臺灣博碩士論文加值系統

背景與目的：行走是日常生活活動中經常執行的一項任務，而“步態”是用來描述行走的方式，藉由步態分析可以得知受測者在行走功能表現上的好壞。步態分析的設備在近三十年來有著相當大的躍進，然而其仍有使用上的限制，例如：價格昂貴、實驗花費時間冗長、可分析的步數有限，且這些系統也無法提供步行期間身體穩定度的相關資訊。因此本研究之目的為發展一套可同時分析步態與行走時平衡能力之評估系統。研究方法：本研究開發的系統主要是一台無動力式跑步機及八個單軸荷重元(load cell)，加上四個以壓電薄膜為感應器的腳踏開關組成之測試平台，評估軟體則是利用Microsoft Visual Studio 2008開發一個擷取及儲存電壓訊號、並運算受試者行走時COP(center of pressure)的軟體程式，在系統運作的過程中，透過八組力量感測器、跑帶速度以及腳踏開關，可即時進行多項指標參數的監測與記錄，包含：步行時的步態與重心變化、步行的速度與距離、行走時每一步的表現差異等。本研究共招募20位受試者來測試系統之再測信度，並比較在本系統上與在平地上行走表現的差異。每位受試者皆須在平地以及跑步機上以“自選速率”與“盡可能快”兩種速度各行走一分鐘，且於隔週再接受一次相同的測試。結果與討論：步態分析常用的三個步態參數(步速、步頻、步長)在本系統中再測信度皆達0.7以上，由身體壓力中心變化演算出來的平衡參數其再測信度也達0.5以上。在跑步機上與在平地上的行走表現比較則呈現顯著差異，受試者在跑步機上的步速較慢、步頻較少、步長較短，最主要的原因是在本系統上行走較費力，跑帶與機身之間的摩擦力過大導致行走時受試者遭遇到不小的阻力所致，然而受試者在跑步機上與在平地上的行走表現仍然有中度以上的相關性。結論：本研究所開發的評估系統具備使用空間小、操作便利、數據量化及可分析多個步態週期等多項優點，且達到可同時分析步態與行走時平衡能力的功用，能區別不同速度下行走表現的不同。雖然在本系統上與在平地上行走表現不同，但本系統再測信度良好，且在跑步機上與在平地上的行走表現相關性高，應當可以成為一個良好的臨床評估系統。

Background and purpose：Ambulation is one of the most common tasks done in our daily life, and the term “gait” is used to describe the pattern of walking. Through “gait analysis”, we can understand the quality of walking performance of the subject. The devices used in gait analysis have been improved in the last thirty years. However, there are still some limitations in these devices. For example, the cost of the whole system is too high, it takes too long to complete the experiment, or the number of gait cycle can be analyzed is too small. In addition to the weakness described above, the systems used for gait analysis at present can only measure the whole body mobility, but they can’t provide any information about stability during walking. Thus, the purpose of this study was to develop a system for gait analysis and evaluation of balance ability during walking. Methods：The system developed in this study is a non-motorized treadmill with eight load cells and four footswitches. The evaluating software is a program for data acquisition and saving, and it can calculate the real-time center of pressure of the subject during walking. Under the operating of the system, we can monitor and record many parameters, for example, gait pattern and change of center of pressure, walking velocity and distance, variation of performance in each step, etc. Twenty subjects were recruited in this study for the test-retest reliability of our system, and we also compared the performance between walking overground and on our system. Each subject needed to walk overground and on the treadmill for one minute in two different speeds: “self-paced” and “as fast as possible”, and they must receive the same evaluation test one week after the first time. Results and Discussion：The test-retest reliability of the commonly used gait parameters of gait analysis (velo city, cadence, and step length) in our system are all over 0.7, and the test-retest reliability of balance parameters derived from center of pressure are over 0.5. There is significant difference in the performance between walking overground and on our system. Subjects had slow velocity, less cadence, and shorter step length while walking on the treadmill. The major cause of the significant difference in the performance between walking overground and on our system is the much more energy cost when walking on the treadmill. The friction force between the belt and the treadmill is too large so subjects suffered a great resistance. However, there is medium to high correlation in the performance between walking overground and on our system. Conclusion：Our system developed in this study has a lot of advantages: space-consuming, easy to use, quantification of evaluation, and large numbers of gait cycle can be analyzed. The results support our hypothesis that our system can do gait analysis and evaluate balance ability during walking at the same time, and it can discriminate the walking performance under different walking speed. Although the performance between walking overground and on our system is different, the test-retest reliability of our system is good, and the correlation in the performance between walking overground and on our system is high, so it can still be a good clinical evaluating tool.

致謝 I
中文摘要 II
Abstract III
目錄 IV
圖目錄 VI
表目錄 VII
第一章 前言 1
第一節 研究背景 1
一、 步態分析的重要性與發展現況 1
二、 平衡能力的評估方式 2
三、 跑步機的研究應用 3
第二節 研究的重要性 4
第三節 研究目的 5
第四節 研究假設 5
第二章 文獻回顧 6
第一節 現行步態分析方法 6
第二節 跑步機結合測力板 8
第三節 無動力式跑步機的相關研究 9
第四節 文獻總結 9
第三章 研究方法 10
第一節 系統開發 10
一、 硬體架構 10
二、 程式介面撰寫與操作 14
三、 評估參數 16
四、 平地上行走之步態量測評估 21
第二節 研究對象與流程 22
第三節 資料統計分析 23
第四章 研究結果 24
第一節 系統驗證與評估 24
一、 信度實驗設計 24
二、 信度分析 24
三、 系統軟硬體之功能成效評估 28
第二節 臨床試驗評估 30
一、 實驗流程 30
二、 受試者基本資料 31
三、 跑步機上兩種不同速度的行走測試比較 32
四、 跑步機上與平地上行走測試的比較 35
第五章 討 論 36
第一節 評估參數再測信度之探討 36
第二節 不同速度及不同平面行走表現之探討 37
第三節 研究限制 38
第四節 未來發展建議 38
第六章 結論 39
參考文獻 40
附錄一 44
附錄二 45

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