懸吊式訓練增強核心控制對下肢傷害預防與運動能力可能性之探討

Effects of the Sling Exercise on Abdominal Muscular Control and Collateral Effects to Lower Limb Performance and Injuries Prevention

10.6127/JEPF.202012_(31).0003

洪宗德(Zhong-De Hung)；唐誌陽(Chih-Yang Taun)；洪暐(Wei Hung)

神經肌肉控制 ； 運動表現 ； 懸吊運動訓練 ； 運動傷害 ； neuromuscular control ； athlete performance ； sling exercise training ； sports injury

運動生理暨體能學報

31輯（2020 / 12 / 01）

21 - 32

繁體中文

預防運動傷害一直是體能訓練領域的熱門議題，而核心穩定能力是預防運動傷害不可或缺的因素，它是同時兼具影響運動表現與傷害預防的重要指標。在運動過程中，核心肌群扮演著穩定動力鏈與協助傳遞力量的重要角色。核心肌群中的脊椎旁肌群（例如：多裂肌等），由於肌梭比率含量頗豐，更是感受身體姿態、提供本體感覺與調整肌肉張力的重要感受器。從過去許多研究發現，核心穩定能力不足將出現動力鏈的力量傳遞不順暢，並導致遠端肢段控制能力不佳，因而使得上肢或下肢關節負荷上升，降低運動表現與增加傷害風險。透過不穩定平面的訓練方式誘發核心肌群與動力鏈的整合，是目前正熱門的運動訓練議題，學界透過研究結果發展出多種不穩定平面的訓練方式，在眾多訓練器材中，懸吊式訓練似乎最能有效提升肌肉活性並增加神經肌肉控制能力；透過閉鎖式動力鏈之動作，提升在運動過程中軀幹的穩定能力，同時整合選手的本體感覺與全身性動力鏈的力量串聯能力，透過肌筋膜理論的連動特性可發現，核心肌群的力量與穩定能力間接影響了下肢的運動表現，但目前尚未有研究證實懸吊式核心訓練對下肢傷害預防之實證性研究，故建議未來研究計畫，觀察藉由懸吊式核心訓練增強核心與髖關節的肌力、神經肌肉控制能力，是否能達到提升運動表現同時預防下肢傷害之效益。

Core muscle function and core stability had attract highly attention among athletic training and performance enhancing in past two decades for it is a remarkable indicator highly relevance to exercise performance and injury prevention. As body performing exercise, core muscle groups not only act as force transducer but also as stabilizer between upper and lower limbs. Further more, paraspine muscle such as multifidus, for it muscle spindle rich nature, work as tension detector while cerebellum coordinating trunk muscles thus to link muscles from lower limb to upper limbs to work together as a kinetic chain and vice versa. Numberous of previous studies indicates that insufficient core stability will result to poor power transduction, decrease exercise performance and possibly increase injury ricks of the distal joints such as knee and shoulder. As present, several training programs using unstable surface training to increase core stability have been developed. Among all those training programs, suspension exercise seems to more effective in facilitate muscle activation and improve neuromuscular control. With close-kinetic chain nature, suspension exercise facilitating trunk muscle activation and participation during exercise thus to provide stability and effectively force transduction. Furthermore, through the interlocking characteristics of myofascial fascia, well-activated trunk muscles indirectly affect the performance of the lower limbs. We collected research document as best we can research to discuss about relationship of trunk muscles activation and performance of lower limbs. Also we will discuss about effects of suspension exercise on trunk muscle activation and lower limbs performance.

