洪暐Hung, Wei2017-02-272025-07-302017-02-272017-02-27https://ir.ntus.edu.tw/handle/987654321/71306學位類別：碩士校院名稱：國立臺灣體育運動大學系所名稱：運動健康科學系碩士班學號：19906001畢業學年度：101年論文頁數：187頁　　研究背景：過頂投擲運動員常見因錯誤的投擲動作與過度訓練，引起肩關節前後側肌力不平衡，造成肩胛肱骨間的律動異常，使肩峰下空間減小，導致肩關節夾擠症候群現象，嚴重者甚至會引發肩盂唇上方病變，影響投擲表現。近年來運動貼布廣泛運用在運動場上，主要可放鬆活性過強肌肉，以減緩疼痛刺激，給予肌肉組織保護性的效果，避免運動傷害。本研究探討在肩關節夾擠患者中，若能於投擲過程中之上臂捲曲期及加速期增加肩關節穩定性，加強下斜方肌、前鉅肌，並放鬆上斜方肌，對肩峰下空間的影響。研究方法：招募棒球專長男性15名與健康大專男性16名，使用複合式肩關節貼紮，分別從事有或無肌內效貼布運動測試，使用等速肌力測試儀將肩關節固定在0°、30°、60°進行35%、55%、100% 的肩胛平面外展的運動測試。採集等長收縮的肌肉扭力峰值變化，並運用超音波探測肩峰下空間距離改變、以肌肉電位訊號儀採集上斜方肌、下斜方肌、前鉅肌之肌電訊號。探討肌內效貼布對改善肩關節夾擠症候群的影響。研究結果：上斜方肌肌肉活化率經肌內效貼紮前後相較，在健康對照組55%-0° (輸出力量-外展角度) 作用下活性顯著增加，棒球專長組在55%-0° 與100%-0° 時顯著降低。健康對照組在手臂30°-60°上抬期間，上斜方肌經貼紮後無顯著性差異，棒球專長組在35% 力量輸出時顯著提升，但55% 力量輸出時顯著被抑制。在60°-0° 上臂下放期間健康對照組55%力量輸出時，上斜方肌活性顯著被降低；棒球專長組在100% 力量輸出時上斜方肌活性顯著被提升。下斜方肌與前鉅肌活性在兩組間皆無顯著性差異。肌肉功能比值方面，健康對照組貼紮後上斜方肌/下斜方功能比在35%-0° 與55%-0° 時顯著提升，棒球專長組在55%-0° 功能比值顯著降低；其餘各輸出力量-外展角度在兩組間無顯著差異。上斜方肌/前鉅肌功能比在健康對照組100%-0° 顯著提升；其餘各輸出力量-外展角度在兩組間無顯著差異。兩組間貼紮後的下斜方肌/前鉅肌功能比值相較於貼紮前各輸出力量-外展角度皆無顯著差異。健康對照組在35%-30°、55%-0°與60°、100%-0° 的輸出力量-外展角度於肩峰下空間達顯著性增加，棒球專組則無顯著性差異。肩峰下空間變化在兩組間皆各輸出力量-外展角度作用皆無顯著性差異。結論：肌內效貼布對上斜方肌肉活性影響較為顯著，可以在短時效性內改變肌電活性較大的專項運動員之功能性作用。但對於健康族群的作用機制可能會與受過訓練專項運動有所差異，貼布會刺激肌電活性相較於專項運動員弱的上斜方肌群，進而誘使肩峰下空間增加。　　Background: Overhead throwing athletes common due to wrong throwing movement and overtraining, causing muscle imbalance around the side of the shoulder joint, causing abnormalities rhythm between scapular and humeral, the subacromial space decreases, resulting in the phenomenon of shoulder impingement syndrome, serious even lead to superior labral anterior posterior effect throwing performance. In recent years sports taping widely used on the sports arena, mainly to relax over-activity muscles to relieve pain stimulation, giving the muscle tissue a protective effect, avoid exercise injuries. This study investigated the patients with shoulder impengment, if on the process of throwing arm cocking and accelerated phase increased shoulder stability, enhance lower trapezius, serratus anterior muscle contraction and relaxation the upper trapezius muscle contractility , whether an impact on the subacromial space or not? Methods: Recruited 15 baseball player male and 16 health college males from National Taiwan University of Physical Education and Sport, use of composite shoulder taping were engaged with or without kinesio tapping exercise testing, the use of shoulder isokinetic dynamometer will be fixed at 0°, 30°, 60° for 35%, 55%, 100% of the scapular plane abduction exercise test. Collected isometric muscle peak torque changes and use of ultrasound detected acromion head distance changed, use of muscle action potential signal analyzer collected upper trapezius, lower trapezius, and serratus anterior muscle EMG. Discussion kinesio tapping to improve the impact of shoulder impingement syndrome. Result：After tapping, the activity ratio of upper trapezius significantly increase in 55%-0° (output power-abduction angle) of health group. In baseball group, the activity of upper trapezius significantly decrease in 55%-0° and 100%-0° after tapping. There was