台灣成人軀幹肌力之評估

Isokinetic Trunk Flexor and Extensor Strength in Taiwanese Adults

很多報告都認為下背痛患者之軀幹肌力，是因為不夠強壯才會導皮下背部的傷害。但一般成年人軀幹肌力值到底應該是多少才合乎正常範圍？截至目前為止，只見有國外報告，卻未見有國人自己的相關資料。因為肌力與身高、體重有密切關係，又國人身高、體重與外國人有顯著差異，理論上國人與外國人彼此間的肌力應會有相當差別，是無法直接引用國外的資料，因此著手此研究，以建立國人軀幹肌力的標準值，可做為未來臨床的參考。從台大醫院健檢中心選擇脊椎及下肢肌肉骨骼系統無任何病變，也無規則運動習性的204位（男性107位，女性97位）受試者為實驗的對象，接受Cybex 6000 TEF等速肌力測試儀的軀幹肌力測試，測試的速度設定在30°/秒，90°/秒，120°/秒三種速度。腰椎前彎－－後仰的活動範圍分別以前彎55°，後仰-20°為終點。以逐步多項迴歸(multiple regression)分析受試者之年齡、性別、身高、體重等因素對軀幹肌力大小之影響。又以ANOVA分析在同樣速度下，不同年齡群肌力之差異。結果發現國人軀幹肌力受身高、性別、年齡、體重四變數的影響極大，其中以性別的影響力最大，身高、年齡次之，體重的影響力最小。同年齡層的男性肌力大於女性肌力；身高越高，肌力越大；體重越重者肌力也越強；但年齡越大者肌力越小。男性四十歲以上，女性六十歲以上，軀幹肌力即出現明顯減弱，伸肌肌力之減退比屈肌明顯；國內女性成年人軀幹之屈肌普遍具有肌力不足的現象。國人不同年齡群之軀幹原始肌力值及標準化後之軀幹肌力值亦分別以男、女兩系列列於文中。

Trunk muscle weakness that results from low back pain has been identified as one of the critical factors leading to worsening back pain. However, normative values for trunk muscle strength in Taiwanese have not been indentified. The aims of this study were to provide normative peak torque of trunk flexion and extension at different speeds in a Taiwanese poplulation ,and to examine the relationships of characteristics such as age , gender, body height, and body weight with isokinetic measurements. One hundred and seven healthy, nonathletic Taiwanese men and 97 healthy, nonathletic Taiwanese women volunteered for the study. The strength of trunk muscle, including flexors and extensors was assessed using the Cybex 6000 TEF Modular Component Isokinetic Dynamometer at speeds of 30°/sec, 90°/sec, and 120°/sec. The normative values of trunk muscle strength at different speeds are presented. These normative data were affected most strongly by gender, followed by body height, age, and body weight. Men over 40 years old and women, over 60 years old had significantly lower trunk muscle strength values than younger men and women, respectively. The trunk muscle strength decreased as the testing speed increased. This phenomenon was more strongly evident in trunk extensors than in flexors. It was also found that Taiwanese women in this report had lower flexor muscle torgue when compared with reports from other countries. These data will be valuable in designing individual exercise programs for Taiwanese subjects.