| 摘要: | 目的：探討不同負重模式 (下肢肌力10%、自體重量10%、固定重量) 對急性郊山健走時生理參數、肌肉損傷程度、肌力恢復以及日常生活影響之差異。方法：通過IRB後召募45名志願參加郊山健走之受試者，隨機分為三組 (n=15人/組)，A組：下肢肌力10% 組 (身高167.27 ± 10.28公分、體重59.66 ± 14.82公斤、年齡21.46 ± 1.28歲和平均負重8.40 ± 3.83公斤)；B組：自體重量10%組 (身高168.33 ± 10.62公分、體重67.68 ± 15.64公斤、年齡20.91 ± 1.35歲和平均負重6.79 ± 1.66公斤)；C組：固定重量4公斤組 (身高163.47 ± 6.89公分、體重59.65 ± 13.38公斤、年齡21.35 ± 1.41歲和平均負重4.00 ± 0.00公斤) 進行基隆山健走實驗。排除條件為有心血管疾病、慢性阻塞性肺病、膝關節炎、懷孕、腦損傷或其他神經系統疾病、三個月內曾前往郊山健走以及近六個月內接受過手術的受試者。所有受試者進行健走活動前，先測試個人的下肢最大肌力、左右單腳最大肌力，採集乳酸與肌酸激酶活性當作前測基礎值。郊山健走時在固定點收集與記錄心跳率、運動自覺量表、肢段 (下肢、肩膀、腰部) 的主觀視覺疼痛指數和血乳酸、肌酸激酶採集。在活動後，連續三天進行肌酸激酶檢測與肌力測試和連續五天收集登山後自我報告問卷 (QNR) 數據。資料以單因子變異數分析 (one-way ANOVA) 探討三組負重模式之間的差異，若達到顯著水準則以雪費法 (Scheffé’s) 進行事後比較；同一組別以重複量數變異數分析 (Repeated Measures ANOVA) 探討組內不同採集點之差異，若有顯著水準再以邦弗朗尼法 (Bonferroni) 進行事後比較。本研究顯著水準皆定為α = .05。結論：結果顯示，一、負重健走顯著提升心跳率、運動自覺量表和血乳酸濃度，尤其在上坡階段更為明顯；二、所有負重模式的肌酸激酶活性均升高且下肢肌力下降，其峰值均出現在運動後第一天，隨時間逐漸恢復，符合延遲性肌肉酸痛的典型時間進程；三、登山後自我報告問卷 (QNR) 的結果強調了負重健走對肌肉骨骼系統的負荷，在地形崎嶇及坡度較大的環境下，股四頭肌和腓腸肌等主要肌群承受過度的機械張力，進而提升整體下肢的疼痛感覺；四、本研究結果可為健走群眾提供自我感知強度、負重增加代謝張力負荷與理解疼痛恢復進程之參考依據。
Purpose: This study investigated the differential effects of various load-carrying modes (10% lower limb strength, 10% body weight, and 4kg weight) on physiological parameters, muscle damage, muscle strength recovery, and daily life impact during acute hilly hiking. Methods: Following IRB approval, 45 volunteers were recruited and randomly assigned to three groups (n=15/group): Group A (10% lower limb strength load: 167.27 ± 10.28 cm, 59.66 ± 14.82 kg, 21.46 ± 1.28 years, 8.40 ± 3.83 kg average load); Group B (10% body weight load: 168.33 ± 10.62 cm, 67.68 ± 15.64 kg, 20.91 ± 1.35 years, 6.79 ± 1.66 kg average load); and Group C (fixed 4kg load: 163.47 ± 6.89 cm, 59.65 ± 13.38 kg, 21.35 ± 1.41 years, 4.00 ± 0.00 kg average load) to conduct a hiking experiment on Keelung Mountain. Participants with cardiovascular disease, chronic obstructive pulmonary disease, knee osteoarthritis, pregnancy, brain injury or other neurological disorders, hilly hiking experience within the past three months, or surgery within the last six months were excluded. Before hiking Mount Keelung, participants' baseline lower limb maximal strength, left and right single-leg maximal strength, blood lactate, and creatine kinase (CK) activity were measured. During the hike, heart rate, rating of perceived exertion (RPE), subjective visual analog scale (VAS) for pain in limbs (lower limbs, shoulders, waist), blood lactate, and CK were collected at fixed points. After the hike, CK levels and muscle strength were assessed for three consecutive days, and Quality of Life after Exercise (QNR) data were collected for five straight days via self-report questionnaires. Data were analyzed using one-way analysis of variance (ANOVA) to explore differences among the three load carriage groups, with Scheffé's post-hoc test for significant findings. Repeated measures ANOVA was employed for within-group differences across various collection time points, followed by Bonferroni post-hoc analysis for substantial findings. Statistical significance was set at α=.05. Conclusions: The results revealed that: 1) Load carriage during hill hiking significantly elevated heart rate, rating of perceived exertion, and blood lactate levels, with this increase being particularly pronounced during the uphill phase; 2) All load carriage modes resulted in elevated creatine kinase activity and decreased lower limb muscle strength, with peak values occurring on the first day post-exercise, followed by a gradual recovery over time, consistent with the typical time course of delayed onset muscle soreness (DOMS); 3) The post-hiking self-report questionnaire (QNR) results underscored the musculoskeletal load imposed by load carriage during hill hiking in challenging and steep terrains, where quadriceps and gastrocnemius, among other major muscle groups, experienced excessive mechanical tension, thereby increasing overall lower limb pain; 4) The findings of this study can serve as a reference for hikers regarding self-perceived intensity, understanding the metabolic tension associated with increased load, and comprehending the pain recovery process. |
