護腕、捏力型態與手腕姿勢對靜態捏力之影響研究

Evaluating the Effects of Splint; Pinch Type, and Wrist Posture on Pinch Strength

10.29977/JCIIE.200307.0009

石裕川(Yuh-Chuan Shih)；陳文林(Wen-Lin Chen)；歐玉琴(Yu-Chin Ou)

捏力 ； 最大意志施力 ； 手腕屈曲/伸展 ； 護腕 ； 累積性外部傷害 ； pinch strenght ； maximum volitional contraction ； wrist extension/flexion ； posture ； wrist splint ； cumulative trauma disorders

工業工程學刊

20卷4期（2003 / 07 / 01）

411 - 421

繁體中文

重複性作業中的捏力使用與累積性外部傷害(Cumulative Trauma Disorders, CTDs)之間有相當大的關連性；若要減低CTDs發生的可能性，則必須儘量降低作業所需之捏力。因此，本研究的主要目的在於探討護腕、不同捏力型態與手腕姿勢對國人手部捏力最大意志施力(Maximum Volitional Contraction, MVC)的影響。本研究共計招募24位受試人員，男女各12位，每位受試者惯用手皆為右手。在實驗設計上採用巢狀因子設計(nested-factorial design)，實驗因子除了性別與受試者（伏集於性別下）之外，尙包含施力型態(Pulp2、Pulp3、Chuck、Lateral等4水準)、手腕姿勢（伸展30度、屈曲30度、不偏等3水準），以及是否配戴護腕（2水準）；所有因子皆視為固定變數(fixed variable)，共計24(4×3×2=24)種實驗組合，每種實驗組合重複2次。研究結果顯示性別與捏力型態，以及兩者之交互作用對MVC有顯著影響，手腕姿勢與護腕則無。女性平均MVC約男性之56%(2.9kg／5.2kg)；就捏力型態而言，不論男女性，Lateral的施力績效為最佳，其次分別為Chuck, Pulp2與Pulp3。綜合文獻及本研究之結果，建議於執行重複性作業時以配戴護腕為佳，不但不影響捏力與腕道壓力，更可避免因腕部過度屈伸或偏移所升高之腕道壓力。另一方面，當手腕屈曲或伸展角度不大時，不會對捏力造成影響。此外，人體計測資料與捏力大小間之相關性尚不明確，而四種捏力型態間，Chuck似乎與Pulp2及pulp3之相關性較高。

Pinch strength applied in repetitive tasks was considered to be highly correlated with cumulative trauma disorders (CTDs). To reduce the magnitude requirement of pinch strength is important to avoid such injuries. But whether the peak pinch strength was affected by wearing wrist splints, sometimes used to protect the wrist from CTDs, is still unknown. This study, therefore, intended to evaluate the effect of wrist splints on the maximum volitional contraction (MVC)of pinch. A total of 24 right-handed volunteers (12males, and 12 females)were recruited, and a nested-factorial design with subject nested within gender was employed. In addition to splint effect, effects of gender, wrist posture(extension 30°,flexion 30°,and neutral),and pinch type (Pulp2, Pulp3, Chuck, and Lateral) were evaluated, and all were considered as fixed variables. There were twenty-four combinations totally, and two replications were conducted. The ANOVA result showed the effects of gender, pinch type and their interaction were highly significant. But the effects of wrist posture and wrist splint were not. Male exerted much greater than female did under all pinch types, and female MVC was averagely about 56% (2.9kg/5.2kg)of male. For both genders, the MVC of Lateral was the largest, followed by Chuck, Pulp2, and Pulp3.Furtheraccording to the result of Duncan's multiple range test, female Lateral MVC and malePulp2 MVC were not different significantly, as well as female Chuck MVC and male Pulp3MVC.Wearing splints during repetitive tasks was recommended because it did not influence the pinch MVC or carpal tunnel pressure, and it can keep the wrist in neutral position as possible. In addition, the correlations between pinch MVC and anthropometry and among pinch types were discussed.

