臺灣博碩士論文加值系統

步行的能力是人類日常生活中最重要的能力之一，如何使病患步行能力得以改善，對於復健醫學上是相當重要的研究方向之一；人類的步態因個體而有所不同，醫師可藉由足底壓力訊號瞭解步行正確性、穩定性或復健情況，進而診斷病患整體狀況。
有鑑於足底壓力有助於步態方面的評估，本研究使用荷重計（load cell）代替以往研究所使用的薄膜式壓阻感測器（Force Sensitive Resister ; FSR），並整合自行開發的量測鞋具模組、訊號放大及轉換電路、單晶片控制之資料儲存裝置，完成足底力量量測裝置。對於裝置所收集記錄之訊號，則使用LabView所開發之軟體進行分析，以獲得有系統之步態相關資料。
本論文的研究成果，建立一以荷重計為基礎之可攜式、高解析度、及可長時間記錄的足底力量量測系統，並參考測力板垂直力的分析方式，建構出新型的量測鞋具與分析系統；由實驗所獲得的結果顯示，本研究所開發出的足底力量量測系統可擷取到精確的訊號，並正確的計算出步態參數，未來在臨床上有助於醫師利用其進行診斷評估。

Walking ability is one of the most important ability in one’s daily living. Since gait performance may differ among individuals, how to improve a patient’s walking ability is an important research topic in the rehabilitation medicine. Analysis of a patients’ foot-ground reactions during locomotion can be helpful for a doctor to diagnosis his walking ability, stability, and balancing performance.
This study integates 14 load cells instead of force sensitive resisters (FRS) used in the past, a self-developed shoe module, a signal amplifica-
-tion and A/D conversion circuit, and a microprocessor-controlled data storage device to build a foot-floor-reaction-force measurement system. An analysis software designed by LabVIEW programming was applied to analyze the collected data to acquire temporal and spatial parameters of the gait.
In this study, a foot-floor-reaction-force measurement system which equipped with portability, high resolutions, and long operation time was built. The newly designed system was built to analyze the vertical ground reactions of individual foot. Results of experiments show the system is capable of acquiring signals with precision during both normal and pathological gaits and to derive accurate parameters for clinical diagnosis.

摘要 i
Abstract ii
目錄 iii
表目錄 v
圖目錄 vi
第一章 緒 論 - 1 -
1‐1 前言 - 1 -
1‐2 研究背景 - 1 -
1‐3 研究目的 - 3 -
1‐4 論文架構 - 3 -
第二章 文獻回顧 - 4 -
2‐1 足底壓力相關研究 - 4 -
2‐2 足底壓力感測元件 - 5 -
2‐2.1 壓力—電容式感測器 - 5 -
2‐2.2 壓力—電阻式感測器 - 5 -
2‐2.3荷重計（load cell） - 6 -
2‐3 足底壓力量測儀器介紹 - 7 -
2‐3.1 F-Scan系統 - 8 -
2‐3.2 Pedar系統 - 8 -
2‐3.3 CDG系統 - 9 -
2‐4 中風病患步態研究 - 10 -
2‐5 文獻總結 - 11 -
第三章 研究方法 - 12 -
3‐1量測鞋具製作 - 13 -
3‐2 感測元件及訊號放大器製作 - 16 -
3‐3 資料記錄器製作 - 20 -
3‐4 硬體訊號校正 - 25 -
3-5 功能測試及資料分析整理 - 30 -
第四章 結果 - 33 -
4‐1 校正結果 - 33 -
4‐2對照組量測結果 - 33 -
4‐3病患組量測結果 - 35 -
4‐3.1 平地步行結果 - 37 -
4‐3.2 上樓步行結果 - 38 -
4‐3.3 下樓步行結果 - 39 -
4‐3.4 平地2步行結果 - 40 -
4‐4 對照組與病患組之比較 - 41 -
第五章 討論 - 42 -
5‐1 資料臨床評估價值 - 42 -
5‐1.1 步態週期 - 42 -
5‐1.2 步態波峰及步態峰值 - 43 -
5‐1.3 步態蝴蝶圖 - 43 -
5‐2系統優缺點 - 44 -
5‐2.1 系統優點 - 44 -
5‐2.2 系統缺點 - 45 -
第六章 結論與未來工作 - 47 -
參考文獻 - 48 -
附錄 - 55 -

1.Alexander, I.J.,Chao, E. Y. S.,& Johnson,K. A.(1990). The assessment of dynamic foot-to-ground contact forces and plantar pressure distribution: A review of the evolution of current techniques and clinical applications. Foot and Ankle , 11(3), 152-167
2.Barnett, Sue; Cunningham, James L.; West, Steven; A Comparison of vertical force and temporal parameters produced by an in-shoe pressure measuring system and a force platform. Clinical Biomechanics Volume: 16, Issue: 4, May, 2001, pp. 353-357
3.Bennent L, Murray MP, Murphy EF & Sowell TT. Locomotion assistance through cane impulse. Bull Prosth. Res 1979;10(31): 38-47.
