本文選題：肩胛骨動力學　切入點：表面肌電　出處：《北京體育大學》2017年碩士論文

【摘要】：目的:肩胛骨動力障礙表現為靜止時肩胛骨位置和(或)運動時肩胛骨軌跡異常。其有三種不同類型,各型肩胛帶肌群激活特點尚不明確,且不同康復動作的針對性效果有待進一步研究。本研究從肩胛骨動力障礙的分型著手,分析不同類型肩胛骨動力障礙肩胛帶肌群的表面肌電特征,對比分析推肩俯臥撐及PNF上肢運動模式等康復動作中肩胛肌群的激活特征,為制定更有針對性的SD康復計劃提供依據。方法:本研究招募北京體育大學上肢過頂項目運動員26名,按照肩胛骨動力障礙分型金標準方法,對26名受試者的每側肩胛骨(52個肩次)進行分型,分為下角型(21人)、內側緣型(11人)、上緣型(4人)和正常型(16人)。采集受試者在肩胛骨動力障礙分型動作、推肩俯臥撐及PNF上肢運動模式中肩胛帶肌群的表面肌電數據。結果:(1)肩上舉過頂運動員中肩胛骨動力障礙的發(fā)生率為69.2%,其中I型(下角型)占40.4%;IV型(正常型)為30.8%;II型(內側緣型)占21.1%;III型(上緣型)為7.7%;(2)肩胛骨分型動作:上抬階段,下角型靶肌肉激活模式變化不明顯(P0.05),內側緣型斜方肌下束(LT)激活水平低,斜方肌上束(UT)與斜方肌中束(MT)及LT的比值較高(P0.05);下降階段,下角型LT及內側緣型MT活動水平低,下角型UT與LT和前鋸肌(SA)的激活比率以及內側緣型UT/MT高(P0.05);(3)推肩俯臥撐動作:下角型SA激活水平及UT/SA低(P0.05);內側緣型靶肌肉的活動水平達正常(P0.05),UT/MT明顯較高(P0.01);(4)PNF上肢D1屈曲動作:兩型UT與下角型MT的激活水平低(P0.05);兩型靶肌肉的激活比率正常(P0.05);(5)推肩俯臥撐動作與PNF上肢D1屈曲相比,前者SA的激活水平高(P0.05),下角型UT/SA顯著較低(P0.01);(6)PNF上肢D2動作:屈曲階段內側緣型SA、伸展階段下角型MT、內側緣型UT、MT的活動水平降低(P0.05);兩型靶肌肉的激活比率正常(P0.05);結論:(1)無肩關節(jié)癥狀的肩上舉過頂項目運動員亦存在肩胛骨動力障礙的可能,各型的分布為I型(下角型)IV型(正常型)II型(內側緣型)III型(上緣型);(2)下角型肩胛骨動力障礙的關鍵肌為斜方肌下束和前鋸肌,內側緣型肩胛骨動力障礙的關鍵肌為斜方肌中、下束;(3)推肩俯臥撐動作對前鋸肌的刺激效果優(yōu)于PNF上肢D1屈曲動作,因此推肩俯臥撐動作適合于下角型肩胛骨動力障礙的康復;PNF上肢D1屈曲動作適合內側緣型肩胛骨動力障礙的康復;(4)PNF上肢運動模式利于靶肌肉之間的激活比率的優(yōu)化,對兩種類型肩胛骨動力障礙均適用,但需在康復中后期加入。
[Abstract]:Objective: scapular motility disorder is characterized by abnormal scapular position and / or track during exercise. There are three different types of scapular dyskinesia, and the activation characteristics of scapular girdle muscle group in different types are not clear. The specific effects of different rehabilitation actions need to be further studied. In this study, the surface electromyography of different types of scapular dyskinesia was analyzed from the classification of scapular dyskinesia. The activation characteristics of scapular muscle group in the rehabilitation of shoulder push-ups and PNF upper limb movements were compared and analyzed. Methods: 26 athletes of Beijing University of physical Education were recruited to type gold according to scapular dynamic disorder. The scapular bones of each side of 26 subjects (52 shoulder times) were classified into inferior horn type (21 cases), medial marginal type (11 cases) and upper margin type (4 cases) and normal type (16 cases). Surface electromyography data of scapular band muscle group in shoulder push-ups and PNF upper limb motion mode. Results the incidence of scapular dyskinesia was 69.2 in the shoulder lift over top athletes, of which I (lower horn) accounted for 40.4g / IV (normal). 30.8Type II (medial margin type) accounted for 21.1D / III (upper margin type) scapular type (7.7m / 2) scapular type movement: lifting stage, 30.8% (medial margin type), 30.8% (medial margin type), 27.5% (upper margin type). The activation mode of target muscle of inferior horn type was not obvious (P0.05), the activity level of LTT of inferior trapezius muscle of medial margin type was low, the ratio of superior trapezius muscle (UTT) to middle trapezius muscle (MTT) and LT was higher than that of trapezius muscle, and the activity level of lower horn type LT and medial margin type MT was low in the descending stage, the ratio of MTT and LT in trapezius muscle was higher than that in trapezius muscle. The activation ratio of lower angle type UT to LT and sac) and the medial marginal type of UT/MT high level P0.05 / 3) push-ups: lower angle type SA activation level and UT/SA low P0.05 level; medial marginal type target muscle activity level to normal P0.05 UT / MT was significantly higher than that of P0.01 / 4NF-PNFD 1. The activation level of UT and MT in two types of UT was lower than that of type MT, and the activation ratio of target muscles of the two types was normal (P0.05 / 5) compared with the D1 flexion of PNF upper limb, the motion of push-ups of two types of UT was compared with that of D1-flexion of the upper limb of PNF. In the former, the activation level of SA was higher than that of P0.05G, and the UT/SA of the lower angle type was significantly lower than that of P0.01PNFD movement of the upper extremity: medial marginal type of SAA in flexion stage, lower angle type of MTT in extensional phase and UTT of medial margin type decreased the activity level of P0.05; the activation ratio of the two types of target muscles was normal P0.055.Conclusion: the activation ratio of the two types of target muscles is normal (P0.05). There is also the possibility of scapular dyskinesia in athletes who have no shoulder joint symptoms. The key muscles of type I (inferior horn type IV) (normal type II (medial margin type III) (upper margin type 2)) of inferior horn type of scapular dyskinesia were trapezius inferior bundle and anterior serratus muscle. The key muscle of medial marginal scapular dynamic disorder was trapezius muscle, and the stimulation effect of push shoulder push-ups on anterior serratus was better than that of D1 flexion of PNF upper limb. Therefore, pushing shoulder push-ups is suitable for the rehabilitation of lower angle scapular dyskinesia. The D1-flexion of PNF upper limb is suitable for the rehabilitation of medial marginal scapular dyskinesia. The PNF upper limb motion mode is beneficial to the optimization of the activation ratio between target muscles. For both types of scapular dyskinesia, but should be added in the middle and late stage of rehabilitation.
【學位授予單位】：北京體育大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R873;R493

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