• 沒有找到結果。

第陸章 結論與建議

第一節 結論

一、 不同運動項目之間的側向跨步切入有不同的下肢關節動作和負荷,即 女性足球員有較小的著地時膝關節屈曲、踝關節蹠屈,和較大的膝關 節內旋角度、髖關節外展角度、踝關節外翻,和較大的膝關節外翻力 矩。而在最大膝關節外翻力矩峰值時,女性籃球員有較大的膝關節外 翻。本研究發現可能在運動項目之間有動作控制的特殊性。

二、 儘管近距離防守的側向跨步切入有較大的膝關節負荷,但即使面對較 遠距離的防守,女性運動員也需防範膝關節角度超出了合理的動作範 圍。

第二節 建議

一、 建議女性運動員需要發展良好的減速動作或訓練,例如側向跨步切入 過人時的動作控制,同時要增強神經肌肉訓練。

二、 建議女性足球運動員要增加著地時膝關節屈曲;女性籃球運動員要避 免過度的膝關節外翻,且專項訓練時應加以評估和預防非接觸膝關節 前十字韌帶傷害的發生。

附錄一

受試者同意書

題目:女性不同運動項目和防守距離對側向跨步切入之膝關節負荷的影響 指導教授:劉錦璋 教授

研究生:李佳美

單位:國立台灣師範大學體育研究所

實驗地點:國立台灣師範大學體育研究所力學實驗室

依實驗研究的規定與保護受試者權益,研究者應將研究過程可能發生 的危險和法律上的責任等事宜,向受試者說明清楚。而研究者應盡其所能 保護受試者的健康與權益,並隨時回答受試者的問題。受試者如有改變意 願時應通知實驗者,可隨時退出實驗而不受任何限制。參與實驗研究的受 試者必須明瞭並注意下列事項:

一、本實驗參與兩種不同防守距離的側向跨步急切動作,請務必瞭解實驗 說明,並盡全力配合及表現。

二、實驗過程使用Vicon 3D動作分析系統和測力板來收集資料。

三、須先行熱身至微微出汗以免傷害之虞。

四、聽實驗者施號即按照實驗動作執行,儘可能與實際情境一致。

五、實驗過程中若有任何不適請立即告知。

本實驗感謝您的參與合作,才能圓滿順利。請您於下表姓名欄內簽名,

表示同意並遵守上述之各項規定。

自願者: 簽名 日期: 年 月 日

附錄二

受試者基本資料表

在您瞭解本實驗並願意配合參與本實驗後,請詳細填寫下列各項基本 資料,讓實驗者了解您的生理狀況及運動背景,讓實驗可以順利進行。而 您所填寫的各項資料將會受到嚴格保密,敬請合作,謝謝。

受試者姓名:

出生日期 : 年 月

身高: 公分 體重: 公斤 球齡: 年

慣用邊:□左 □右

球員位置:

就讀學校系所:

最佳成績/經歷:

是否受過運動傷害:□是 □否 ,如受過傷,受傷部位:

是否痊癒:□是 □否

編號 肢段名稱 右Right (cm) 左Left (cm)

1 左右邊前上髂棘寬 2 大轉子寬

3 膝寬 4 踝寬 5 腳寬 6 腳長 7

8 備註

謝謝您如實的填寫!

附錄三

受試者實驗紀錄表

受試者姓名: 編號:

實驗流程

編號 近距離防守 備註 遠距離防守 備註

01 02 03 04 05

附錄四 Visual 3D名詞解釋

(資料來源:http://www.c-motion.com/help)

※Joint Angle關節角度

The default convention that Visual3D uses to define joint angles 定義關節角度方向 The default segment coordinate system in Visual3D is defined as follows:

Right Leg

x-lateral, y-anterior, z-up

The default Cardan sequence for the calculation of joint angles is x-y-z, which is equivalent to flexion/extension - abduction/adduction - axial rotation. The default sign conventions for describing the joint angles are as follows:

Right Leg

Ankle (DFL+) (EVER+) (FFADDUCTION+) Knee(EXT+) (ADD+) (INTROT+)

Hip(FL+)(ADD+) (INTROT+)

Transformation Matrix 旋轉矩陣計算

A Joint Angle is the transformation between two coordinate system that is described by a rotation matrix.

This rotation matrix is rarely used to report the joint angle. From the rotation matrix several different representations are possible, such as Cardan/Euler angle, Helical angle, Quaternion.

