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系統識別號 U0026-2801201109334700
論文名稱(中文) 肩頸肌力訓練或拳擊有氧運動對有症狀電腦族之效益
論文名稱(英文) Effects of body combat exercise and neck/shoulder strengthening exercise on symptomatic computer users
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 99
學期 1
出版年 100
研究生(中文) 吳倉華
研究生(英文) Tsang-Hua Wu
學號 T6697107
學位類別 碩士
語文別 中文
論文頁數 102頁
口試委員 指導教授-卓瓊鈺
口試委員-黃英修
口試委員-楊政峰
口試委員-蔡一如
中文關鍵字 肌肉活性  姿勢  電腦工作  肩頸痠痛  拳擊有氧  運動治療 
英文關鍵字 muscle activity  posture  computer work  neck/shoulder pain  combat exercise  exercise intervention 
學科別分類
中文摘要 研究背景與目的: 電腦普及與使用率越來越高,因電腦使用造成的肌肉骨骼系統症狀也越來越多,這些患者通常以肩頸部位為主要抱怨位置。前人的研究顯示長時間處在同一固定姿勢或是從事重複性高的電腦操作常是造成這些骨骼肌肉症狀的危險因子,因此針對這些有肩頸症狀的電腦族給予治療介入是很重要的。由文獻回顧可發現,在運動治療中以肌力訓練對肩頸痠痛最為有效,而近年來健身房新興的拳擊有氧運動除了具備一般傳統有氧運動下肢的肌耐力訓練外,也包括了上肢的肌耐力訓練。然而,拳擊有氧運動對肩頸痠痛的療效仍未得到證實。因此,本研究想探討針對有肩頸症狀的年輕電腦族給予六周的肌力訓練或拳擊有氧運動是否能減輕肩頸症狀,改善在執行電腦工作時的姿勢,或是降低其肩頸肌肉活性。
研究方法:本研究收入43位有肩頸症狀電腦族,分為肌力訓練組、拳擊有氧組與伸展運動組,共三組。完成6周治療與前後測者有31人,其中肌力訓練組13人,拳擊有氧組11人,伸展運動組7人。在運動前後受試者所接受的測試包括:一般與快速打字工作與滑鼠敲擊敲擊工作各8分鐘。實驗中會利用6台紅外線攝影機與1台肌電訊號擷取器,記錄在電腦工作中頭頸與上肢姿勢以及肩頸肌肉活性。另外,在運動前後還會量測頸部活動度、肩頸肌力、肩頸肌肉疼痛閾值與上半身疼痛分數,且填寫中國人健康量表、頸部失能指數與頸痛恐懼逃避信念問卷。統計方法使用重複量數變異數分析評量姿勢、肌電圖與物理檢測結果,利用魏可遜符號等級檢定與克瓦檢定評量問卷分數。
結果:經過六周的運動治療之後,肌力訓練組、拳擊有氧組與伸展運動控制組在頸部活動度、肩頸肌力、肩頸肌肉疼痛閾值、肩頸疼痛分數皆有顯著改善,但上述參數在三組之間的改善程度沒有顯著差異。運動後,在執行電腦工作時,三組頭部前移的姿勢皆有改善,肩頸肌肉活性也有降低,但肌力訓練組與拳擊有氧組在執行打字工作時的兩側上斜方肌與滑鼠敲擊的右上斜方肌肌肉活性下降的量皆稍大於伸展運動組,但未達統計上顯著差異。
結論:經過六周的肩頸肌力訓練、拳擊有氧運動或是肩頸伸展運動之後,均能降低有肩頸症狀的年輕電腦族肩頸疼痛的程度、增加肩頸肌力、頸部活動度、減少失能程度以及改善電腦工作時的姿勢與肌肉活性。未來,此種介入模式可應用於臨床或職場上非特別原因造成的肩頸症狀患者身上。
英文摘要 Background and purpose: More and more people use computer for work tasks but also for activities of daily living including social communication and entertainment. Neck and shoulder pain are most prevalent musculoskeletal complaints in computer users. There are several factors which are related to musculoskeletal symptoms. While using computer, prolonged posture and repetitive movement are the most important risk factors. According to the review, neck and shoulder strengthening exercises are the most effective intervention to reduce musculoskeletal symptoms. Combat exercise is a very popular exercise during these years. This exercise combines strength and endurance training for the upper and lower extremity. However, the effect of combat exercise for neck/shoulder pain group has not been examined. Therefore, the purpose of this study was to evaluate the effect of six-week strengthening or combat exercise on pain, posture and muscle activity for symptomatic computer users while performing computer tasks. Method: This study included 43 symptomatic computer users and they were separated to three groups, strengthening, combat and stretching exercise group. There were 31 subjects completed the pre and post tests, including 13 subjects in strengthening group, 11 subjects in combat group and 7 subjects in stretching group. Subjects performed 8-minute preferred speed typing, fast speed typing and mouse clicking task before and after exercise intervention. While performing the computer task, posture of head, neck and upper extremity were