比較膝關節四個方向的穩定性來觀查是否從小學習舞蹈會改變膝關節的穩定性,以提供舞蹈課程的參考依據。 研究方法:本研究的受試者共60位,舞蹈班孩童30位,3年級孩童15位(D3, 8.8±0.3yrs),6年級學童15位(D6, 11.9±0.3 yrs),非舞蹈班孩童30位,3年級孩童15位(N3, 9.0±0.3yrs),6年級學童15位(N6, 11.9±0.3 yrs)。於本次的實驗中,使用Lachman test,posterior drawer test,varus test,valgus test,patella chondromalacia test,Thomas test及rectus femoris contracture test等7種骨科理學檢查方式來評估所有受試者膝關節的穩定性及柔軟度。研究結果:在Lachman test,posterior drawer test兩種檢查方式中,3年級檢測成陽性的比例較6年級高,而舞蹈班3年級成陽性的比例較非舞蹈班3年級來的高,但舞蹈班6年級成陽性的比例較非舞蹈班6年級來的低;在varus test,valgus test,patella chondromalacia test中,6年級檢測成陽性的比例較3年級高,舞蹈班檢測成陽性的比例較非舞蹈班來的高;在Thomas test及rectus femoris contracture test中,舞蹈班3年級檢測成陽性的比例較舞蹈班6年級來的高,但是非舞蹈班3年級檢測成陽性的比例較非舞蹈班6年級來的低。討論與結論:膝關節矢狀面的穩定度隨著年紀的增長而提高,特別是舞蹈班的學群。但是學舞的孩童會降低膝關節冠狀面的穩定度。因此,學舞蹈能改善柔軟度,增加膝關節矢狀面的穩定度;但是如果下肢的肌肉力量不足,學習舞蹈對膝關節冠狀面的穩定度並無益處。
The knee joints led hip joints and trunk to perform the technique of dance in close chain kinetic mode, and promoted the esthetics of ankle and foot. Ligaments were very important to provide stability of knee joints, but some dancing motions take shearing force to knee joints and caused ligaments overstretch. In orthopetic physical examination of dancing children, we found the dancing children with knee pain were more than undancing children. What was the cause of the knee pain? PURPOSE: To compare the stability of knee joints in four directions to find if dancing training in childhood changes the stability of knee, hence to provide recommendation for dancing curriculum of children. METHODS: Sixty children were involved in the study: children in grade three who had dance training (D3, 8.8±0.3 yrs, n=15); children in grade six who had dance training (D6, 11.9±0.3 yrs, n=15); children in grade three who had no dance training (N3, 9.0±0.3 yrs, n=15); and children in grade six who had no dance training (N6, 11.9±0.3 yrs, n=15). The orthopetic physical examinations for stability and flexibility tests of knee, such as Lachman test, posterior drawer test, varus test, valgus test, patella chondromalacia test , Thomas test and rectus femoris contracture test, were examined for all subjects. RESULTS: On the Lachman test and posterior drawer test, the rate of positive in grade three is higher than grade six, D3 higher than N3 but D6 lower than N6; on varus test, valgus test and patella chondromalacia test showed the rate of positive in grade six was higher than grade three and dancing groups were higher than undancing group; on Thomas test and rectus femoris contracture test showed D3 was higher than D6 but N3 was lower than N6. DISCUSSION: Antero-posterior stability becomes better by age especially in dancing group. But dancing during childhood is damaging to medio-latera stability. CONCLUSION: Dancing can improve flexibility and increase stability in sagittal plane, but dancing is disadvantageous to frontal plane if muscle strength is insufficiency.
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