https://scholars.lib.ntu.edu.tw/handle/123456789/157888
標題: | 行政院國家科學委員會補助專題研究計畫成果報告:不同肌力訓練計畫對腦性麻痺兒童粗動作功能之效果(1/3) | 作者: | 廖華芳 | 關鍵字: | 腦性麻痺;坐站活動;阻力測試;肌電圖;肌力訓練;cerebral palsy;sit to stand;resistive testing;electromyography;strength training | 公開日期: | 2000 | 出版社: | 臺北市:國立臺灣大學醫學院物理治療學系暨研究所 | 摘要: | 根據現代理論,阻力訓練於功能性活動中進行較能促進腦性麻痺兒童(CP)之功 能,加阻力是否會造成不良反應尚未知,乃進行此研究。目的:探討兒童坐站荷重測 試之再測信度,與不同阻力下動作分期時間與下肢肌肉肌電活動。方法:選取6 至12 歲一般兒童與痙攣型CP 兒童各16 位;於間隔一星期內進行2 次坐/站最大荷重測試, 分析不同日再測信度及1RM、6RM 與10RM 之相關;並在坐/站活動10RM、6RM、 1RM 阻力值及無阻力等4 種情況下,以電子量角器電壓式開關及肌電訊號收集及分析 系統,分析坐/站各分期時間及優勢腳下肢7 條肌肉(臀大肌、髖外展肌、髖內收肌、 後腱肌、股外側肌、脛前肌、腓腸肌)之肌電活動表現。結果:兩組兒童之坐/站1RM、 6RM、10RM 阻力值之再測信度良好(ICC>0.88);3 個阻力值有高度相關(R ³0.99)。 隨阻力增加,兩組兒童站起各分期時間顯著延長,下肢各肌肉標準化最大肌電值顯著 增加;在高阻力(1RM)下CP 兒童各分期時間顯著較一般兒童長,大部分肌肉較一 般兒童提早收縮且較慢達到最大肌電收縮。在加阻力之情況下,CP 兒童下肢動作型態 較趨近正常,即遵循脛前肌®股外側肌®臀大肌順序收縮。CP 兒童之股外側肌及髖內 收肌於1RM 時最大肌電值比值顯著高於10RM。CP 兒童互為拮抗肌比值與共同收縮 比,於各阻力下無顯著差異。結論:兩組兒童之坐/站最大荷重測試之再測信度高。CP 兒童於不同阻力下進行坐/站活動,其動作時間與肌肉之肌電活動表現有些不同,作者 依據8 個指標,建議10RM 比1RM、6RM 較適合做為CP 兒童之訓練阻力。不同功能 性阻力活動及其效果尚待進一步研究。 According to the new concept, resistance exercise with functional movement pattern ( such as sit to stand) may bring about greater functional improvement. Which amount of loading may cause the side-effect in cerebral palsy (CP) children. Purposes: (1) examining the test-retest reliability of repetitive maximum test (10RM, 6RM, and 1RM) during sit-tostand task in ND children; (2) investigating the movement time and electromyography activities of lower extremity muscles in different loading amount during sit-to-stand task. Method: Sixteen non-disabled (ND) children and sixteen CP children with agedrange 6-12 years were included. The measurements of sit-stand repetition maximum (10RM, 6RM, 1RM) were tested with an one-week interval to test the test-retest reliability. Electromyography system, electro-goniometer and switches were used to collect the data of movement time and electromyography activities of muscles of dominant leg (gluteus maximum, abductor, adductor, medial hamstrings, vastus lateralis, tibialis anterior, medial gastrocnemius) in 3 loading conditions. Result and Discussion: Test-retest reliability was good in both groups (ICC 0.86 – 0.96). The loads of 10RM, 6RM and 1 RM were highly correlated (r = 0.99 –1.0). The movement time of each phase of standing up was longer with increasing resistance in both groups. There were significant differences between the movement time in 1RM, 6RM and NW conditions. Also, CP children took longer time to stand up than ND children in higher resistance condition (6RM, 1RM). In CP children, more children showed normal phasing of muscle contractions when they performed the sit to stand task with resistance than without weight. The normal phasing is that from sitting to standing that the onset of muscle activities begin from tibialis anterior, followed by vastus lateralis and then gluteus maximus. The onset of muscle activities of most muscles was earlier and took longer time to reach maximum amplitude in CP children while comparing to that of ND children. The normalized maximal activities of muscles of lower extremities increased with increasing resistance. Neither the ratio of normalized maximal activities of couples of agonists and antagonists nor co-contraction ratio did not reveal any significant differences in different loading conditions. From the results of this stady, the authors use 8 indicators to evaluate which loas can cause better strengthening effects and induce less side effects for CP children. Authors suggest 10RM better than 1RM and 6RM. Conclusion: Sit-to-stand repetition maximum tests is reliable in CP and ND children. From the results of Movement time and EMG activities of LE were different in various loads, The authors suggest using 10RM for functional resistance training for CP children. The loading effects in different functional tasks effects of functional strengthening program for CP children need further investigations. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/25609 | 其他識別: | 892320B002070 | Rights: | 國立臺灣大學醫學院物理治療學系暨研究所 |
顯示於: | 物理治療學系所 |
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