4.Beely F. Zur Mechanik des Stehans Uber die Bedeutung des Fussge- woblesbiem Stehan. Langenbecks Arch Klinishe Chir 27:457-468 1881.
5.Bohannon RW, Andrews AW & Smith MB. Rehabilitation goals of Patients with hemiplegia. Int. J Rehabil 1988; 11: 181-183
6.Chia-Ling Chen.; Hsieh-Ching Chen.; Fuk-Tan Tang.; Kuo-Dai Hou.; Wei-Hsien Hong.; Rong-Shun Chen.; Bel-Wen Lu.; May-Kuen Wong; Analysis of Cane-Assisted Gait in Patients with Hemiplegic Stroke. 中華復健醫誌 2000; 28(4): 221-228
7.Chia-Ling Chen, MD, PhD, Hsieh-Ching Chen PhD, May-Kuen Wong, MD, Fuk-Tan Tang, MD, Rong-Shun Chen, PhD. Temporal Stride and Force Analysis of Cane-Assisted Gait in People With Hemiplegic Stroke. Arch Phys Med Rehabil Vol 82, January 2001.
8.Costigan, Patrick A.; Deluzio, Kevin J.; Wyss, Urs P. Knee and hip kinetics during normal stair climbing. Gait and Posture Volume: 16, Issue: 1, August, 2002, pp. 31 — 37
9.Gaviria, M.; D'Angeli, M.; Chavet, P.; Pelissier, J.; Peruchon, E.; Rabischong, P. Plantar dynamics of hemiplegic gait: a methodological approach. Gait & Posture Volume: 4, Issue: 4, October, 1996, pp. 297-305
10.Gerald F. Harris, Hongsheng Zhu, Jacqueline J. Wertsh, Willis J. Tompkins, and John G. Webster. A Microprocessor-Based Data-Acquisition System for Measuring Plantar Pressure from Ambulatory Subjects IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING. VOL. 38. NO. 7. JULY 1991
11.Gerald F. Harris.; Kandarp R. Acharya.; Rebecca A. Bachschmidt.; Investigation of Spectral Content from Discrete Plantar Areas During Adult Gait: An Expansion of Rehabilitation Technology. IEEE TRANSACTIONS ON REHABILITATION ENGINEERING, VOL. 4. NO. 4, DECEMBER 1996
12.H.L.P. Hurkmans, J.B.J. Bussmann, E. Benda, J.A.N. Verhaar, H.J. Stam, Techniques for measuring weight bearing during standing and walking. Clinical Biomechanics 18 (2003) 576—589.
13.Hongsheng Zhu , Nabil Maalej, John G. Webster, Willis J. Tompkins, Pual Bach-y-Rita, and Jacqueline J. Werisch. A MICROPROCESSO- RBASED DATA-ACQUISITION SYSTEM FOR MONTIORING FOOT PRESSURE. IEEE 1988.
14.Jahnke, M T; Hesse, S; Schreiner, C; Mauritz, K-H. Dependences of ground reaction force parameters on habitual walking speed in hemiparetic subjects. Gait and Posture Volume: 3, Issue: 1, March, 1995, pp. 3-12
15.Kathryn A. Christina, Peter R. Cavanagh. Ground Reaction Forces and frictional demands during stair descent: effects of age illumiaation. Gait and posture 15 (2002) 153-158.
