背景與目的：坐到站的動作過程中，雙腳擺放的位置對於動作表現有相當大的影響，而踝關節的本體感覺訊息可提供我們感知雙腳的位置。並且利用振動肌腱可活化第一型傳入纖維而產生錯誤的本體感覺，產生肌肉伸長的錯覺。因此，本研究主要探討藉由振動阿基里斯腱給予錯誤的本體感覺訊息對於坐到站動作的影響。方法：共收取25位健康年輕受試者，受試者需在沒有振動刺激 (no vibration, NV)、雙邊振動 (bilateral vibration, BV)、單邊振動,即慣用邊振動 (unilateral vibration, UV)情況下進行本體感覺測試，以及執行坐到站的動作。本體感覺測試的部份，受試者必須戴眼罩且手持一長棍，並在不同的情況下指出大腳趾最前方的位置。而坐到站測試時，受試者必須戴上眼罩、雙手抱胸，以自行選擇的速度站起。主要以動作分析系統及測力板紀錄肢體動作與反作用力情形。並分析在不同振動情況下，本體感覺測試結果，以及坐到站完成動作時間、離開椅面時間、軀幹肢段前傾的角度、最大瞬時速度、最大瞬時加速度，以及最大向上地面反作用力和足底壓力中心的移動特徵。統計方面則採用重複量數變異數分析，p值訂於0.05。結果：本體感覺測試發現雙邊振動的情況下，受試者所感覺雙腳位置比沒有振動和單邊振動時顯著向後，而單邊振動情況下與沒有振動無顯著差異。坐到站測試部份，在完成動作時間、軀幹肢段最大前傾角度以及最大向上反作用力方面、以及足底壓力中心最大前後方向移動距離方面，三種情況之間沒有差異。而雙邊振動和單邊振動都比沒有振動的情況提早離開椅面、有較大的軀幹前傾速度和加速度，最大向上反作用力的時間也較早。而雙邊振動的總移動軌跡和最大左右向距離小於單邊振動和沒有振動的情況，且單邊振動的情況下足底壓力中心偏向非振動邊的比例較高。結論：本篇利用雙邊振動刺激改變踝關節的本體感覺輸入來探討對於動作的影響，結果發現雙邊踝關節振動刺激不僅會造成受試者雙腳位置感覺的錯誤；在坐到站的過程中，會影響坐到站動作發生的時間點以及施力點的移動。而單邊踝關節振動雖不能使受試者產生振動邊足部位置改變的感覺，然而單邊踝關節的振動刺激會使足底壓力中心偏移至非振動邊，並可應用於中風病人臨床訓練上，以增強患側下肢的使用。

Background and purpose: Sit-to-stand movement is an important functional task in our daily life. Factors which would influence sit-to-stand movement are worth of investigation. Proprioceptive inputs from the ankle joint provide information regarding the foot placement, which is known to affect the sit-to-stand movement. Thus, the aim of this study was to investigate how additional proprioceptive inputs from bilateral sides and unilateral side of ankle joint affected the performance of sit-to-stand. Methods: 25 healthy young adults required to perform proprioceptive test and sit-to-stand test under 3 conditions: no vibration (NV), bilateral vibration (BV), and unilateral vibration (UV). Mechanical vibrators were placed on the Achilles tendons to induce erroneous proprioceptive inputs. In proprioceptive test, subjects with blindfold needed to point out the anterior site of big toe. In sit-to-stand test, subjects required to stand up with the blindfold and arms across the chest at their selected speeds. VICON system and force plate were used to collect performance of sit-to-stand. Results of proprioceptive test, and sit-to-stand characteristics including task duration, seat-off time, trunk inclination, maximum trunk segment forward velocity, maximum trunk segment forward acceleration, peak vertical ground reaction force, onset of peak vertical ground reaction force, and movement characteristics of center of pressure were used to analysis. Repeated measure ANOVA was used to compare the difference between three conditions. Significant level was p<0.05. Results: In proprioceptive test, subjects in BV showed erroneous sensation of foot placement which was posterior than real position. In sit-to-stand test, subjects in BV and UV showed earlier seat-off and onset of peak vertical ground reaction force than NV. BV and UV also show larger trunk inclination forward velocity and acceleration than NV. In addition, BV showed less COP trajectory and peak to peak range in medial-lateral direction than NV and UV. However, there was no significant difference between three conditions in task duration, trunk inclination forward displacement, and peak vertical ground reaction force. Conclusion: In this study, we found out vibration-induced erroneous proprioceptive inputs from bilateral ankle joints could cause illusory sensation of posterior foot placement. In addition, erroneous proprioceptive inputs from bilateral ankle joints could affect events onset and location of force application on sit-to-stand movement. On the other hand, though unilateral ankle joint vibration could not affect sensation of foot placement, it could modify the location of force application which shifted to the non-vibrated side on sit-to-stand. And we could apply the results on stroke patients to improve the use of affected-side lower limb.

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