目的：本文研究目的在於比較傳統式及競賽式?椅推進方式之肩關節三維運動與肩擠壓?為的差?性。研究背景：肩關節疼痛在競賽?椅選手有極高的發生?，田徑競賽中?椅推進法主要可分為傳統式及競賽式?種。選手為求提高競技表現多使用競賽式?椅推進法。?解?同?椅推進方法與肩擠壓性傷害將有?於預防肩關節傷害的發生。方法：10位?動???椅使用者?與本研究受試者使用傳統與競賽式?椅。?用Zebris動作分析系統收集受試者身上的標點之動態軌跡。?用運動學原?，本文發展一個三維的肩關節運動模式，?用實驗設計及統計t-test檢定以比較各組間分析??的差?性。結果：本研究所發展出?的肩部運動模式，是一具效?的工具。因其總均方根誤差小於6.5?，且皮爾遜相關係?高達0.9。?椅推進是一週期性運動，肩部的擠壓位置往往發生在推動期早期。在時間??比較上傳統式與競賽式有相似的推動時間(60%)與恢?時間(40%)。競賽式?椅推進法有較多肩肘角位移發生在有效的出?區域(t=-4.87，p<.05)，但?也有相對較多肩關節位移發生在?受傷害的擠壓區域(t=-4.67，p<.05)。討?與結?：競賽?椅選手有極高的肩關節疼痛發生?，其原因可能是選手在推進?椅時其肩部過分被放在肩關節的擠壓位置，因為?椅的推進需要肱骨頭在肩峰下關節內，做大?的內轉動作，且該動作是被侷限在一定狹小的活動空間內，因此這種?正常的機械性?激恐是重要的?學致病因素。雖然競賽式?椅推進法較傳統式有較有?的肌?產生方式，但?得擔負肩部潛在性被擠壓的傷害。為預防?椅選手的肩關節疼痛問題，教?及運動訓??宜過份要求競賽?椅選手大?使用競賽式?椅推進法的動作。

This study compared shoulder impingement behaviors between two commonly used wheelchair propulsion techniques, the conventional and the competitive techniques. High incidence of shoulder pain was found in wheelchair athletes. Wheelchair athletes commonly used two techniques in manual wheelchair propulsion, that is, the conventional and the competitive. Shoulder pain involves abnormal stress acts on the subacromial space in which many soft tissues exist. Understanding shoulder impingement behavior associated with different propulsion techniques may provide important information in shoulder pain prevention. Ten wheelchair users voluntarily participated in this study. In order to understand shoulder kinematics behaviors, the Zebris motion analysis system was used to collect marker coordinates. A biomechanical model was developed for describing shoulder three-dimensional motion behavior. The t-test was used to examine the difference among the investigated parameters in both the conventional and the competitive techniques. The results showed that the biomechanical model in the present study was valid as supported by the root-mean-square value less than 6.50 and the Pearson correlation coefficient of 0.9. In shoulder kinematics behaviors, the conventional and the competitive techniques had similar push time (60%) and recovery time (40%) (p＞.05). Compared with the conventional technique, the competitive technique had a larger shoulder-elbow working area occurrence in the efficient zone (t=4.67, p＜.05) and had more joint excursion in the impingement zone (t=4.87, p＜.05). Based on the present study, we believed the propulsion technique could be a pre-determined factor in causing shoulder impingement injury. Competitive propulsion caused an athlete's shoulder to be largely involved in position of abduction, flexion and internal rotation. This combined shoulder position may produce abnormal stress acting on the soft tissue beneath the subacromial space. In order to prevent shoulder pain in wheelchair athletes, coaches and trainers must realize the differences of mechanical stress acting on the shoulder tissue in both the conventional and the competitive propulsion techniques.