1. Zemková, E.(2017).Instability resistance training for health and performance.Journal of Traditional and Complementary Medicine,7(2),245-250.
   連結：
2. 陳書芸,陳哲修,賴長琦,江鴻粧,鄭鴻文(2016)。高強度間歇性懸吊運動訓練對舞者運動表現之影響。大專體育學刊，18(3)，235-247。
   連結：
3. 游晴惠,許正心,宋映呈,高敏雄,沈志堅(2017)。懸吊訓練（TRX）對國中柔道選手專項運動表現之研究。運動教練科學，47，15-25。
   連結：
4. 楊明達,鄭羽潔,詹貴惠(2015)。抗力球訓練對射箭選手肌肉功能，平衡能力與運動表現的影響。體育學報，48(2)，139-148。
   連結：
5. 楊建志,高明峰(2010)。懸吊運動介紹。體育學系系刊，10，53-64。
   連結：
6. 葉益銘,侯建文(2010)。抗力球訓練對高中棒球選手專項運動表現的影響。大專體育學刊，12(2)，51-58。
   連結：
7. Angel, R. W.,Higgins, J. R.(1969).Correction of false moves in pursuit tracking.Journal of Experimental Psychology,82(1),185-187.
8. Ardern, C. L.,Webster, K. E.,Taylor, N. F.,Feller, J. A.(2011).Return to sport following anterior cruciate ligament reconstruction surgery: A systematic review and meta-analysis of the state of play.British Journal of Sports Medicine,45(7),596-606.
9. Bashir, S. F.,Nuhmani, S.,Dhall, R.,Muaidi, Q. I.(2019).Effect of core training on dynamic balance and agility among Indian junior tennis players.Journal of Back and Musculoskeletal Rehabilitation,32(2),245-252.
10. Beynnon, B. D.,Uh, B. S.,Johnson, R. J.,Abate, J. A.,Nichols, C. E.,Fleming, B. C.(2005).Rehabilitation after anterior cruciate ligament reconstruction: A prospective, randomized, double-blind comparison of programs administered over 2 different time intervals.The American Journal of Sports Medicine,33(3),347-359.
11. Borreani, S.,Calatayud, J.,Colado, J. C.,Moya-Nájera, D.,Triplett, N. T.,Martin, F.(2015).Muscle activation during pushups performed under stable and unstable conditions.Journal of Exercise Science & Fitness,13(2),94-98.
12. Chung, J. S.,Park, S.,Kim, J.,Park, J. W.(2015).Effects of flexi-bar and non-flexibar exercises on trunk muscles activity in different postures in healthy adults.Journal of Physical Therapy Science,27(7),2275-2278.
13. Clark, M. A.,Lucett, S.,Corn, R. J.(2008).NASM essentials of personal fitness training.Philadelphia, PA:Lippincott Williams & Wilkins.
14. Cugliari, G.,Boccia, G.(2017).Core muscle activation in suspension training exercises.Journal of Human Kinetics,56(1),61-71.
15. Dannelly, B. D.,Otey, S. C.,Croy, T.,Harrison, B.,Rynders, C. A.,Hertel, J. N.(2011).The effectiveness of traditional and sling exercise strength training in women.The Journal of Strength and Conditioning Research,25(2),464-471.
16. De Blaiser, C.,Roosen, P.,Willems, T.,Danneels, L.,Bossche, L. V.,De Ridder, R.(2018).Is core stability a risk factor for lower extremity injuries in an athletic population? A systematic review.Physical Therapy in Sport,30,48-56.
17. Demorat, G.,Weinhold, P.,Blackburn, T.,Chudik, S.,Garrett, W.(2004).Aggressive quadriceps loading can induce noncontact anterior cruciate ligament injury.The American Journal of Sports Medicine,32(2),477-483.
18. do Carmo Carvalhais, V. ,O.de Melo Ocarino, J.,Araújo, V. L.,Souza, T. R.,Silva, P. L. P.,Fonseca, S. T.(2013).Myofascial force transmission between the latissimus dorsi and gluteus maximus muscles: An in vivo experiment.Journal of Biomechanics,46(5),1003-1007.
19. Escamilla, R. F.,Lewis, C.,Bell, D.,Bramblet, G.,Daffron, J.,Lambert, S.(2010).Core muscle activation during Swiss ball and traditional abdominal exercises.Journal of Orthopaedic & Sports Physical Therapy,40(5),265-276.
20. Faries, M. D.,Greenwood, M.(2007).Core training: Stabilizing the confusion.Strength and Conditioning Journal,29(2),10-25.
21. Frank, B.,Bell, D. R.,Norcross, M. F.,Blackburn, J. T.,Goerger, B. M.,Padua, D. A.(2013).Trunk and hip biomechanics influence anterior cruciate loading mechanisms in physically active participants.The American Journal of Sports Medicine,41(11),2676-2683.
