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系統識別號 U0026-0812200914214971
論文名稱(中文) 有過與沒有過內側手肘疼痛的少棒選手在投球運動學及身體特徵上的差異
論文名稱(英文) Throwing Kinematics and Physical Characteristics in Youth Baseball Players with and without Medial Elbow Pain
校院名稱 成功大學
系所名稱(中) 物理治療研究所
系所名稱(英) Department of Physical Therapy
學年度 96
學期 2
出版年 97
研究生(中文) 吳亭諭
研究生(英文) Ting-Yu Wu
電子信箱 t6695102@mail.ncku.edu.tw
學號 t6695102
學位類別 碩士
語文別 中文
論文頁數 93頁
口試委員 指導教授-蔡鏞申
口試委員-黃永賢
口試委員-陳文玲
中文關鍵字 平衡能力  柔軟度  投球動作  棒球肘  肌肉力量 
英文關鍵字 muscle strength  little league elbow  throwing kinematics  flexibility  balance 
學科別分類
中文摘要 背景與研究目的
少棒選手的內側肘關節傷害很常見,其原因不外乎重複的執行投球動作,以致於在未成熟的肘關節上施加過度的外翻壓力所造成。過去有學者探討健康的棒球選手在投球過程中的運動學參數與外翻壓力間的關係,但沒有研究比較曾經有過及沒有過內側手肘疼痛的少棒選手在投球動作上的不同。此外,核心肌群的肌肉力量、柔軟度及單腳站立平衡能力的好壞,皆對投球過程中的軀幹穩定度及投球表現有所影響。曾經有過內側手肘疼痛與沒有過內側手肘疼痛的少棒選手,是否在這些身體特徵上有所不同,仍缺乏相關研究。因此本研究的目的在於探討曾經有過內側手肘疼痛的少棒選手與沒有過內側手肘疼痛的少棒選手,在投球動作、肌力、柔軟度,及單腳站立平衡能力上的差異。

研究方法
共有三十位少棒選手參與本研究,其中十五位曾經有過內側手肘疼痛,餘十五位沒有過內側手肘疼痛的問題,兩組選手以年齡、身高及體重配對而成。少棒選手投快速直球的動作採用三度空間電磁場動作分析系統來記錄,並配合足底開關來協助分辨前導腳抬起與著地的時間點,球速以手持式測速槍量測。軀幹、髖部及肩部的等長肌力以一力矩傳感器配合特製的測力裝置來測量。肘、肩及髖關節的柔軟度利用量角器及皮尺量測。單腳站立平衡則以一測力板來評估張眼及閉眼時的平衡能力。統計分析採用成對樣本 t 檢定來比較兩組少棒選手在投球動作、肌力、柔軟度及單腳站立平衡能力上的不 同。

研究結果
曾經有過內側手肘疼痛的少棒選手在最大肩關節外轉角度時,肘彎曲角度明顯較沒有過內側手肘疼痛的少棒選手來得小。有受過傷組在棒球離手瞬間時,軀幹側彎角度明顯較沒有受過傷組來得大。兩組選手的軀幹、髖部及肩部等長肌力無顯著的不同。受過傷組的少棒選手被動肩關節外轉角度較沒受過傷組小。受過傷組的選手慣用手肘關節最大彎曲角度及總關節活動度皆較非慣用手小。受過傷組的前導腳髖關節柔軟度亦比其支撐腳側差。兩組少棒選手單腳站立的平衡能力並無明顯差異。

結論
少棒選手棒球肘運動傷害的危險因子,除了年齡、身高、體重及過度使用外,還存在有動作及關節柔軟度上的問題。臨床治療師及教練在訓練及照顧這些選手時,必須兼顧所有可能影響選手運動表現及運動傷害的相關因素,以培育更多的優秀選手。
英文摘要 Background and purpose
Medial elbow injuries are common in youth baseball players. Repetitive throwing movement places excessive valgus stress over the immature elbow that may cause medial elbow injury. Previous studies have investigated the relationships between throwing kinematics and elbow valgus stress in healthy adult throwers. No research compares the differences in throwing kinematics and physical characteristics between youth baseball players with and without medial elbow pain. The purpose of this study was to investigate throwing kinematics and physical characteristics (muscle strength, flexibility and balance) in youth baseball players with and without medial elbow pain.