All representations of the transformation are equivalent but the interpretation of the joint angle relative to the anatomy varies with the description.

For example, the Cardan sequence XYZ as represented in the following transformation matrix αβγ can be computed as follows:

Step 1: compute β

Step 2: compute α

Step 3: compute γ

For example, represent the rotation matrix as:

Resolve the joint angle as follows:

※Joint Moment 關節力矩

Visual3D always follows the right hand rule. The direction of positive rotation about the axis u (red arrow aligned with the right thumb) in the above figure is in the direction of curl of the fingers (blue arrow)

In order to determine the sign of the joint moment, the user must visualize the segment coordinate system that the moment is resolved into, then follow the right hand rule. For example, consider the knee moment. The typical knee moment is defined as the shank with respect to the thigh. The default segment coordinate system in Visual3D is x-lateral,

y-anterior, z-axial. Therefore, knee extension moment is positive, knee adduction moment is positive, and internal rotation is positive.

[Kinetics Overview]

Internal vs External Joint Moment 內在的和外在的關節力矩 Visual3D calculates the Internal Moment.

The external moment is balanced by the net internal moment produced by the muscles and ligaments. For example, a net internal moment dominated by the quadriceps muscles would be needed to balance an external flexion moment.

Mathematically, the external moment is equal and opposite to the internal moment, but the user is cautioned to reference the term if it is used in an article.

Note: The external moment is a term that is not commonly used.

Inverse Dynamics Calculations in Visual3D 逆動力學計算

Kinetics is the study of the forces and moments that cause motion of a body. For human movement, biomechanics attempt to determine the forces that result from muscle contractions and the torques that are produced, which together bring about the movement of the segments and thus of the whole body.

Visual3D's inverse dynamics calculations are implemented using the following recursive scheme. One of the features of the inverse dynamics algorithms is that it is straightforward to add external forces and torques to any segment.

The Proximal Joint Reaction force is computed in the Global Coordinate System. The segments attached distally to any segment are identified (e.g. for a conventional lower body gait analysis the pelvis segment as two distal chains comprising a thigh, shank, and foot segment. An iterative algorithm for the proximal joint force, which allows any applied external force on segments is:

The Proximal Couple (moment) computed at the proximal end of a segment is computed in a segment (local) coordinate system:

Transform the inertial torque from the Segment Coordinate System into the Global (Laboratory) Coordinate System using a transformation matris that is computed from the motion capture data.

The Couple acting on a segment due to the inertial terms is:

Expanding the Force terms and reducing the resulting equation yields the proximal moment due to the inertial forces and applied moments at the joint.

An advantage of this recursive formulation is that the approach is generalizable because there is substantially less bookkeeping required to keep track of the external forces and torques.

殘差(A×S) 87.179 18 4.843

全體 Total 1439.258 39

*p<.05

表 14 膝關節外翻力矩峰值時的膝關節外翻角度變異數分析摘要表

變異來源 SS df MS F η2

運動項目(獨立樣本) 104.998 1 104.998 8.473* 0.320

防守距離(重複量數) 0.452 1 0.452 1.606 0.082

運動項目×防守距離 0.004 1 0.004 0.015 0.001

組內(誤差)

受試者間 S 223.049 18 12.392

殘差(A×S) 5.062 18 0.281

全體 Total 333.565 39

*p<.05

表 15 膝關節外翻力矩峰值時膝關節內旋角度變異數分析摘要表

變異來源 SS df MS F η2

運動項目(獨立樣本) 6.255 1 6.255 0.147 0.008

防守距離(重複量數) 0.009 1 0.009 0.011 0.001

運動項目×防守距離 7.161 1 7.161 9.119* 0.336

組內(誤差)

受試者間 S 766.023 18 42.557

殘差(A×S) 14.136 18 0.785

全體 Total 793.584 39

*p<.05

表 15-1 膝關節外翻力矩峰值時膝關節內旋角度的單純主要效果變異數分析摘要表

變異來源 SS df MS F

運動項目(獨立因子)

近距離防守 0.015 1 0.015 0.001

遠距離防守 13.401 1 13.401 0.618

誤差(殘差) 780.159 36 21.671

籃 8 103.33 100.75 -18.68 -17.84 -25.78 -26.03 籃 9 98.31 99.33 -15.11 -16.76 -26.20 -26.44 籃 10 110.61 114.45 -11.98 -12.13 -21.80 -20.22

