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系統識別號 U0026-0812200915393521
論文名稱(中文) 足底皮表感覺對於跨步起始時預期性姿勢調節的影響
論文名稱(英文) Influence of Plantar Cutaneous Sensation on the Anticipatory Postural Adjustments for Step Initiation
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 97
學期 2
出版年 98
研究生(中文) 楊文傑
研究生(英文) Wen-chieh Yang
學號 t6696104
學位類別 碩士
語文別 中文
論文頁數 137頁
口試委員 指導教授-林桑伊
口試委員-蘇芳慶
口試委員-呂東武
中文關鍵字 足底感覺  跨步起始  預期性姿勢調節 
英文關鍵字 plantar sensation  Anticipatory postural adjustments  step initiation 
學科別分類
中文摘要 背景:跨步起始時的預期性姿勢調節包含壓力中心預應性位移與支持面水平剪力,目的為於跨步腳離地前產生適當的體重側移與身體初始前進速度。由於足底是站立時唯一與支持面接觸的區域,故來自足底的感覺輸入很可能會影響預期性調節的執行,而本實驗之目的即為探討足底感覺對跨步起始時預期性姿勢調節的影響。方法:25位健康年輕成人參與本實驗。實驗任務請受試者雙手抱胸,於視覺正常或眼罩遮蔽下,當聽到音響訊號時用最快的速度向前行走,並分別在:(a)足底感覺正常;(b)支撐腳感覺抑制;(c)跨步腳感覺抑制;(d)雙腳感覺抑制 下執行。足底感覺由15分鐘的隔水冰浴來抑制。實驗對預期性姿勢調節的量測包含壓力中心位移、水平剪力及兩側前脛肌活動程度,此外亦測量跨步腳擺盪時間代表跨步表現。統計以多變量變異數分析探討不同足底感覺抑制情境對預期性姿勢調節與跨步表現的影響,顯著水準定為p<.05。結果:足底感覺抑制後,跨步起始時壓力中心最大側移與最大側向剪力顯著地較感覺正常下來的小(p<.001),但不同的足底感覺抑制情境之間並無差異。而前後向的壓力中心最大位移、最大剪力、前脛肌的平均活化程度以及跨步腳擺盪時間等參數皆不受足底感覺抑制影響。結論:足底感覺抑制會降低側向的預期性姿勢調節,但未影響前後向的預期性調節表現。這樣的變化可能會減少跨步腳離地前體重側移至支撐腳的程度,並在跨步擺盪時造成側向的不穩定。
英文摘要 Background: Anticipatory postural adjustments (APAs) for step initiation include the shift of center of pressure (COP) and shear forces upon the supporting surface, to produce a lateral weight shift and initial progression velocity of body prior to stepping limb unloading. Since plantar surfaces contact directly with the ground, sensory input from soles may probably influence these APAs. Therefore, our study aimed to investigate the influence of plantar cutaneous sensation on the APAs for step initiation. Method: Twenty-five healthy young adults participated in this study. Subjects initiated a rapid walking with arms around chest once hearing the auditory signal, under either eyes open or shaded. Task was conducted under (a) Normal plantar sensation; (b) Stepping foot desensitized; (c) Supporting foot desensitized; (d) Bilateral foot desensitized. Foot was desensitized by 15-minute icy water immersion. The COP shift, horizontal shear force and bilateral tibialis anterior activation were measured as the APAs. The duration of leg swing was also measured as the performance of stepping. MANOVA was used for investigating the effect of plantar desensitization on the APAs and step performance. Result: The maximum lateral COP shift and shear force decreased significantly (p<.001) under desensitized conditions compared to the normal, but no differences identified between the 3 desensitized conditions. Contrarily, the maximum anterior-posterior COP shift, shear force, bilateral tibialis anterior activation and the leg swing duration were unchanged to plantar desensitization. Conclusion: Plantar desensitization suppressed the lateral APAs without affecting the anterior-posterior ones. This may reduce the lateral weight shift warranted prior to stepping limb unloading and induce lateral instability during leg swinging forward.
論文目次 中文摘要……………………………………………………………1
英文摘要……………………………………………………………2
致謝…………………………………………………………………4
表目錄………………………………………………………………8
圖目錄………………………………………………………………9
第一章 理論及文獻回顧…………………………………………11
第一節:靜立站姿的維持…………………………………11
一、站姿的運動力學與運動學特徵簡介…………11
二、靜立時的下肢肌肉活動特徵簡介……………15
三、下肢體感覺輸入對站姿維持的影響…………16
第二節:步態的維持 …………………………………… 22
一、步態的運動力學與運動學特徵簡介…………22
二、步態中下肢肌肉活動特徵簡介………………26
三、下肢體感覺輸入對步態的影響………………30
第三節:靜立至步行的轉銜-跨步起始…………………32
一、跨步起始中的運動力學與運動學變化………32
二、跨步起始中下肢肌肉活動的變化……………34
三、下肢體感覺輸入對跨步起始的影響…………37
第四節:預期性姿勢調節在姿勢變換過程中扮演的角色39
一、降低動作過程中對姿勢穩定的干擾…………39
二、促進任務(task)動作的表現…………………42
三、姿勢穩定與任務動作表現間的折衷…………44
四、跨步起始時的預期性姿勢調節………………46
第五節:中樞神經系統對預期性姿勢調節的影響………49
一、與工作情境有關………………………………49
二、受到經驗與練習的影響………………………52
三、中樞協調姿勢調節與任務動作執行的模式…55
第六節:體感覺輸入對預期性姿勢調節的影響…………59
一、本體覺…………………………………………59
二、皮表觸壓覺……………………………………61
第二章 研究背景…………………………………………………64
第一節:研究目的…………………………………………64
第二節:研究假設…………………………………………66
第三章 研究方法…………………………………………………67
第一節:研究設計…………………………………………67
第二節:受試者……………………………………………69
第三節:測試工具…………………………………………70
第四節:測試步驟…………………………………………73
一、前置實驗………………………………………73
二、主要實驗………………………………………82
第五節:訊號處理與參數計算……………………………89
一、訊號處理………………………………………89
二、參數計算………………………………………93
第六節:統計分析…………………………………………97
第四章 研究結果…………………………………………………100
第一節:受試者基本資料…………………………………100
第二節:冰浴前後足底觸壓覺閾值變化…………………101
第三節:足底感覺與視覺對預期性調節與跨步表現的影響103
第五章 討論………………………………………………………111
第一節:冰浴對於足底感覺功能的影響…………………112
第二節:足底感覺對跨步起始時預期性姿勢調節的影響113
一、對預期性姿勢調節的動作強度之影響………113
二、對預期性姿勢調節的持續時間之影響………116
第三節:足底感覺抑制對於跨步表現的影響……………118
第四節:不同側抑制對預期性調節與跨步表現的影響…120
第五節:實驗限制…………………………………………122
第六節:臨床應用…………………………………………124
第六章 結論………………………………………………………125
第七章 參考文獻…………………………………………………126
附錄…………………………………………………………………134
自述…………………………………………………………………137
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