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系統識別號 U0026-2808201415424600
論文名稱(中文) 下肢矯正性貼紮對於患有髕股關節痛籃球員之立即效益
論文名稱(英文) Immediate Effects of Hip Corrective Taping on Basketball Players with Patellofemoral Pain
校院名稱 成功大學
系所名稱(中) 物理治療學系
系所名稱(英) Department of Physical Therapy
學年度 102
學期 2
出版年 103
研究生(中文) 陳宜伶
研究生(英文) Yi-Ling Chen
電子信箱 vul4vul4@gmail.com
學號 T66001087
學位類別 碩士
語文別 英文
論文頁數 40頁
口試委員 口試委員-陳譽仁
口試委員- 徐阿田
指導教授-蔡一如
中文關鍵字 髕股關節痛  矯正性貼紮  疼痛  動作模式 
英文關鍵字 Patellofemoral pain  hip corrective taping  pain  movement patterns 
學科別分類
中文摘要 背景與目的:髕股關節痛好發於運動員,有多種不同的原因與此種疼痛的產生有關。一般認為髕骨的過度外傾在動作時會造成不正常的髕骨活動軌跡,進而使關節面間的壓力升高,影響軟骨及附近組織。近年來學者發現,在承重情況下,股骨內轉可能是造成髕骨外傾更重要的因素。許多研究也已證實髕股關節疼痛的患者在髖關節的動作學上有不同於正常人的模式。患者在動作時可能產生過多的髖關節內收及內轉動作,此現象可能與患者臀肌力量不足以及神經動作控制上的缺失有關。先前研究指出,使用髖關節穩定護具提供髕股關節痛患者在髖關節上外展及外轉的力量,有助於降低患者在動作時的疼痛,以及達到髖關節動作的矯正效果。然而,護具對於需要執行大量大幅度下肢動作的籃球運動員來說,穿戴上過於厚重不便,因此本篇研究利用肌內效貼布,嘗試提供髕股關節痛球員在髖關節上外轉及外展的矯正力量,來觀察球員們的疼痛及動作模式是否改變。方法:共12名有髕股關節痛的籃球員及14名健康籃球員參與此次實驗,以動作分析系統觀察兩組間動作的不同,以及使用下肢矯正之肌內效貼布對疼痛球員的動作學所產生的影響。動作任務包括模擬球員平常動作的上籃單腳跳以及靜態的單腳蹲動作。結果:髕股關節痛球員在上籃動作表現了比健康球員更多的膝蓋外轉動作,身體質量中心較為接近髖關節中心,然而髖關節的動作模式並無差異。單腳蹲的動作兩組在動作學上沒有差異。在貼上肌內效貼布之後,髕股關節痛球員在上籃跳時的膝蓋外轉減少,單腳蹲時,貼布使球員的疼痛降低,髖關節內轉也有減少的情形。結論:肌內效貼布對籃球員在動作時的模式矯正及疼痛控制上有一定的作用,臨床上可用於減少髕股關節痛球員的不適,對球員在傷害的預防上也有益處。
英文摘要 Background and Purpose: Patellofemoral pain syndrome (PFPS) is a common musculoskeletal disorder on athletes. The etiology was feathering multi-factorial. Femur internal rotation was proved to contribute in patella lateral laterization position in patients with PFPS. Excessive hip adduction and internal rotation during various tasks were recognized in patients with PFPS and associated with the increased stress of patellofemoral joint. Therefore, hip movement control can be an important issue when making management decision. Hip stabilization brace was proved to be effective in pain reduction, decreasing hip internal rotation and improving posture stability. Kinesio taping has been applied in the upper extremity for movement correction. However, whether applying Kinesio taping is able to correct the movement patterns of the lower extremity during weight bearing activities remains unknown. Therefore, the purpose of this study was to investigate the immediate effects of hip corrective taping on hip and knee movements during lay-up jump and single-leg squat in basketball players with PFPS. Methods: 12 basketball players (10 males, 2 females) with PFPS and 14 healthy (10 males, 4 females) player were asked to perform lay-up jump and single-leg squat with and without corrective taping. Whole body kinematics and ground reaction forces were recorded using Vicon 3D motion analysis system (200Hz) and an AMTI force plate (1000Hz). The primary objectives of corrective taping in this study were to limit hip adduction and internal rotation and provide guidance of hip abduction and external rotation during tasks. Thus, kinesio tape was applied from 3 cm below medial tibia epicondyle to 3 cm above ipsilateral anterior superior iliac crest spirally with maximal tension. Results: The PFPS group showed greater knee external rotation than healthy players (10.23° v.s. 4.88°) but no significant differences in hip joint kinematic during lay-up jump. However, distance between center of mass and hip joint center in PFPS group was shorter than control group. In terms of taping effects, for lay-up jump task at initial contact, the angle of knee external rotation was significantly decreased after taping. (10.24° vs. 8.02°, p = 0.038). For single-leg squat task, hip internal rotation was significantly decreased (7.94° vs. 4.72°, p = 0.050). A trend of decreased hip adduction were also observed (11.45° vs. 10.16°, p = 0.059). Conclusions: Corrective taping applied in this study may have the effects of decreasing hip adduction and internal rotation in basketball players with PFPS during both static and dynamic tasks. Clinical Relevance: The results of current study provided evidence for corrective taping in basketball players with PFPS to limit hip movement patterns associated with increased patellofemoral joint stress. Clinically this taping method may be beneficial for the other populations with PFPS.
論文目次 List of Contents
中文摘要 I
Abstract II
誌謝 IV
List of Contents V
List of Tables VII
List of Figures VIII
Chapter 1. Introduction 1
1.1. Background and Research Purposes 1
1.2. Hypothesis 2
Chapter 2. Literature Review 4
2.1. Epidemiology of patellofemoral pain syndrome 4
2.2. Biomechanics of patellofemoral joint 4
2.3. Etiology of patellofemoral pain syndrome 6
2.3.1. Patellofemoral pain syndrome is featuring with multifactorial etiology 6
2.3.2. Osseous structure abnormality 7
2.3.3. Muscle function deficiency 8
2.3.4. Neuromuscular control during dynamic tasks on patients with PFPS 10
2.4. Management of PFPS 10
2.4.1. Focus on patellar tracking and distal segment of lower extremity 10
2.4.2. Management focus on the control of hip joint 11
Chapter 3. Methods 13
3.1. Subjects 13
3.2. Instruments 13
3.2.1. Motion analysis system 13
3.2.2. Markers application 14
3.3. Procedure 14
3.3.1. Experiment protocol 14
3.3.2. Task 15
3.3.3. Hip corrective taping 15
3.4. Data reduction and analysis 16
3.4.1. Joint angle 16
3.4.2. The distance between center of mass and lower extremity joint centers 16
3.5. Statistics analysis 17
Chapter 4. Results 18
4.1. Differences between PFPS and control groups 18
4.1.1. Subjects characteristics 18
4.1.2. Kinematics differences between control group and pain group in lay-up jump 18
4.2. Taping effect 19
4.2.1. Kinematics change after taping application in PFPS group in lay-up jump 19
Chapter 5. Discussion 20
5.1. Kinematic difference between PFPS and controls 20
5.2. The effect of correction taping on PFPS subjects 21
5.3. Conclusion 23
5.4. Limitation 23
References 24
Appendix I. 40
List of Tables
Table 1. Basic data of control and pain group 31