recorded by six motion captured cameras. Surface electromyography of bilateral cervical erector spinae, upper trapezius, sternocleidomastoid, right flexor carpi radialis and extensor digitorum were recorded. Neck range of motion, neck/shoulder strength and pain threshold were also assessed. Standardized Nordic questionnaire, Chinese Health Questionnaire, neck disability index and fear-avoidance beliefs questionnaire were used to assess psychological stress and neck/shoulder disability. Analysis of variance with repeated measure on speed (preferred and fast speed typing), effect(pre and post) and time(2nd,5th ,8th minute) was used to evaluate posture , postural variability and muscle activity among three groups. Comparison of questionnaires among the groups was made using Wilcoxon signed ranks test and Kruskal-Wallis test. Results: After six-week exercise intervention, all groups significantly improved their neck range of motion, neck/shoulder strength, pain threshold and pain score, but there were no significant differences among three groups. The Combat group significantly decreased scores on Chinese Health Questionnaire, neck disability index and fear-avoidance beliefs questionnaire. The Strengthening group significantly decreased scores on neck disability index. Although the Stretching group decreased scores on these questionnaire but it did not reach the significant level. All of the subjects showed improvement on forward head posture and neck/shoulder muscle activity while performing the computer task. Both Strengthening and Combat group obtained more improvement on bilateral upper trapezius during typing and on right upper trapezius during mouse clicking than stretch group, although not significantly. Conclusion: The symptomatic computer users increased their neck range of motion, neck/shoulder strength, pain threshold, decreased neck/shoulder pain score, psychological stress and neck/shoulder disability after six-week intervention. In the future, these exercise programs may be applied in clinical intervention or prevention of neck/shoulder pain among computer users.
論文目次 英文摘要 I
中文摘要 III
致謝 V
目錄 VI
表目錄 VIII
圖目錄 IX
第一章 文獻回顧 1
第1節 電腦使用率 1
第2節 肩頸累積性傷害與盛行率 1
第3節 電腦工作姿勢與肌電圖 2
第4節 治療介入 4
4-1 電腦工作環境調整 4
4-2 運動治療 5
4-2.1 伸展運動 5
4-2.2 肩頸肌力訓練 6
4-2.3 顱頸深層屈曲肌運動 7
4-2.4 全面性運動 8
第5節 研究動機與問題 8
第6節 研究目的 9
第二章 研究方法 10
第1節 受試者 10
第2節 實驗設計與過程 11
第3節 運動訓練 11
3-1 肩頸肌力訓練組 12
3-2 拳擊有氧訓練組 12
3-3 伸展運動控制組 13
第4節 儀器與參數 13
4-1 頸部活動度 13
4-2 頸部肌肉力量 13
4-3 肩頸疼痛閾值 14
4-4 問卷 14
4-5 姿勢與肌電圖 15
第5節 電腦工作 16
第6節 統計方法 16
第三章 結果 18
第1節 基本資料 18
第2節 頸部活動角度 18
第3節 肩頸肌力 19
第4節 肩頸肌肉疼痛閾值 20
第5節 上半身疼痛分數 20
第6節 問卷 21
第7節 電腦工作表現 22
第8節 運動頻率與時間 22
第9節 電腦打字工作 24
9-1 身體姿勢 24
9-1.1 上肢姿勢 24
9-1.2 頭頸姿勢 25
9-2 身體角度變異度 27
9-3 肩頸與前臂肌電圖 29
第10節 電腦滑鼠敲擊工作 34
10-1 身體姿勢 34
10-2 身體角度變異度 36
10-3 肩頸與前臂肌電圖 36
第四章 討論 39
第1節 頸部活動度 39
第2節 肩頸疼痛閾值 41
第3節 上半身疼痛分數 42
第4節 肩頸肌力 43
第5節 問卷 44
第6節 打字工作 45
6-1 運動效果 45
6-2 打字速度 48
6-3 時間 48
第7節 滑鼠敲擊 50
7-1 運動效果 50
7-2 時間 51
第8節 研究限制 52
第9節 臨床貢獻 53
第五章 研究結論 54
表 55
圖 73
參考文獻 90
附錄 96
作者背景 102
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