Methods
Fifteen players with previous medial elbow pain and 15 healthy players participated in this study. Age, height, and weight were matched for the two groups. Throwing kinematics were recorded by an electromagnetic motion analysis system. Foot switch was used for determining foot off and foot strike. Ball speed was recorded with a sports radar gun. Isometric strength of trunk, hip, and shoulder was measured using a torque sensor attached to a custom device. Elbow, shoulder, and hip flexibility were measured with a goniometer and a tape measure. Single leg standing balance with eyes open and eyes closed was assessed with a force plate. Paired-t tests were used to compare the differences in throwing kinematics,
muscle strength, flexibility, and single leg standing balance between the two groups.

Results
Elbow pain group demonstrated less elbow flexion angle at maximum shoulder external rotation in late cocking phase and had more trunk lateral tilt at ball release compared to the healthy group. No significant differences were found in isometric strength of trunk, hip, and shoulder between the two groups. Elbow pain group had less passive range of motion in shoulder external rotation compared to the healthy group. In the elbow pain group, elbow flexion angle and total elbow range of motion were less in the throwing arm compared to the non-throwing arm. Less flexibility was observed in the lead hip compared to the non-lead hip in the elbow pain group. There were no significant differences in single leg standing balance between the two groups.

Conclusions
Differences in throwing kinematics and flexibility were found between youth baseball players with and without previous medial elbow pain. Clinicians and baseball coaches should pay attention to these risk factors in addition to their age, height, weight, and overuse for protecting these players.
論文目次 中文摘要 ----------------------------------------------- 3
英文摘要 ----------------------------------------------- 5
誌謝 --------------------------------------------------- 7
目錄索引 ----------------------------------------------- 8
表目錄 ------------------------------------------------ 11
圖目錄 ------------------------------------------------ 12
第一章、 研究簡介 ------------------------------------- 14
1.1 研究動機 ------------------------------------- 14
1.2 研究目的 ------------------------------------- 19
1.3 研究假設 ------------------------------------- 19
1.4 研究重要性 ----------------------------------- 22
第二章、 文獻回顧 ------------------------------------- 23
2.1 棒球肘關節傷害的盛行率及原因 ----------------- 23
2.2 棒球投球過程分期 ----------------------------- 26
2.3 動力傳遞鏈與投球的相關性 --------------------- 28
2.4 投球動作之運動學及動力學參數與少棒選手內側肘關節傷
害的相關性 ----------------------------------- 28
2.5 肌肉力量與少棒選手肘關節傷害的相關性 --------- 31
2.6 柔軟度與少棒選手肘關節傷害的相關性 ----------- 35
2.7 平衡能力與少棒選手肘關節傷害的相關性 --------- 37
2.8 總結 ----------------------------------------- 38
第三章、 研究方法 ------------------------------------- 40
3.1 研究設計 ------------------------------------- 40
3.2 研究對象 ------------------------------------- 40
3.3 儀器與設備 ----------------------------------- 41
3.4 測試流程與方法 ------------------------------- 46
3.5 資料處理及統計分析 --------------------------- 56
第四章、 研究結果 ------------------------------------- 61
4.1 受測者基本資料 ------------------------------- 61
4.2 投球動作運動學參數 --------------------------- 62
4.3 投球動作運動學參數與球速的關係 --------------- 63
4.4 肌肉力量及肌力比值 --------------------------- 64
4.5 柔軟度 --------------------------------------- 66
4.6 單腳站立平衡能力 ----------------------------- 69
4.7 身體特徵參數與球速的關係 --------------------- 70
第五章、 討論 ----------------------------------------- 73
5.1 兩組少棒選手在基本資料上的差異 --------------- 73
5.2 兩組少棒選手在投球動作上的比較 --------------- 74
5.3 兩組少棒選手在肌肉力量上的比較 --------------- 77
5.4 兩組少棒選手在柔軟度上的比較 ----------------- 78
5.5 兩組少棒選手在平衡能力上的比較 --------------- 80
5.6 棒球肘運動傷害復健與預防的建議與討論 --------- 81
5.7 本篇研究的限制 ------------------------------- 82
5.8 結論 ----------------------------------------- 83
參考文獻 ---------------------------------------------- 84
附件 -------------------------------------------------- 92
自述 -------------------------------------------------- 93
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