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研究生: 林芸代
Yun-Tai Lin
論文名稱: 局部震動伸展訓練對五十肩患者的立即療效
Acute local vibration training increase shoulder range of motion and decrease pain in patients with frozen shoulder
指導教授: 相子元
Shiang, Tzyy-Yuang
學位類別: 碩士
Master
系所名稱: 運動競技學系
Department of Athletic Performance
論文出版年: 2013
畢業學年度: 101
語文別: 中文
論文頁數: 66
中文關鍵詞: 震動伸展肩關節角度疼痛肌肉張力本體感覺
英文關鍵詞: vibration-stretching, shoulder range of motion, pain, muscle stiffness, proprioception
論文種類: 學術論文
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目的:瞭解局部震動伸展訓練對五十肩患者肩關節活動度及疼痛的立即效果,並探討其作用機轉。方法:本實驗收集15位罹患五十肩的受試者(平均年齡48.56±5.48歲;平均罹病時間5.50±3.41個月),在肩屈曲、外展、外旋、內旋最大角度接受局部震動伸展訓練,頻率設在40Hz,每個角度震動1分鐘休息20秒重複三次,共12分鐘的震動訓練。比較震動前後肩關節活動度及自覺疼痛量表的差別,並探討患側肩及健側肩的肌肉張力及本體感覺差異。結果:震動後患側肩的肩屈曲、外展、及被動外旋角度都有顯著進步,休息時及動作時疼痛皆顯著降低,然而肩周圍肌肉張力及本體感覺無顯著差異。介入前健側肩與患側肩的肩周圍肌肉張力及本體感覺無顯著差異。結論:局部震動伸展訓練可以快速有效的改善五十肩患者的肩關節活動度及疼痛,其增加角度的機轉主要經由提高疼痛閾值所致。

Purpose: To investigate the acute effect of local vibration training on shoulder range of motion (ROM) and pain (visual analog scale, VAS) in patients with frozen shoulder. Methods: Fifteen participants were included to receive local vibration training (40Hz) while stretching to tolerable end range of shoulder flexion, abduction, external rotation, and internal rotation. The vibration was performed 1 minute followed by 20 seconds of rest, repeated 3 times of each shoulder motion (12 minutes total). Pre- and post-test ROM, VAS, shoulder muscle stiffness, and proprioception were compared. The muscle stiffness and proprioception in both side were analyzed. Results: After local vibration, the shoulder ROM and VAS were significantly improved. As for muscle stiffness and proprioception, there was no significant difference between pre- and post-test and between affected shoulder and sound side. Conclusion: Local vibration with stretching could immediately increase shoulder ROM and decrease pain. The mechanism may through alter pain threshold.

中文摘要 i 英文摘要 ii 誌謝詞 iii 目次 iv 表次 vi 圖次 vii 第壹章 緒 論 1 第一節 問題背景 1 第二節 研究問題 4 第三節 研究目的 4 第四節 研究假設 5 第五節 研究範圍與限制 6 第六節 名詞操作性定義 7 第七節 研究的重要性 8 第貳章 相關文獻探討 10 第一節 震動訓練對關節柔軟度的效益 10 第二節 粘黏性肩關節囊炎(五十肩)簡介與治療 19 第三節 文獻總結 23 第參章 方法 24 第一節 實驗對象 24 第二節 實驗儀器設備及成果指標測量 25 第三節 實驗步驟 28 第四節 實驗流程 31 第五節 統計方法 32 第肆章 結果 33 第一節 關節活動度 33 第二節 自覺疼痛量表 34 第三節 肌肉張力 34 第四節 本體感覺 36 第伍章 討論 40 第一節 局部震動訓練對五十肩患者關節活動度的立即效果 40 第二節 局部震動訓練對五十肩患者疼痛程度的立即效果 42 第三節 五十肩患者肌肉張力的表現 44 第四節 五十肩患者本體感覺的表現 47 第五節 結論 49 引用文獻 51 附錄一 病人基本資料表 60 附錄二 Modified Constant Score中文量表 61 附錄三 Oxford Shoulder Score中文量表 62 附錄四 受試者同意書(節錄) 64 個人小傳 66 表3-1 受試者基本資料 25 表4-1 震動訓練前後各方向關節活動度 33 表4-2 震動訓練前後自覺疼痛量表指數 34 表 4-3 震動前後患側肩肌肉張力比較 35 表4-4 震動前患側肩與健側肩肌肉張力比較 36 表4-5 自主自覺角度與再現角度的差值與平均差值 37 表4-6震動前後患側肩本體感覺的比較 38 表4-7 震動前患側肩與健側肩本體感覺比較 39 表4-8 最高點角度與中點角度本體感覺比較 39 圖2-1 震動訓練於神經肌肉系統的作用 12 圖2-2 Sands等人採用之前後分腿柔軟度測量及震動訓練方式 16 圖2-3 Cronin所使用動態膝關節活動度量測及腿後肌震動訓練 17 圖3-1 震動機台 26 圖3-2 局部震動伸展訓練動作 30 圖3-3 實驗流程圖 31

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