本研究的目的為了解衝刺性的輪椅推進中，肩關節主要作用肌群於輪椅推進時的
疲勞情形，並觀察推進期與回復期作用肌群肌電強度在疲勞前後是否有所改變，以探
究肩關節肌肉周邊疲勞與輪椅運動員肩傷的關係。研究以肌電訊號中數功率頻率
（median power frequency,MPF）與積分肌(integrate EMG,iEMG)電圖的變化趨勢
作為評估肌肉疲勞狀態的實驗指標，另外以最大等長收縮測試的平均相對肌電強度
（the average percentage of EMG intensity relative to maximal voluntary
isometric contraction,perMVIC）作為判別作用肌群的實驗變項。受試者為國內男
性輪椅運動員14 名，年齡34.50 ± 6.60 歲、殘障年數30.36 ± 8.83 年、體重為55.21 ± 7.80
公斤重、全臂長75.04 ± 3.44 公分、坐高86.93 ± 5.73 公分。將表面肌電電極(MEDI TRACE;
Ag /AgCl electrode;radius:0.5cm;interelectrode distance:3.7cm;sampling
rate:1000Hz)貼附於鎖骨部三角肌(CLD)、肩胛部三角肌(SCD)、胸大肌(SPM)、闊背
肌(LAD)與上、下斜方肌(UPT &LOT)，於輪椅衝刺推進的衰竭測試中擷取肌電訊號至
受試者衰竭為止。結果中指出在衝刺性的輪椅推進中，肩關節推進期與回復期主要作
用肌群與一般輪椅推進之作用肌群相近，但在衝刺推進中將動用回復期的肌肉（如：
SCD 、LAD 、LOT）在推進期產生拮抗作用，以流暢且穩定地完成高速度與高強度的輪
椅衝刺推進動作，而SCD 是輪椅衝刺推進中達最大疲勞程度的肌肉，CLD 、SPM 、LOT
亦達到一定的疲勞程度。由研究結果所歸納的結論為：上述肩部肌群的疲勞情形的確
可能透過特殊機制造成輪椅運動員肩傷的高發生率。因此，若需針對輪椅運動者的肩
關節肌群進行運動傷害的預防性訓練，應首要重視後三角肌與中三角肌的訓練，其次
再考慮前三角肌、胸大肌、與下斜方肌的訓練，但有關此建議的實際效果仍須運動傷
害領域的人員進行相關性的研究加以證明。
關鍵詞：輪椅推進、疲勞指數、肩關節、中數功率頻率

The main purposes of this study were to investigate the characteristics of shoulder
local muscle fatigue during wheelchair athlete sprinting. Additionally, the shoulder active
muscles both in pushing and in recovering phases of wheelchair sprinting were examined.
Fourteen-wheelchair athletes voluntarily participated in this study.
Self-designed wheelchair stationary roller and hand contact triggers were used in this
study. Six channels of EMG amplifiers were used to measure the myoelectric signals. One
channel of hand-on trigger was used to distinguish the pushing phase and recovery phase.
Six crucial muscles regarding to shoulder motion during wheelchair propulsion were
studied. Those muscles included clavical part of deltoid (CLD), scapular part of deltoid
(SCD), sternal part of pectoralis major (SPM), latissimus dorsi (LAD), upper trapezius
(UPT), and lower trapezius (LOT). Surface EMGs were used to analyze the shoulder
myoelectric signal both in frequency domain (mean power frequency, MPF) and time
The results indicated that CLD, SCD, SPM, and LOT easily became fatigue after
exhaustion of wheelchair fast propulsion. However, the SCD was most prone to fatigue.
Based on our study findings, we believed that the shoulder muscle fatigue could be one of
major factor contribute causing shoulder impingement injuries. This is due to muscle losing
its balance in protection of glenohumeral stability. In order to maintain shoulder dynamic
stability and prevent shoulder impingement injury, shoulder muscle endurance exercise
training is important for wheelchair athletes, especially SCD, CLD, SPM and LOT muscles.