1. Aghazadeh, F.,Mital, A.(1987).Injuries due to Hand Tools: Results of a Questionnaire.Applied Ergonomics,18(4)
2. Anderson, C. T.(1965).Wrist joint position influences normal hand function.Iowa City, IA:University of Iowa.
3. Armstrong, T. J.,Chaffin, D. B.(1979).Carpal Tunnel Syndrome and selected personal attributes.Journal of Occupational Medicine,21(7)
4. Berg, V. J.,Clay, D. J.,Fathallah, F. A.,Higginbotham, V. L.(1988).Trend in Ergonomics/ Human Factors.
5. Caldwell, L. S.,Chaffin, D. B.,Dukes-Dobos, F. N.,Kroemer, K. H. E.,Laubach, L. L.,Snook, S. H.,Wasserman, D. E.(1974).A proposed standard procedure for static muscle strength testing.American Industrial Hygiene Association Journal,35(4)
6. Chao, E. Y.,Opgrande, J. D.,Axmear, F. E.(1976).Three dimensional force analysis of finger joints in isometric hand functions.Journal of Biomechanics,9
7. Dempsey, P. G.,Ayoub, M. M.(1996).The influence of gender, grasp type, pinch width and wrist position on sustained pinch strength.International Journal of Industrial Ergonomics,17
8. Eastman Kodak Company Ergonomics Group(1986).Ergonomic design for people at work, Volume 2.New York:Van Nostrand Reinhold.
9. Esch, D.,Lepley, M.(1974).Evaluation of joint motion: Methods of measurement and recording.Minneapolis, MN:University of Minnesota Press.
10. Fernandez, J. E.,Dahalan, J. B.,Halpern, C. A.,Fredericks, T. K.(1992).Advance in Industrial Ergonomics and Safety IV.London:Taylor and Francis.
11. Fernandez, J. E.,Dahalan, J. B.,Halpern, C. A.,Viswanath, V.(1991).Proceedings of the Human Factors Society 35th Annual Meeting, Human Factors Society.Santa Monica, CA:
12. Hallbeck, M. S.,McMullin, D. L.(1993).Maximal power grasp and three-jaw chuck pinch force as a function of wrist position, age, and glove type.International Journal of Industrial Ergonomics,11
13. Holbrook, T. L.,Grazier, K.,Kelsey, J.,Stauffer, R. N.(1984).Annual Conference of the American Academy of Orthopedic Surgeons.
14. Hymovich, L.,Lindholm, M.(1966).Hand, wrist, and forearm injuries: The result of repetitive motions.Journal of Occupational Medicine,8(11)
15. Imrhan, S. N.(1991).The influence of wrist position on different types of pinch strength.Applied Ergonomics,22(6)
16. Imrhan, S. N.,Loo, C. H.(1989).Trends in finger pinch strength in children, adults, and the elderly.Human Factors,31(6)
17. Imrhan, S. N.,Rahman, R.(1995).The effect of pinch width on pinch strengths of adult males using realistic pinch-handle coupling.International Journal of Industrial Ergonomics,16
18. Imrhan, S. N.,Sundararajan, K.(1992).An investigation of finger pull strengths.Ergonomics,35(3)
19. Kamal, A. H.,Moore, B. J.,Hallbeck, M. S.(1992).Advances in Industrial Ergonomics and Safety IV.London:Taylor and Francis.
20. Keyserling, W. M.,Stetson, D. S.,Silverstein, B. A.,Brouwer, M. L.(1993).A checklist for evaluating ergonomic risk factors associated with upper extremity cumulative trauma disorders.Ergonomics,36(7)
21. Kraft, G. H.,Detels, P. E.(1972).Position of function of the wrist.Archives of Physical Medicine and Rehabilitation,53
22. Lifshitz, Y.,Armstrong, T.(1986).Proceeding of the Human Factors Society 30th Annual Meeting, Human Factors Society.Santa Monica, CA:
23. Malone, L. A.,Gervais, P. L.,Burnham, R. S.,Chan, M.,Miller, L.,Steadward, R. D.(1998).An assessment of wrist splint and glove use on wheeling kinematics.Clinical Biomechanics,13(3)
24. Mital, A.(1986).Effect on body posture and common hand tools on peak torque exertion capabilities.Applied Ergonomics,17
25. Mital, A.,Pennathur, A.,Kansal, A.(1999).Nonfatal occupational injuries in the United States, Part III - Injuries to the upper extremities.International Journal of Industrial Ergonomics,25
26. Petrofsky, J. S.,Kamen, C. W. G.,Lind, A. R.(1980).The effect of handgrip span on isometric exercise performance.Ergonomics,23(12)
27. Rempel, D.,Manojlovic, R.,Levinsohn, D. G.,Bloom, T.,Gordon, L.(1994).The effect of wearing a flexible wrist splint on carpal tunnel pressure during repetitive hand activity.The Journal of Hand Surgery, A,19(1)
28. Rojviroj, S.,Sirichativapee, W.,Kowsuwon, W.,Wongwiwattananon, J.,Tamnanthong, N.,Jeeravipoolvarn, P.(1990).Pressures in the carpal tunnel: A comparison between patients with carpal tunnel syndrome and normal subjects.Journal of Bone Joint Surgery, B,72
29. Silverstein, B. A.,Fine, L. J.,Armstrong, T. J.(1986).Hand wrist cumulative trauma disorders in industry.British Journal of Industrial Medicine,43
30. Swanson, A. B.,Matev, I. B.,De Groot, G.(1970).The strengths of the hand.Bulletin of Prosthetics Research,Fall
31. 何文島 Ho, Wen-Dau、張顯洋 Chang, Shien-Young、王崇文 Wang, Chung-Wen、黃明和(2000)。手握力與指捏力之正常值：15至20歲青少年之先期測量報告 Grip and key pinch strength: Norms for 15- to 22-year-old Chinese students。中華醫學雜誌 Chinese Medical Journal (Taipei)，63(1)
32. 李正隆 Lee, Cheng-Lung(1997)。簡易護腕於電腦文書作業之改善研究。勞工安全衛生研究所。
33. 許勝雄 Sheu, Sheng-Hsiung、陳元和 Chan, Yuan-Ho(1998)。非動力手工具人因設計指引之編訂 The Establishment of Ergonomic Design Guidelines on Non-Powered Hand Tools。勞工安全衛生研究季刊 Journal of Occupational Safety and Health，6(1)
34. 楊育仁陳志勇李正隆 Lee, Cheng-Lung(1993)。簡易護腕治療腕道症候群療效評估。勞工安全衛生研究所。