22. Frank, C.,Kobesova, A.,Kolar, P.(2013).Dynamic neuromuscular stabilization & sports rehabilitation.International Journal of Sports Physical Therapy,8(1),62-73.
23. Hewett, T. E.,Myer, G. D.(2011).The mechanistic connection between the trunk, knee, and anterior cruciate ligament injury.Exercise and Sport Sciences Reviews,39(4),161-166.
24. Huang, J. S.,Pietrosimone, B. G.,Ingersoll, C. D.,Weltman, A. L.,Saliba, S. A.(2011).Sling exercise and traditional warm-up have similar effects on the velocity and accuracy of throwing.The Journal of Strength and Conditioning Research,25(6),1673-1679.
25. Iizuka, S.,Imai, A.,Koizumi, K.,Okuno, K.,Kaneoka, K.(2016).Immediate effects of deep trunk muscle training on swimming start performance.International Journal of Sports Physical Therapy,11(7),1048-1053.
26. Imai, A.,Kaneoka, K.,Okubo, Y.,Shiraki, H.(2014).Effects of two types of trunk exercises on balance and athletic performance in youth soccer players.International Journal of Sports Physical Therapy,9(1),47-57.
27. Kibler, W. B.(1994).Clinical biomechanics of the elbow in tennis: Implications for evaluation and diagnosis.Medicine & Science in Sports & Exercise,26(10),1203-1206.
28. Kibler, W. B.,Press, J.,Sciascia, A.(2006).The role of core stability in athletic function.Sports Medicine,36(3),189-198.
29. Kim, J. H.,Kim, Y. E.,Bae, S. H.,Kim, K. Y.(2013).The effect of the neurac sling exercise on postural balance adjustment and muscular response patterns in chronic low back pain patients.Journal of Physical Therapy Science,25(8),1015-1019.
30. Kim, J.-H.,Kim, Y.,Chung, Y.(2014).The influence of an unstable surface on trunk and lower extremity muscle activities during variable bridging exercises.Journal of Physical Therapy Science,26(4),521-523.
31. Kline, P. W.,Burnham, J.,Yonz, M.,Johnson, D.,Ireland, M. L.,Noehren, B.(2018).Hip external rotation strength predicts hop performance after anterior cruciate ligament reconstruction.Knee Surgery, Sports Traumatology, Arthroscopy,26(4),1137-1144.
32. Krause, D. A.,Elliott, J. J.,Fraboni, D. F.,McWilliams, T. J.,Rebhan, R. L.,Hollman, J. H.(2018).Electromyography of the hip and thigh muscles during two variations of the lunge exercise: A cross-sectional study.International Journal of Sports Physical Therapy,13(2),137-142.
33. Lee, D.,Park, J.,Lee, S.(2015).Effects of bridge exercise on trunk core muscle activity with respect to sling height and hip joint abduction and adduction.Journal of Physical Therapy Science,27(6),1997-1999.
34. Lee, S.-J.,Kim, Y.-N.,Lee, D.-K.(2016).The effect of flexi-bar exercise with vibration on trunk muscle thickness and balance in university students in their twenties.Journal of Physical Therapy Science,28(4),1298-1302.
35. Lloyd, D. G.(2001).Rationale for training programs to reduce anterior cruciate ligament injuries in Australian football.Journal of Orthopaedic & Sports Physical Therapy,31(11),645-654.
36. Markolf, K. L.,Burchfield, D. M.,Shapiro, M. M.,Shepard, M. F.,Finerman, G. A. M.,Slauterbeck, J. L.(1995).Combined knee loading states that generate high anterior cruciate ligament forces.Journal of Orthopaedic Research,13(6),930-935.
37. Marshall, R. N.,Elliott, B. C.(2000).Long-axis rotation: The missing link in proximal-to-distal segmental sequencing.Journal of Sports Sciences,18(4),247-254.
38. Myers, T. W.(2013).Anatomy trains e-book: Myofascial meridians for manual and movement therapists.Amsterdam, The Netherlands:Elsevier Health Sciences.
39. Nagai, T.,Sell, T. C.,House, A. J.,Abt, J. P.,Lephart, S. M.(2013).Knee proprioception and strength and landing kinematics during a single-leg stop-jump task.Journal of Athletic Training,48(1),31-38.
