穿著足弓支撐鞋墊對低足弓大學生走路之影響

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Title:	穿著足弓支撐鞋墊對低足弓大學生走路之影響 Effect of Arch Support Insoles for Colledge Students with Low Arch Feet During Walking
Authors:	黃宇平
Contributors:	體育學系運動教練碩博士班
Keywords:	疲勞肌電圖足底壓力上坡走路下坡走路走路速度 fatigue EMG plantar pressure uphill walking downhill walking walking speed
Date:	2018
Issue Date:	2018-05-08 16:16:34 (UTC+8)
Abstract:	本研究目的是比較穿足弓支撐鞋墊在上坡、下坡和平坡走路時，對男女扁平足族群足底壓力立即性的影響及下肢肌電訊號疲勞現象之影響。以男女扁平足大學生各15名為受試者，運用 Delsys無線肌電訊號系統和Tekscan 無線足底壓力系統為實驗工具，受試者隨機選擇未穿或穿足弓支撐鞋墊及隨機在上坡、下坡和平坡，先走路30秒量測足底壓力，卸除無線足底壓力系統後，再走路6分鐘量測肌電圖。上坡和下坡都在不同的一天執行，間隔至少24小時。肌電訊號裁減前 (0-60 秒)、後 (300-360 秒) 各一分鐘的數據，當作是疲勞前和疲勞後數據，功率頻譜分析視窗的類型選擇Hanning，分析視窗的長度為0.5秒，分析視窗的部分重疊為0.375秒，選取功率頻譜低頻部分 (15-45 Hz) 計算出功率頻譜低頻面積。足底壓力訊號主要分為足前、足中和足跟3部份，然後再細分為9個區域，計算出步態時間和足壓各分區之峰值壓力、接觸面積、力量-時間積分值和壓力與時間積分值。所得之數據經SPSS 18.0 統計軟體分析，運用同質性檢驗男女肌電訊號和足底壓力訊號之參數，若發現男女性不同質，則進一步將男女資料分開呈現，並且運用重複量數變異數分析於此次的統計檢驗中，顯著性水準設定為α = .05。結果顯示男性在上坡行走時，腓腸肌在疲勞前功率頻譜低頻面積，表現出未穿足弓支撐鞋墊大於穿足弓支撐鞋墊。女性在上坡行走時脛骨前肌亦表現出未穿足弓支撐鞋墊大於穿足弓支撐鞋墊，且股二頭肌、股直肌和腓腸肌功率頻譜低頻面積疲勞前大於疲勞後。男性在下坡行走時，脛骨前肌、股二頭肌和腓腸肌功率頻譜低頻面積都是疲勞前大於疲勞後。女性下坡行走時，股直肌和股二頭肌功率頻譜低頻面積亦是疲勞前大於疲勞後，且腓腸肌表現出未穿足弓支撐鞋墊功率頻譜低頻面積大於穿足弓支撐鞋墊。另外從足底壓力訊號中發現，穿足弓支撐鞋墊能夠更快速完成每個步態，並且在足跟區域表現出較小的峰值壓力。從接觸面積中發現，穿足弓支撐鞋墊增加了接觸面積，可能與足中區域被撐起相關。從壓力-時間積分中發現，穿足弓支撐鞋墊在足跟內側和足跟外側，能有效的降低壓力-時間積分值。在力量-時間積分中發現，穿足弓支撐鞋墊足跟區域較未穿足弓支撐鞋墊小，代表穿足弓支撐鞋墊能夠提供足跟區域在步態行走中更高的舒適度。結論，從肌電訊號中發現穿足弓支撐鞋墊，對於減緩低足弓族群肌肉疲勞具有正面的幫助。從足底壓力的方面發現，穿足弓支撐鞋墊能夠縮短每個步態的時間。對於減緩足跟區域的峰值壓力有立即性正面的幫助。足中部分在穿足弓支撐鞋墊時，能夠增加與地面的接觸面積，亦能分散足中區域受地面反作用力衝擊時的壓力值。穿足弓支撐鞋墊在足跟內側和外側均顯示，能有效的降低壓力-時間積分值，此外，穿足弓支撐鞋墊在足跟區域力量-時間積分值較未穿足弓支撐鞋墊小，代表穿足弓支撐鞋墊舒適度較高。 The main purpose of this study was to understand the immediate effect of arch support insoles on plantar pressure and lower limbs muscle fatigue of colledge students with flatfeet during uphill, downhill and level walking. This study recruited fifteen female and fifteen male subjects with flatfeet and utilized Delsys wireless EMG systems and Tekscan wireless plantar pressure system as research tools. Researchers collected the plantar pressure parameter of subjects who randomly chose to wear insoles with and without arch support and walk on uphill, downhill or level for thirty seconds and then collected EMG data of lower limbs for six minutes during walking without wireless plantar pressure system. Uphill walking and downhill walking should be performed on different days with at least twenty-four hours’ time lapse. We extracted the first stance (0-60 seconds) and the last stance (300-360 seconds) EMG data as pre-fatigue and post-fatigue EMG data, respectively. We set window type of power spectrum at Hanning, window length at 0.5 second and window overlap at 0.375 seconds, then chose low frequency part (15-45 Hz) of the power spectrum to calculate the area of the low frequency part. Researchers divided plantar pressure data mainly into three parts: forefoot, midfoot and heel and then subdivided into nine areas in order to calculate peak pressure, contact area, pressure- time integral and force-time integral. Collected data were analyzed by SPSS 18.0 using homogeneity to test male and female EMG and plantar pressure signals. If we found different quality existed between male and female subjects, we would further presented male and female data separately and apply the repeated measures define factors test in this statistic test setting the level of significance at p < .05. The results showed males’ power spectrum low-frequency area of gastrocnemius in pre-fatigue without arch support insoles was larger than that with arch support insoles during uphill walking. Females’ power spectrum low-frequency area of tibialis anterior without arch support insoles was also larger than that with arch support insoles, and females’ power spectrum low-frequency area of biceps femoris, rectus femoris, and gastrocnemius were larger in pre-fatigue than those in post-fatigue. During downhill walking, males’ power spectrum low-frequency area of tibialis anterior, biceps femoris and gastrocnemius in per-fatigue was larger than those in post-fatigue. Females also displayed larger power spectrum low-frequency areas of rectus femoris and biceps femoris in per-fatigue than those in post-fatigue. Furthermore, females’ power spectrum low-frequency area of gastrocnemius was larger without arch support insoles than those with arch support insoles. In terms of the plantar pressure signals, subjects with arch support insoles can complete each gait more quickly and displayed less peak pressure in the heel. We found that wearing arch support insoles increased the contact area which might be associated with the sustained mid-foot area. Wearing arch support insoles can effectively reduce the pressure-time integral in the medial and lateral heel. Wearing arch support insoles showed small force-time integral in the heel which represented arch support insoles provided comfortableness for the heel during walking. In conclusion, in terms of the EMG, this study revealed that wearing arch support insoles showed positive effect on reducing muscle fatigue of colledge students with low arch. In terms of the plantar pressure, wearing arch support insoles can shorten the time of each gait and immediately relieve the peak pressure in the heel. Wearing the arch support insoles can increase the contact area of midfoot and disperse the pressure of the midfoot under the impact of the ground reaction force. Wearing arch support insoles effectively reduced the pressure-time integral in the medial and lateral heel and showed small force-time integral which represented high comfortableness with arch support insoles.
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