Keywords ：wheelchair propulsion, fatigue index, shoulder joint, median power

中華民國殘障體育運動總會。（1999 ）。殘障運動體位分級。中華民國殘障體育
運動總會C 級體位分級員講習會講義。中華民國台北市：台北市肢體殘障協會印製。
李孔嘉。（1995 ）。運動傷害防治與簡易生物力學。嘉義市：力仁印刷企業有限
公司。
Barber, D. B. & Gall, N. G. (1991). Osteonecrosis: an overuse injury of the shoulder
in paraplegia: case report. Paraplegia, 29, 423-426.
Bayley, J. C., Cochran, T. P., & Sledge, C. B. (1987). The weight-bearing shoulder.
The Journal of Bone and Joint Surgery, 69(5), 676-678.
Berne, R. M. & Levy, M. N. (1998). Physiology(4 th ed.). Baltimore: Mosby.
Bobbert, M. F., Gerriten, K. G. M.,Litjens, M. C. A., & Soest, A. J. V. (1996). Why is
counter-movement jump height greater than squat jump height. Medicine and Science in
Sports and Exercise, 28(11), 1402-1412.
Burnham, R. S., May, L., Nelson, E., Steadward, R., Reid, D. C. (1993). Shoulder
pain in wheelchair athletes: the role of muscle imbalance. The American Journal of Sports
Medicine, 21, 238-242.
Carola, R., Harley, J. P., & Noback, C. R. (1992). Human anatomy. New York:
McGraw-Hill.
Chaffin, D. B. (1973). Localized muscle fatigue - definition and measurement. Jour-nal
of Occupational Medicine, 15(4), 346-354. Chen, W. Y., Balmos, T., Wang, W. T. J., Olson, S., & Hanten, W. P. (1997).
Comparison of initial median frequency values formulated by two different methods.
Journal of Clinical Electrophysiology, 9(1), 2-6.
Chen, W. Y. (1998). Between-week test-retest reliability of some endurance measures
in the trunk extensors. Journal of the Physical Therapy Association of the Republic of China,
23(3), 178-186.
Curtis, K. A. & Dillion D. A. (1985). Survey of wheelchair athletic injury: common
pattern and prevention. Paraplegia, 23, 170-175.
Curtis, K. A., Roach, K. E., Applegate, E. B., Amar, T., Benbow, C. S., Genecco, T.
D., & Gualano, J. (1995). Development of the wheelchair user’s shoulder pain index (WU-SPI).
Paraplegia, 33, 290-293.
De Luca, C. J. (1997). The use of surface electromyography in biomechanics. Journal
of Applied Biomechanics, 13, 135-163.
Ferrara, M. S., Buckley, W. E., McCann, B. C., Limbird, T. J., Powell, J. W., & Robl,
R. (1992). The injury experience of the competitive athlete with a disability: prevention im-plications.
Medicine and Science in Sports and Exercise, 24(2), 184-188.
Ferrara, M. S. & Davis, R. W. (1990). Injuries to elite wheelchair athletes. Paraplegia,
28, 335-341.
Field, L. D. & Altchek, D.W. (1995). Elbow injuries. Clinics in Sports medicine,
14(1), 59-78.
Gellman, H. , Sie, I., & Waters, R. L. (1988). Late cpmplications of the weightbearing
upper extremity in the paraplegic patient. Clinical Orthopedics and related research, 233,
132-135.
Harburn, K. L. & Spaulding, S. J. (1986). Muscle activity in the spinal cord injured
during wheelchair ambulation. The American Journal of Occupational Therapy, 40(9), 629-636.
Hertling, D. & Kessler, R. (1996). Management of common Musculoskeletal dis-orders
(3 rd Ed). Lippincott: New York.
Horita, T., Ishiko, T. (1987). Relationships between muscle lactate accumulation and
surface EMG activities during isokinetic contractions in man. European Journal of Applied
Physiology and Occupational Physiology, 56(1), 18-23.
Hulstyn, M. J. & Fadale, P. D. (1997). Shoulder injuries in the athlete. Clinics in
Sports Medicine, 16(4), 663-678.