各受試者膝關節各力矩峰值

參數 膝關節屈曲力矩 膝關節外翻力矩 膝關節內旋力矩

近 遠 近 遠 近 遠

足 1 -0.55 -0.37 -1.70 -1.05 0.59 0.48 足 2 -0.35 -0.67 -2.23 -1.75 0.89 0.73 足 3 -0.52 -0.44 -1.60 -2.15 0.88 0.90 足 4 -0.83 -0.99 -2.03 -2.05 0.86 0.94 足 5 -1.69 -0.70 -2.53 -2.26 0.90 0.48 足 6 -0.68 -0.62 -2.40 -2.13 1.18 0.99 足 7 -0.40 -0.29 -1.28 -1.37 0.82 0.71 足 8 -0.29 -0.26 -1.26 -1.20 0.37 0.32 足 9 -0.38 -0.36 -1.83 -2.11 0.60 0.86 足 10 -0.61 -0.40 -0.63 -0.46 0.34 0.33 籃 1 -0.34 -0.44 -1.07 -1.20 0.39 0.44 籃 2 -0.70 -0.68 -1.28 -1.14 0.41 0.49 籃 3 -0.75 -0.72 -0.75 -0.84 0.21 0.30 籃 4 -0.63 -0.69 -1.48 -1.87 0.44 0.48 籃 5 -0.50 -0.58 -1.19 -1.70 0.60 0.78 籃 6 -0.45 -0.38 -1.03 -1.01 0.38 0.30 籃 7 -0.43 -0.45 -1.21 -0.89 0.66 0.46 籃 8 -0.12 -0.11 -1.11 -1.17 0.23 0.27 籃 9 -0.73 -0.62 -1.40 -1.56 0.75 0.71 籃 10 -0.86 -0.74 -1.58 -1.10 1.07 0.82

參考文獻

一、中文部分

王進華 (2007)。女性籃球運動員與前十字韌帶傷害之關係。大專體育第90 期。頁183~191。

王顯智 (2003)。膝關節的運動解剖學探討。中華體育季刊第20卷第2期。頁 20~26。

柴新、王華 (2010)。足球運動中膝關節損傷研究。河南師範大學學報 第38 卷第4期。頁167~169。

曹育翔、林世澤 (2002) 。認識膝關節前十字韌帶運動傷害。大專體育第60 期。169~176頁。

許孟霖、林晉利 (2009)。神經肌肉訓練降低非接觸性前十字韌帶傷害之效 果。大專體育第101期。頁210~216。

詹明昇 (2008)。運球側向跨步切入動作對女子籃球員膝關節負荷的影響。

國立臺灣師範大學體育研究所。未出版碩士論文。

燕小妮、任超學 (2008)。膝關節內側副韌帶運動損傷原因及治療效果調查。

中國組織工程研究與臨床康復第12卷第28期。頁5567~5570。

二、英文部分

Agel, J., Arendt, E.A., & Bershadsky, B. (2005). Anterior cruciate ligament injury in national collegiate athletic association basketball and soccer: A 13-Year Review. American Journal of Sports Medicine, 33, 524–531.

Agel, J., Olson, D.E., Dick, R., Arendt, E.A., Marshall, S.W., & Sikka, R.S.

(2007). Descriptive Epidemiology of Collegiate Women’s Basketball Injuries: National Collegiate Athletic Association Injury Surveillance

System, 1988–1989 Through 2003–2004. Journal of Athletic Training, 42(2), 202-210.

Arendt, E.A., & Dick, R. (1995). Knee injury patterns among men and women in collegiate basketball and soccer: NCAA data and review of literature.

American Journal of Sports Medicine, 23(6), 694-701.

Arendt, E.A., Agel, J., & Dick, R. (1999). Anterior Cruciate Ligament Injury Patterns Among Collegiate Men and Women. Journal of Athletic Training, 34(2), 86–92.

Besier, T. F., Lloyd, D. G., & Ackland, T. R. (2003). Muscle Activation Strategies at the Knee during Running and Cutting Maneuvers. Medicine and science in sports and exercise, 35(1), 119–127.

Besier, T. F., Lloyd, D. G., Ackland, T. R., & Cochrane, J. L. (2001b).