40. Nalbant, Ö.,Kinik, A. M.(2018).The effect of suspension workout on agility and forces performance in elite basketball players.Journal of Education and Training Studies,6(6),128-133.
41. Nascimento, V. Y. S.,Torres, R. J. B.,Beltrão, N. B.,dos Santos, P. S.,Pirauá, A. L. T.,de Oliveira, V. M. A.(2017).Shoulder muscle activation levels during exercises with axial and rotational load on stable and unstable surfaces.Journal of Applied Biomechanics,33(2),118-123.
42. Olsen, O.-E.,Myklebust, G.,Engebretsen, L.,Bahr, R.(2004).Injury mechanisms for anterior cruciate ligament injuries in team handball: A systematic video analysis.The American Journal of Sports Medicine,32(4),1002-1012.
43. Paterno, M. V.,Rauh, M. J.,Schmitt, L. C.,Ford, K. R.,Hewett, T. E.(2012).Incidence of contralateral and ipsilateral anterior cruciate ligament (ACL) injury after primary ACL reconstruction and return to sport.Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine,22(2),116-121.
44. Saeterbakken, A. H.,van den Tillaar, R.,Seiler, S.(2011).Effect of core stability training on throwing velocity in female handball players.The Journal of Strength and Conditioning Research,25(3),712-718.
45. Shinkle, J.,Nesser, T. W.,Demchak, T. J.,McMannus, D. M.(2012).Effect of core strength on the measure of power in the extremities.The Journal of Strength and Conditioning Research,26(2),373-380.
46. Shultz, R.,Silder, A.,Malone, M.,Braun, H. J.,Dragoo, J. L.(2015).Unstable surface improves quadriceps: Hamstring cocontraction for anterior cruciate ligament injury prevention strategies.Sports Health: A Multidisciplinary Approach,7(2),166-171.
47. Snarr, R. L.,Esco, M. R.(2014).Electromyo-graphical comparison of plank variations performed with and without instability devices.The Journal of Strength and Conditioning Research,28(11),3298-3305.
48. Stray-Pedersen, J. I.,Magnusen, R.,Kuffel, E.,Seiler, S.,Katch, F. I.(2006).Sling exercise training improves balance, kicking velocity, and torso stabilisation strength in elite soccer players: 1611Board #250 9:30 AM–10:30 AM.Medicine & Science in Sports & Exercise,38(5),S243.
49. Teyhen, D. S.,Bluemle, L. N.,Dolbeer, J. A.,Baker, S. E.,Molloy, J. M.,Whittaker, J.(2009).Changes in lateral abdominal muscle thickness during the abdominal drawing-in maneuver in those with lumbopelvic pain.Journal of Orthopaedic & Sports Physical Therapy,39(11),791-798.
50. Thomas, A. C.,Villwock, M.,Wojtys, E. M.,Palmieri-Smith, R. M.(2013).Lower extremity muscle strength after anterior cruciate ligament injury and reconstruction.Journal of Athletic Training,48(5),610-620.
51. Weston, M.,Hibbs, A. E.,Thompson, K. G.,Spears, I. R.(2015).Isolated core training improves sprint performance in national-level junior swimmers.International Journal of Sports Physiology and Performance,10(2),204-210.
52. Willardson, J. M.,Fontana, F. E.,Bressel, E.(2009).Effect of surface stability on core muscle activity for dynamic resistance exercises.International Journal of Sports Physiology and Performance,4(1),97-109.
53. Willson, J. D.,Dougherty, C. P.,Ireland, M. L.,Davis, I. M.(2005).Core stability and its relationship to lower extremity function and injury.Journal of the American Academy of Orthopaedic Surgeons,13(5),316-325.
54. You, Y.-L.,Su, T.-K.,Liaw, L.-J.,Wu, W.-L.,Chu, I.-H.,Guo, L.-Y.(2015).The effect of six weeks of sling exercise training on trunk muscular strength and endurance for clients with low back pain.Journal of Physical Therapy Science,27(8),2591-2596.
55. Zazulak, B. T.,Hewett, T. E.,Reeves, N. P.,Goldberg, B.,Cholewicki, J.(2007).Deficits in neuromuscular control of the trunk predict knee injury risk: Prospective biomechanical-epidemiologic study.The American Journal of Sports Medicine,35(7),1123-1130.