no difference for the activity ratio of upper trapezius when the arm was elevation for 30°-60° of health group, there was significantly increase in 35% output power of baseball group, but decrease at 55% output power.The activity of upper trapezius was significantly decrease when the arm was downward for 60°-0° in 55% output power of health group, and it was significantly increase in 100% output power of baseball group.There were no difference among lower trapezius and serratus anterior activity between groups. In upper trapezius and lower trapezius muscle function ratio, it was significantly increased in 35%-0° and 55%-0° after tapping in health group. However, it was significantly decreased for 55%-0° in baseball group. There were no difference between every output power-abduction angle among groups. The upper trapezius/serratus anterior function ratio were significantly increased in 100%-0° in health group, it was no difference between every output power-abduction angle among groups.After kinesio tapping lower trapezius/serratus anterior muscle function ratio compared to before taping the output power - abduction angle were no significant differences between groups. 35% -30 °, 55% -0 ° and 60 °, 100% -0 ° of output power - abduction angle acting on the acromion head distance were significant increase in the healthy group, there was no significant difference in baseball groups . Acromion head distance variation for each output power - abduction angle effect were no significant differences between the two groups. Conclusion: Kinesio Tapping for upper trapezius muscle activity have more significant impact that can changed EMG activity larger within a short time of the athlete's functional effect. However, the mechanism of action for the health of groups might be different trained Specific Athletic, tapping would stimulate muscle activity compared to the special athletes weak upper trapezius and thus inducing an increase s acromion head distance.目　次 第壹章　緒論………………………………………………………………………1 　第一節　研究背景………………………………………………………………1 　第二節　研究目的………………………………………………………………3 　第三節　研究假設………………………………………………………………3 第貳章　文獻探討…………………………………………………………………4 　第一節　肩關節活動與傷害……………………………………………………4 　第二節　肩關節功能障礙與慢性損傷…………………………………………11 　第三節　貼布效應………………………………………………………………17 　第四節　超音波應用在肩峰下空間夾擠症候群………………………………20 　第五節　本章總結………………………………………………………………23 第參章　研究方法…………………………………………………………………25 　第一節　實驗對象………………………………………………………………25 　第二節　實驗程序………………………………………………………………26 　第三節　肌電訊號分析…………………………………………………………32 　第四節　資料處理與統計分析…………………………………………………32 第肆章　實驗結果…………………………………………………………………33 　第一節　受試者基本資料………………………………………………………33 　第二節　肌電訊號變化…………………………………………………………34 　第三節　超音波肩峰下空間變化………………………………………………128 第伍章　研究討論…………………………………………………………………148 　第一節　肩胛骨運動障礙與肩峰夾擠症候群肌電訊號影響…………………148 　第二節　肌內效貼紮影響肌肉活性與影響效果之因素………………………152 　第三節　肌內效貼紮對肩峰下空間的影響……………………………………156 　第四節　本章總結………………………………………………………………161 第陸章　結論與未來研究建議……………………………………………………162 　中文參考文獻……………………………………………………………………163 　英文參考文獻……………………………………………………………………164 　附錄………………………………………………………………………………1762880580 bytesapplication/pdf肌內效貼布;過頂投擲運動;肩峰下空間;肌電訊號Kinesio Tapping;overhead throwing exercise;acromion head distance;EMGthesis