Anticipatory effects on knee joint loading during running and cutting maneuvers. Medicine and science in sports and exercise, 33, 1176-1181.

Besier, T. F., Lloyd, D. G., Cochrane, J. L., & Ackland, T. R. (2001a). External loading of the knee joint during running and cutting maneuvers. Medicine and science in sports and exercise, 33(7), 1168-1175

Boden, B.P., Dean, G.S., Feagin, J.A. Jr., & Garrett, W.E. Jr. (2000).

Mechanisms of anterior cruciate ligament injury. Orthopedics, 23, 573-578.

Borotikar, B.S., Newcomer, R., Koppes, R., & McLean, S.G.(2008). Combined effects of fatigue and decision making on female lower limb landing postures: Central and peripheral contributions to ACL injury risk. Clinical Biomechanics, 23, 81-92.

Butler, D. L., Noyes, F. R., & Grood, E. S. (1980). Ligamentous restraints to anteriorposterior drawer in the human knee. A biomechanical study.

Journal of Bone and Joint Surgery, 62, 259-270.

Chappell J.D., Yu, B., Kirkendall, D.T., & Garrett, W.E. (2002). A Comparison of knee kinetics between male and female recreational athletes in stop-jump tasks. American Journal of Sports Medicine, 30, 261-267.

Cochrane, J. L., Lloyd, D.G., Buttfield, A., Seward, H., & McGivern, J. (2007).

Characteristics of anterior cruciate ligament injuries in Australian football.

Journal of Science and Medicine in Sport, 10, 96-104.

Cowley, H.R., Ford, K.R., Myer, G.D., Kernozek, T.W., & Hewett, T.E.(2006).

Differences in Neuromuscular Strategies Between Landing and Cutting Tasks in Female Basketball and Soccer Athletes. Journal of Athletic Training, 41(1), 67–73.

Davis, I.I.I., Ounpuu, S., Tyburski, D., & Gage, J.R. (1991). A gait analysis data collection and reduction technique. Human Movement Science, 10, 575-587.

Dick, R., Putukian, M., Agel, J., Evans, T.A., & Marshall, S.W. (2007).

Descriptive Epidemiology of Collegiate Women’s Soccer Injuries: National Collegiate Athletic Association Injury Surveillance System, 1988–1989 Through 2002–2003. Journal of Athletic Training, 42(2), 278-285.

Ferber, R., Davis, I.M., & Williams, D.S. ( 2003). Gender differences in lower extremity mechanics during running. Clinical Biomechanics, 18, 350-357.

Fleming, B.C., Renstrom, P.A., Beynnon, B.D., Engstrom, B., Peura, G.D., Badger, G.J., & Johnson, R.J. (2001a). The effect of weightbearing and external loading on anterior cruicate ligament strain. Journal of Biomechanics, 34, 163-170.

Ford, K. R., Myer, G. D., Toms, H. E., & Hewett, T. E. (2005). Gender

differences in the kinematics of unanticipated cutting in young athletes.

Medicine & Science in Sports, 37, 124-129.

Ford, K.R., Myer, G.D., & Hewett, T.E. (2003). Valgus knee motion during landing in high school female and male basketball players. Medicine and Science in Sports and Exercise, 35, 1745-1750.

Frank, C.B., & Jackson, D.W. (1997). Current concepts review - the science of reconstruction of the anterior cruciate ligament. The Journal of Bone and Joint Surgery, 79, 1556-1576.

Fukubayashi, T., Torzilli, P. A., Sherman, M. F., & Warren, R. F. (1982). An in vitro biomechanical evaluation of anterior-posterior motion of the knee.

Tibial displacement, rotation, and torque. The Journal of Bone and Joint Surgery, 64, 258-264.

Gillquist, J, & Messner, K. (1999). Anterior cruciate ligament reconstruction and the long-term incidence of gonarthrosis. Sports Medicine, 27(3), 143-156.

Griffin, L.Y., Agel, J., Albohm, M.J., et al. (2000). Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies. Journal of the American Academy of Orthopaedic Surgeons, 8(3), 141–150.

Hewett, T. E., Myer, G. D., Ford, K. R., Heidt, R. S., Jr., Colosimo, A. J., McLean, S. G., van den Bogert, A. J., Paterno, M. V., & Succop, P. (2005).

Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. American Journal of Sports Medicine, 33, 492-501.