Jerosch, J., Castro, W. H., Sons H. U., & Moersler, M. (1989). Etiology of sub-acromial
impingement syndrome – a biomechanical study. Beitrage zur Orthopedie und
Tramatologie, 36(9), 411-418.
McArdle, W. D., Katch, F. I., & Katch, V. L. (1994). Essential of exercise physiology.
Baltimore:. LEA & FEBIGER.
McQuade, K. J., Wei S. H., and Smidt, G. L. (1995). Effects of local muscle fatigue
on three-dimensional scapulaohumeral rhythm. Clinics Biomechanics, 10(3), 144-148.
Miyahara, M., Sleivert, G. G., & Gerrard, D. F. (1997). The relationship of strength 60
and muscle balance to shoulder pain and impingement syndrome in elite quadriplegic whe-elchair
rugby players. International Journal of Sports Medicine, 19, 210-214.
Mulroy, S. J., Gronley, J. K., Newsam, C. J., & Perry, J. (1996). Electromyo-graphic
activity of shoulder muscle during wheelchair propulsion by paraplegic persons. Archives
of Physical Medicine and Rehabilitation, 77, 187-193.
Nichols, P. J. R., Norman, P. A., & Ennis J. R.（1979 ）Wheelchair user’s shoulder.
Scandinavian Journal of Rehabilitation Medicine, 11, 29-32.
Nilsen, R., Nygaard, P., & Bjorholt, P. G. (1985). Complications that may occur in
those with spinal cord injuries who participate in sport. Paraplegia, 23, 152-158.
Norkin, C. C. & Levangie, P. K. (1992). Joint structure and function (2 nd Ed).
Philadephia: F. A. Davis Company.
Nyland, J., Robinson, K., Caborn, D., Knapp, E., Brosky T. (1977). Shoulder rotator
torque and wheelchair dependence differences of national wheelchair basketball association
players. Archives of Physical Medicine and Rehabilitation, 78, 358- 363.
Olenik, L. M., Laskin, J. J., & Burnham, R., Wheeler, G. D., Steadward, R. D. (1995).
Efficacy of rowing, backward wheeling and isolated scapular retractor exercise as remedial
strength activities for wheelchair users: application of electromyography. Paraplegia, 33,
148-152.
Pentland, W. E. & Twomey, L. T. (1991). The weigh-bearing upper extremity in wo-men
with long term paraplegia. Paraplegia, 29, 521-530.
Perry, J., Gronley, J. K., Newsam, C. J., Reyes, M. L., & Mulroy, S. J. (1996). Eletro- myographic analysis of the shoulder muscles during depression transfers in subjects with
low level paraplegia. Archives of Physical Medicine and Rehabilitation, 77, 350-355.
Petrofsky, J. S. (1979). Frequency and amplitude analysis of the EMG during exercise
on bicycle ergometer. European journal of Applied Physiology and Occupational Physiolo-gy,
43, 173-182.
Rodgers M. M., Gayle G. W., Figoni S. F., Kobayashi M., Lieh J., & Glaser R. M.
(1994). Biomechanics of wheelchair propulsion during fatigue. Archives of Physical Me-dicine
and Rehabilitation, 75, 85-93.
Schaefer, R. S. & Proffer, D. S. (1989). Sports medicine for wheelchair athletes. Am-erican
Family Physician, 39(5), 239-245.
Taylor, D. & Williams, T. (1995). Sports injuries in athletes with disability: wheel-chair
racing. Paraplegia, 33, 296-299.
Vanlandewijck, Y. C., Spaepen, A. J., & Lysens, R. J. (1994). Wheelchair propulsion
efficiency: movement pattern adaptation to speed change. Medicine and Science in Sports
and Exercise, 26(11), 1373-1381.
Veeger, H. E .J., Van der Woude, L. H. V., & Rozendal, R. H. (1991). Within- cycle
characteristics of the wheelchair push in sprinting on a wheelchair ergometer. Medicine and
Science in Sports and Exercise, 23(2), 264-271.
Wilson, P. E. & Washington, R. L. (1993). Pediatric wheelchair athletics: sports
injuries and prevention. Paraplegia, 31, 330-3