上肢阻力式結合振動式訓練對瘦弱女性骨質密度和骨骼代謝之影響

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上肢阻力式結合振動式訓練對瘦弱女性骨質密度和骨骼

代謝之影響

林瑞興

1

_、

_林吟映

1

_、滕文豹

2

_、林蕙君

1

_、涂瑞洪

1

國立屏東教育大學

1

_{、屏東基督教醫院}

2

摘要

目的：探討上肢阻力式結合振動式訓練對瘦弱女性骨質密度和骨骼代謝之影響。方法：篩選召募30個受試者，年齡18-22歲，身體質量指數較低(BMI＜18.5) 的非訓練年輕女性為研究對象，阻力式訓練組10人、阻力式結合振動式訓練組10 人及控制組10人。兩組訓練組均於每週一、三、五進行阻力訓練，每次1-3組，每組12-15下，訓練時間30-50分鐘，強度範圍為1RM的60-70%，包含全身八種訓練動作；另外，阻力式結合振動式訓練組先進行完阻力式訓練後再額外進行上肢振動式訓練，以頻率40Hz及振幅4g方式於每週一、三、五，每次3-5組，每組60 秒，組間休息30秒，非慣用手的方式進行；控制組未進行任何訓練。所有受試者於訓練前後測量下列變項：(1)身體質量指數：體重（kg）/身高2_{（m）來換算；}

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去的研究顯示在二十四週的振動式訓練計畫中，能有效地增加停經後婦女股骨頸骨質密度 (Verschueren et al., 2004) 。Stengel, Kemmler, Bebenek, Engelke, and Kalender (2010) 的研究指出，振動式訓練能明顯地增加腰椎骨質密度與腿部肌力。然而，長期的阻力式結合振動式訓練是否能有效地強化年輕瘦弱女性 (BMI ＜18.5) 的骨骼力量，並增加上肢的骨質密度，降低骨骼疏鬆症的風險，值得深入探討。二、研究目的上肢阻力式訓練組、上肢阻力式結合振動式訓練組與控制組三組在16週對瘦弱年輕女性 (BMI＜18.5) 骨質密度與骨骼代謝之影響。三、名詞定義解釋

（一）骨質密度 (bone mineral density)

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及振幅4g方式進行。

貳、研究方法

一、實驗對象本研究年齡 18-22 歲且 BMI<18.5 kg/m2_{未受訓練年輕女性為研究對象，透過} 校內網路、海報及教室走道間的宣傳，召募並經由健康狀況調查表篩選出受試者 30 名，分別為阻力式訓練組 10 名 (Group RT) 、阻力式結合振動式訓練組 10 名 (Group RT+VT) 與控制組 10 名 (Group CON)。

二、實驗時間民國100年9月3日至民國101年1月6日共16週。三、實驗地點國立屏東教育大學運動生理學實驗室、重量訓練室及屏東基督教醫院。四、實驗工具（一）參與研究說明、研究對象同意書、健康狀況調查表。（二）身體組成測量儀 (Inbody 720) ：檢測身高、體重、骨質重、體脂肪百分比、骨骼肌重等。（三）器械式重量訓練器材。（四）振動訓練儀器（如圖一）。圖一訓練儀器模式圖

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表二上肢阻力式結合振動式訓練對骨骼代謝之影響測試值組別前測後測交互作用（ F值）顯著性 OCN （ ng/ml） RT RT＋ VT C 25.2±5.1 30.3±9.6 24.5±7.8 25.0±6.6 29.5±8.6 23.4±9.0 0.18 NS CTx （ ng/ml） RT RT＋ VT C 0.60±0.19 0.59±0.18 0.53±0.16 0.54±0.20 0.74±0.31 0.58±0.12 2.25 NS *p<.05 NS：未達顯著差異

