目的：低能量雷射最近被證實在耐力或阻力運動訓練可減緩肌肉疲勞。本研究探討低能量雷射應用的創新嘗試，了解血流限制合併低能量雷射在肌肉活化與動態力量表現的立即性效果，作為延緩血流限制所引發肌肉疲勞的參考。
方法：15名無神經肌肉疾病的健康成年人 (平均年齡 : 28.1±4.6歲) 參與本實驗。受試者在至少2天的間隔，以隨機方式下列三種實驗情況完成靜態肌肉收縮:包含血流限制合併低能量雷射(BFR+LLLT)、血流限制合併假雷射輸出(BFR)以及對照(NR)(無血流限制與假雷射輸出)。實驗情況包含了前測期，介入期以及立即性後測。前測期量測收縮壓、休息時1分鐘血氧平均值、以及最大用力收縮。受試者在不同的實驗情況的介入期接受不同的介入。在血流限制合併低能量雷射情況中，伸腕肌接受60焦耳低能量雷射的照射，並在肱二頭肌肌腹用加壓帶以百分之六十的收縮壓限制血流4分鐘；在血流限制合併假雷射輸出情形下，除了低能量雷射照射輸出之外，血流限制的實驗步驟與血流限制合併低能量雷射情況相同。在對照情形下，受試者沒有接收有效的雷射照射與血流限制。受試者在立即性後測，透過視覺回饋進行百分之二十的最大用力收縮且穩定的施力追蹤活動。在不同介入情形下，比較立即性後測各項參數的差異，包括：力量收縮波動、肌肉活化、以及標準化血氧飽和度等等。
結果：在立即性後測標準化肌肉血氧飽和度隨介入情形有明顯的差異 (NR> BFR+LLLT> BFR)，以前測期的肌肉血氧飽和度為參考基準，合併低能量雷射情況可有效降低單純血流限制所造成的肌肉血氧飽和度下降。立即性後測力量波動的平均頻率 (mean frequency) 及頻率自由度 (spectral degree of freedom) 隨介入情形有明顯的差異 (BFR+LLLT > BFR)；肌肉活化方面，立即性後測肌電圖的均方根值及0到4赫茲共調頻譜 (EMG-EMG coherence spectra) 則未達到顯著的差異。
結論：本實驗首次探討血流限制合併低能量雷射在力量波動、肌肉活化及肌肉血氧飽和度等特徵改變的立即效果。實驗新發現顯示：相較單純血流限制，合併低能量雷射在血流限制下的低強度收縮，可以帶來較少的肌肉血氧飽和度降低、以及施力修正頻率與多樣性的增加，此生理適應現象對於肌力訓練有安全性提高、與施力精準的正面潛在效益，未來需要更進一步探討血流限制合併低能量雷射的長期肌肉訓練效益與其生理機制。

Objective: Low-level laser therapy (LLLT) have been recently proved to alleviate muscle fatigue during endurance or resistance training. The aim of this study was to investigate the immediate effect of combined LLLT with blood flow restriction (BFR) on force fluctuations, muscle activation and muscle oxygen saturation of hemoglobin/myoglobin during a low-load exercise, as an innovative LLLT application on muscle training.
Methods: Fifteen healthy adults (mean age : 28.1±4.6 years) without diagnosed neuromuscular disease were included in the study of a crossover randomized design. All participants completed a static isometric contraction of 20% maximal voluntary contraction under three conditions (blood flow restrictions with low-level laser therapy (BFR+LLLT), blood flow restrictions without low-level laser therapy (BFR), no restriction (NR)), interleaved with at least two days among various experimental conditions. All conditions were comprised of baseline period, intervention session, and immediate after-test. The baseline measures included systolic blood pressure, 1-minute muscle oxygen saturation (SmO2) in the rest, and maximum voluntary contractions (MVC). During the intervention session, in the BFR+LLLT condition, the subjects received 60 Joule low-level laser therapy and blood flow restriction with 60% of systolic blood pressure applied on the belly of the biceps brachii for another 4 minutes. The experimental procedure in the BFR condition was the same in the BFR+LLLT condition, except for sham laser therapy. In the NR condition, the participants received sham laser therapy without receiving blood flow restriction. During the immediate after-test, the participants conducted a static force tracking under visual guidance. Parametric differences in the immediate after-test were contrasted among intervention approaches, including force fluctuations, muscle activation, and normalized muscle oxygen saturation.
Results: In the immediate after-test, normalized muscle oxygen saturation were significantly different with intervention approaches (NR> BFR+LLLT> BFR). In reference to baseline muscle oxygen saturation, combined LLLT with BFR resulted in a smaller reduction in muscle oxygen saturation than BFR. Force fluctuation characteristics also varied with intervention, with increasing trends for mean frequency and spectral degree of freedom for the combined approach (BFR+LLLT> BFR). However, muscle activation patterns in the immediate after-test of the BFR condition, including root mean square and peak EMG-EMG coherence spectra under 4 Hz, were not significantly different as compared with those of combined LLLT and BFR.
Conclusion: It was the first time to reveal immediate effect of combined LLLT with BFR on force fluctuation dynamics, muscle activation, and oxygen saturation of hemoglobin/myoglobin. The novel finding is that combined LLLT with BFR leads to a smaller reduction in muscle oxygen saturation with more frequent and intricate correction attempts in the immediate after-test, as compared to traditional BFR. The adaptive phenomenon is advantageous to training safety and force precision control. Long-term effect of muscle training with combined LLLT with BFR and underlying physiological mechanisms need further investigation.

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