Hewett, T.E., Lindenfeld, T.N., Riccobene, J.V., & Noyes, F.R. (1999). The effect of neuromuscular training on the incidence of knee injury in female athletes: a prospective study. American Journal of Sports Medicine, 27,

699-706.

Houck,J.R. ,Duncan, A., De Haven, K.E. (2006). Comparison of frontal plane trunk kinematics and hip and knee moments during anticipated and unanticipated walking and side step cutting tasks. Gait & Posture, 24, 314-322.

Krosshaug, T., Nakamae, A., Boden, B. P., Engebretsen, L., Smith, G., Slauterbeck, J. R., Hewett, T. E., & Bahr, R. (2007). Mechanisms of anterior cruciate ligament injury in basketball: video analysis of 39 cases.

American Journal of Sports Medicine, 35, 359-367.

LaPrade, R. F., Wentorf, F. A., Fritts, H., Gundry, C., & Hightower, C. D.

(2007). A prospective magnetic resonance imaging study of the incidence of posterolateral and multiple ligament injuries in acute knee injuries presenting with a hemarthrosis. Arthroscopy, 23, 1341-1347.

Li, G., Rudy, T. W., Sakane, M., Kanamori, A., Ma, C. B., & Woo, S. L.

(1999b). The importance of quadriceps and hamstring muscle loading on knee kinematics and in-situ forces in the ACL. Journal of Biomechanics, 32, 395-400.

Lloyd, D.G., Buchanan, T.S., & Besier, T.F. (2005). Neuromuscular biomechanical modeling to understand knee ligament loading. Medicine &

Science in Sports & Exercise, 37, 1939-1947.

Ireland M.L.(1999). Anterior cruciate ligament injury in female athletes:

epidemiology. Journal of Athletic Training, 34(2),150-4.

Malinzak, R.A., Colby, S. Kirkendall, D. & Garrett, W. E. (2001). A comparison of knee joint motion patterns between men and women in selected athletic tasks. Clinical Biomechanics, 16, 438-445.

Matsumoto, H., Suda, Y., Otani, T., Niki, Y., Seedhom, B.B., & Fujikawa, K.

(2001). Roles of the anterior cruciate ligament and the medial collateral ligament in preventing valgus instability. Journal of Orthopaedic Science, 6(1), 28-32.

McLean, S. G. Huang, X., Antonie, & J. van den Bogert. (2005). Association between lower extremity posture at contact and peak knee valgus moment during sidestepping: Implications for ACL injury. Clinical Biomechanics, 20, 863-870.

McLean, S. G., Huang, X., & van den Bogert, A. J. (2008). Investigating isolated neuromuscular control contributions to non-contact anterior cruciate ligament injury risk via computer simulation methods. Clinical Biomechanics, 23, 926-936.

McLean, S.G., Felin, R.E., Suedekum, N., Calabrese, G., Passerallo, A., & Joy, S.(2007). Impact of fatigue on gender-based high-risk landing strategies.

Medicine & Science in Sports & Exercise, 39, 502-514.

McLean, S.G., Huang, X., Su, A., & Van Den Bogert, A.J.( 2004b). Sagittal plane biomechanics cannot injure the ACL during sidestep cutting. Clinical Biomechanics, 19, 828-838.

McLean, S.G., Lipfert, S.W., & Van Den Bogert, A.J. (2004a). Effect of gender and defensive opponent on the biomechanics of sidestep cutting. Medicine and Science in Sports and Exercise, 36, 1008-1016.

McLean, S.G., Neal, R.J., Myers, P.T., & Walters, M.R.(1999). Knee joint kinematics during the sidestep cutting maneuver: potential for injury in women. Medicine and Science in Sports and Exercise, 31, 959-968.

McNair, P.J., Marshall, R.N., & Matheson, J.A. (1990). Important features

associated with acute anterior cruciate ligament injury. The New Zealand Medical Journal, 103, 537-539.

Mesfar, W., & Shirazi-Adl, A. (2006b). Knee joint mechanics under quadriceps-hamstrings muscle forces are influenced by tibial restraint.

Clinical Biomechanics, 21, 841-848.

Myer, G. D., Ford, K.R., & Hewett, T. E. (2004). Rationale and Clinical

Myer, G. D., Ford, K.R., & Hewett, T. E. (2004). Rationale and Clinical

相關文件