4週瑜伽訓練改善肩關節功能的效益

Abstract

研究背景：科技發展與社會經濟轉型使生活型態發生改變。長期活動量少，只以手部操作工作或娛樂，易肩膀僵硬酸痛，長期忽略可能導致肩關節不適與發炎。目的：本研究為了解瑜伽是否具舒緩人體肩部緊繃作用，藉瑜伽介入後肩關節活動角度與痠痛不適表現，評估瑜伽訓練介入後對肩部影響。方法：招募 24 位高齡且肩痛及無力指數量表((Shoulder Pain and Disability Index, SPADI)篩選 40~70分肩關節僵硬及酸痛問題者。納入條件包括：肩膀疼痛持續三個月以上；疼痛指數3~7/10 (0分無痛，10分最痛)；做外展與外轉肩膀時疼痛。受試者瑜伽訓練4週，每週兩次，每次60分鐘。四週後以Micro FET3電子關節角度檢測儀量肩關節活動度，並以疼痛指數評估主觀肩部整體疼痛。整體瑜伽訓練介入前(第0週)、後(第4週)，測量受試對象肩關節之屈曲、伸直、內轉、外轉、外展、內收活動度。若測量未達測量執行標準則重新測量，直到達成測量標準。整體瑜伽訓練介入前、後計進行2次測量，每次測量3遍，數據採用標準差作統計分析。統計方式則用成對樣本t檢定與獨立樣本t檢定，檢定不同組受試者與其訓練前後肩關節功能的差異。統計顯著水準訂為 α=.05。結果：實驗組受試者肩關節屈曲(t=-5.09, p<.001)、伸直(t =-4.51, p <.05)、外轉(t =-3.08, p <.05)及外展(t = -3.24, p <.05)等活動度顯著提升，雖主觀疼痛指數未達顯著水準，但仍呈現下降趨勢，顯示瑜伽介入明顯改善關節活動度。未參與瑜伽介入的對照組受試者在肩關節伸直 (t = 3.51, p < .05) 和外展 (t = 2.45, p < .05) 方面，後測表現高於前測。結論：短期瑜伽訓練顯著提高關節的靈活性和活動範圍，且疼痛程度有下降趨勢。未來研究可延長介入為8~12週，以期達效果更佳。

Background: Technological advancements and socioeconomic transformations have changed people's lifestyles. A long-term lack of physical activity, often in the form of sitting and performing work or entertainment with only the hands, has made people more prone to suffer from stiffness and soreness in the shoulders, particularly the right shoulder. Neglecting this condition over time may lead to shoulder joint discomfort and even joint inflammation. Objective: This study aims to investigate whether yoga can alleviate tension in the human shoulders. The evaluation of the effects of yoga intervention on the shoulders is based on the changes in the shoulder joint's range of motion and the participants' experiences of soreness and discomfort. Methods: The study recruited 24 aged adults who score over 40 on the Shoulder Pain and Disability Index (SPADI), indicating problems with shoulder stiffness and pain. Inclusion criteria include: persistent shoulder pain for more than three months; pain index exceeding 3 out of 10 (0 being no pain and 10 being the most severe pain); pain during abduction and external rotation of the shoulder. Participants will undergo 4 weeks of yoga training, with two sessions per week, each lasting 60 minutes. The shoulder joint's range of motion will be measured with a micro FET3 electronic goniometer, and pain index will be used to assess the overall shoulder pain as perceived by the participants. Measurements of shoulder flexion, extension, internal rotation, external rotation, abduction, and adduction will be taken before (week 0) and after (week 4) the yoga intervention. If the measurements do not meet the standard upon the first attempt, they will be taken again until the standard is met. Two sets of measurementswill be conducted, with three repetitions each, before and after the yoga intervention, using standard deviation for statistical analysis. paired samples t-test and independent samples t-test will be used to test the differences in shoulder joint function between participants before and after training. The significance level for statistics is set at α=.05. Results: In this study, the experimental group showed significant improvements in shoulder joint flexion (t = -5.09, p< .001), extension (t = -4.51, p < .05), external rotation (t = -3.08, p < .05), and abduction (t = -3.24, p < .05). Although the subjective pain index did not reach a significant level, there was a decreasing trend, indicating that yoga intervention can significantly improve joint mobility. The control group, which did not participate in the yoga intervention, showed higher post-test performance in shoulder joint extension (t = 3.51, p < .05) and abduction (t = 2.45, p < .05) compared to pre-test performance. Conclusion: Short-term yoga training significantly enhances joint flexibility and range of motion, with a trend towards reduced pain levels. Future research can extend the intervention time to 8 to 12 weeks in order to achieve better results.