| Abstract: | 行走是普通人或者糖尿病足患者最常見且有益於健康的運動。不同材質的氣墊鞋墊對於行走的影響是不一樣的。氣墊鞋墊已經被證實可以減少人體行走時對足底帶來的衝擊力。而且, 不同氣墊鞋墊的內壓, 也可以用來對應不同材質硬度的鞋墊。目前已證實氣墊鞋墊的內壓會影響足底壓力, 而足底壓力的不同會改變行走時步態肌肉結構。疲勞時, 過高的足底壓力會對糖尿病足患者造成一定的損害。穿戴適合的內壓鞋墊減壓鞋, 可以降低足底壓力和延?肌肉疲勞, 並降低糖尿病患者受傷風險。本研究旨在通過控制氣墊鞋墊的內壓, 來探討空氣鞋墊對下肢肌肉疲勞的影響。本研究採用3 × 2析因設計, 招募12名受測者在跑步機上穿戴不同內壓空氣鞋墊 (80、160、和240 mmHg) , 以恆定速度 (3.6英里每小時) 進行不同持續時間 (10和20 min) 的步行測試, 每組實驗進行時間為一週, 同時收集人體行走時的腓腸內肌 (Gastrocnemius medialis, GM) 和脛骨前肌 (Tibialis Anterior, TA) 的表面肌電訊號 (surface electromyography, sEMG) 訊號, 計算其均方根振幅 (root mean square, RMS) 、平均中位頻率 (median frequency, MF) 、和平均峰值中位頻率 (median frequency peak, MFP) 。並使用統計方法雙因子方差分析 (Two-way ANOVA) 、單因子方差分析 (One-way ANOVA) 、Fisher事後檢驗 (Least Significant Difference, LSD) 、和成對T檢定 (Paired t-test)進行比較分析。其實驗結果顯示, 穿戴不同內壓的氣墊減壓鞋墊行走存在顯著差異 (P<0.01) , 而持續時間則沒有顯著差異。步行期間, 中位頻率 (MF) 在三種不同壓力狀態下, 腓腸內肌 (GM) 其160 mmHg和240 mmHg氣墊內壓比較存在顯著差異, 10分鐘 (P=0.001) , 20分鐘 (P=0.030) 。脛骨前肌 (TA) 其160 mmHg和240 mmHg氣墊內壓比較存在顯著差異10分鐘 (P=0.011) , 20分鐘(P=0.005) 。本研究結果表明, 氣墊內壓是誘發腿部肌肉疲勞的重要因素, 而步行時間則不是。適中內壓的氣墊鞋墊, 相較於過硬或過軟的氣墊鞋墊, 對於人體行走延緩下肢肌肉疲勞效果最佳且呈顯著性。隨著時間的增加, 下肢肌肉會趨向疲勞, 脛骨前肌肌力增加, 腓腸內肌肌力會減小。腓腸內肌相較於脛骨前肌, 隨著步行時間的增加, 其肌肉參與度逐漸降低。因此本研究得出結論, 相較之下160 mmHg內壓的空氣鞋墊, 對於人體行走延緩下肢疲勞最有幫助。
Walking is the most common and healthy exercise for people or patients with diabetes foot. Air cushioned insoles of different materials have different effects on walking. Air cushioned insoles have been shown to reduce the impact of walking on the soles of the feet. Moreover, the internal pressure of different air-cushioned insoles can also correspond to insoles with different material hardness. It has been confirmed that the internal pressure of the air cushion insole will affect the plantar pressure, and the difference in plantar pressure will change the gait muscle structure when walking. When muscle fatigue, excessive plantar pressure will cause certain damage to patients with diabetes foot. Wearing shoes with suitable internal pressure insole can reduce plantar pressure, delay muscle fatigue, and reduce the risk of injury in patients with diabetes. This study aims to explore the effect of the air insole on lower limb muscle fatigue by controlling the internal pressure of the air insole.This study uses a 3 × 2 factorial design, 12 subjects were recruited to wear different internal pressure air insoles (80, 160, and 240 mmHg) on the treadmill, and the walking test with different duration (10 and 20 minutes) was carried out at a constant speed (3.6 miles per hour). The surface electromyography (sEMG) signals of Gastrocnemius medialis (GM) and Tibialis anterior (TA) during human walking were collected, and their root mean square (RMS), median frequency (MF), and median frequency peak (MFP) were calculated. Statistical methods such as two-way ANOVA, one-way ANOVA, Fisher LSD, and paired t-test were used for comparative analysis.The experimental results showed a significant difference in walking with air cushion decompression insoles with different internal pressure (P<0.01), but there was no significant difference in duration. During walking, the mean frequency (MF) under three different pressure states, the internal pressure of 160 mmHg and 240 mmHg air cushion of the gastrocnemius medial (GM) muscle was significantly different, 10 minutes (P=0.001), 20 minutes (P=0.030). In addition, there was a significant difference between the air cushion internal pressure of 160 mmHg and 240 mmHg in TA for 10 minutes (P=0.011) and 20 minutes (P=0.005). This study's results show that the air insole's internal pressure is an important factor inducing leg muscle fatigue, while the walking time is not. The air insole with moderate internal pressure has the best and most significant effect on delaying lower limb muscle fatigue for human walking compared with the air insole with too hard or too soft. With the increase of time, the lower limb muscles will tend to fatigue, the strength of TA muscle will increase, and the strength of GM muscle will decrease. Compared with the anterior TA muscle, the muscle participation of the GM muscle gradually decreased with the increased walking time. Therefore, this study concluded that, in contrast, 160 mmHg air insole with internal pressure is the most helpful for human walking to delay lower limb fatigue. |