肆、分析與討論

一般正常人的骨質密度在兒童及青少年階段都會逐漸增加，男性大約 30 歲、女性 28 歲以前將會達到骨峰值 (peak bone mass)，Erickson and Sevier (1997) 指出，女性於 50 歲時在腰椎部位骨質密度平均下降 7%，在股骨部位平均下降 16% 。Bevie 等 (1988) 研究指出，骨質密度和其連結肌肉組織的力量呈顯著正相關。傳統阻力訓練可改善骨質密度及肌肉力量，因為具有高衝擊力 (high impact) 和負重 (weight bearing) 的運動型態對骨骼質量的增加較有助益 (Maimoun 等, 2004) 。本研究在骨質密度方面，以二因子混合設計變異數分析結果顯示如表一，RT 組（阻力訓練）及 RT+VT 組（阻力結合振動訓練）的效果在非慣用手前臂（上端、中間、遠端 1/3 及全部）、慣用手前臂（上端、中間、遠端 1/3 及全部）、腰椎（L1、L2、L3、L4 及全部）、股骨頸及臀部等骨質密度檢測項目上，均未有顯著的增加 (p＞.05) 。此與 Lohman 等研究相類似，其研究針對年輕女性進行十八個月長期的阻力訓練對骨骼的影響，結果指出透過阻力訓練全身、手臂與腿部之骨質密度未明顯改變 (Lohman et al., 1995) 。有篇研究針對大學女性為對象，進行十二個月的阻力訓練，結果指出，訓練後骨質量及骨質密度未明顯改變 (Heinonen, Sievänen, Kannus, Oja, & Vuori, 1996)。同樣研究在 Warren, Petit, Hannan, and Schmitz (2008) 針對 25 至 44 歲停經前女性為對象進行阻力訓練兩年，結果指出阻力組股骨頸及腰椎均未有顯著改變。

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骼代謝方面，以二因子混合設計變異數分析結果顯示如表二，RT 組（阻力訓練）及 RT+VT 組（阻力結合振動訓練）的效果在 OCN 及 CTx 檢測項目上，均未有顯著的增加 (p＞.05) 。Torvinen 等（2003）研究以 21 名男性和 35 名女性 19-38 歲為受試對象，隨機分為振動組及控制組，振動組分別進行每週 3-5 次，每次 4 分鐘，頻率 25-45Hz 訓練，經過八個月訓練後發現，振動組的骨骼代謝指標中，骨鈣素與 CTx 等均未明顯改變。Humphries, Fenning, Dugan, Guinane, and MacRae (2009) 針對 51 位健康年輕女性平均年齡為 21 歲，探討振動結合阻力訓練對年輕女性骨質密度之影響，結果指出，16 週的振動結合阻力訓練對骨骼代謝未明顯改變。本研究 16 週上肢阻力式結合振動式訓練無法明顯改善瘦弱女性骨質密度和骨骼代謝，但本研究提供器材研發上不同的思維和想法，後續將改良震動的型式和運動處方介入的模式。

致謝

本研究感謝行政院科技部補助計畫(計畫編號：NSC-100-2410-H-153-016)

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Effects of combined upper body resistance and vibration

training on bone mineral density and bone turnover

biomarkers in untrained weak women

Lin, Jui-Hsing

1

、Lin, Ying-Yin

1

、Teng, Wen-Bao

2

Lin, Hui-Chun

1

、Tu, Jui-Hung

1

National Pingtung University of Education

1

、Pingtung Christian Hospital

2

Abstract

The purpose of this study was to examine the effects of combined resistance and vibration training on bone mineral density and bone turnover markers in untrained weak women. Thirty subjects were recruited from untrained young women of body mass index (BMI＜18.5) accomplished the programs. They were including resistance training (RT, n=10), combined resistance and vibration training (RT+VT, n=10) and control group (CON, n=10). The resistance training protocol was eight exercises consisted of whole body, 1-3 sets, 12-15 repetitions with 60-70% 1RM and 30-50 min of resistance training groups, with training 3 times (Mon., Wed., and Fri.) per week. RT+VT group had received upper body vibration exercise after resistance training. It was composed of 60 seconds on/ 30 seconds off arm curved positioning in frequency of 40 Hz and amplitude of 4g and would be repeated 3-5 times in a training set. Control group maintained their regular lifestyles without training. The following dependent variables of all subjects were measured before and after 16 weeks of training: 1) Body mass index (BMI) by measuring weight (kg) and height (m), 2) Bone mineral density (BMD) of the left and right forearm, at lumbar (L1-4), and

femoral neck using a dual energy X-ray absorptiometry (DEXA), and 3) Bone turnover markers: measuring plasma osteocalcin (OCN) and C-terminal telopeptide (CTx). The collected data were analyzed by two-way analysis of variance (group × time) with repeated measures to examine after training. The results indicated that the bone mineral density (forearm, lumbar, and femoral neck) and bone turnover biomarkers (OCN, and CTx) showed no changes (p>.05) among three groups after 16-week of RT or RT+VT. We concluded that there are no effects on bone mineral density and bone turnover markers after combined resistance and vibration training in untrained weak women. But this study provided the thinking on vibration training machine and exercise prescription design.

上肢阻力式結合振動式訓練對瘦弱女性骨質密度和骨骼代謝之影響