Table 2. Hip, knee angle and distance between COM and hip and knee joint center control and pain group at initial contact 31

Table 3. Hip and knee angle at maximal ground reaction force 32

Table 4. Peak hip and knee angle in ground phase of lay-up jump 32

Table 5. Peak distance of COM and hip or knee joint center between control and PFPS group 33

Table 6. Peak hip and knee angle in ground phase between control and pain group of single-leg-squat 33

Table 7. Peak distance between COM and HJC and KJC of control and PFPS group in single-leg-squat 34

Table 8. Initial contact angle and distance between pre-taping and taping condition 34

Table 9. Hip and knee angle at maximal vertical ground reaction force between pre-taping and taping condition in pain group 35

Table10. Peak hip and knee angle and distance between pre-taping and taping condition 35

Table 11. Maximal distance of COM and hip or knee joint center between pre-taping and taping condition 36

Table 12. Visual analogy scale of pre-taping and taping condition 37

Table 13. Peak hip and knee angle between pre-taping and taping condition in single-leg squat 37

Table 14. Peak distance of hip and knee joint center to center of mass between pre-taping and taping condition in single-leg-squat 37
List of Figures
Figure 1. Possible etiology of PFPS 38

Figure 2. Lay-up jump illustration 38

Figure 3. Hip corrective taping 39
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