16.Kim, C. Maria; Eng, Janice J. symmetry in vertical ground reaction force is accompanied by symmetry in temporal but not distance variables of gait in persons with stroke. Gait and Posture Volume: 18, Issue: 1, August, 2003, pp. 23 — 28
17.Lepic, T.; Ilic, T.; Jovcic, A.; Djordjevic, D.; Martic, V.; Raicevic, R. Simple clinical distinction of stroke type . Journal of the Neurological Sciences Volume: 150, Supplement 1, September, 1997, pp. S221
18.Lord, M.; Hosein, R.; A study of in-shoe plantar shear in patients with diabetic neuropathy. Clinical Biomechanics Volume: 15, Issue: 4, May, 2000, pp. 278-283
19.M P Griffin PhD, S J Olney PhD, I D McBride Msc. Role of symmetry in gait performance of stroke subjects with hemiplegia. Gait & Posture 1995; Vol. 3: 132-142, September
20.M T Jahnke, M Schauer, A S Hess, K H Mauritz. Symmetry of GRF as dependent on walking speed in hemiplegics. Gait & Posture 1995; 3: No 3
21.MacWilliams, B.A.; Armstrong, P.F. Clinical applications of plantar pressure measurement in pediatric orthopedics. Pediatric Gait, 2000. A new Millennium in Clinical Care and Motion Analysis Technology , 22 July 2000 Pages:143 — 150
22.Mehta, D.; Tompkins, W.J.; Webster, J.G.; Wertsch, J.J. Analysis of foot pressure waveforms. Engineering in Medicine and Biology Society, 1989. Images of the Twenty-First Century. Proceedings of the Annual International Conference of the IEEE Engineering in , 9-12 Nov. 1989 Pages:1487 - 1488 vol.5
23.Michael W. Whittle.; Clinical gait analysis: A review. Human Move- ment Science 15(1996) 369-387
24.Mueller, M J; Strube, M J; Generalizability of in-shoe peak pressure measures using the F-scan system. Clinical Biomechanics Volume: 11, Issue: 3, April, 1996, pp. 159-164
25.Olney, Sandra J.; Richards, Carol; Hemiparetic gait following stroke. Part I: Characteristics. Gait & Posture Volume: 4, Issue: 2, April, 1996, pp. 136-148
26.Patil, M.K.; Vasanth Bhat, V.; Bhatia, M.; Parivalavan, R.; Narayanamurthy, V.B.; Ganesan, V.S.; New methods and parameters for dynamic foot pressure analysis in diabetic neuropathy. Engineering in Medicine and Biology society, 1997. Proceedings of the 19th Annual International Conference of the IEEE , Volume: 4 , 30 Oct.-2 Nov. 1997 Pages:1826 - 1828 vol.4
27.Ranu, H.S.; Gait analysis of diabetic foot. Biomedical Engineering Conference, 1995., Proceedings of the 1995 Fourteenth Southern , 7-9 April 1995 Pages:197 — 200
28.Ravindarn, G.; Manivannan, R.; Measurement And Analysis Of Pressure At Various Points On The Sole Of The Foot During Gait Engineering in Medicine and Biology Society, 1992. Vol.14. Proceedings of the Annual International Conference of the IEEE , Volume: 1 , October 29- November 1, 1992 Pages:56 — 57
29.Ray, J.; Snyder, D.; Pedobarographic gait analysis on male subjects. Biomedical Engineering Conference, 1996., Proceedings of the 1996 Fifteenth Southern , 29-31 March 1996 Pages:25 — 27
30.Richards, Carol L.; Olney, Sandra J.; Hemiparetic gait following stroke. Part II: Recovery and physical therapy. Gait & Posture Volume: 4, Issue: 2, April, 1996, pp. 149-162
31.Riener, Robert; Rabuffetti, Marco; Frigo, Carlo; Stair ascent and descent at different inclinations. Gait and Posture Volume: 15, Issue: 1, February, 2002, pp. 32 — 44
32.Salsich, Gretchen B.; Brechter, Jacklyn Heino; Powers, Christopher M. Lower extremity kinetics during stair ambulation in patients with and without patellofemoral pain. Clinical Biomechanics Volume: 16, Issue: 10, December, 2001, pp. 906-912
33.Starita, A.; Dario, P.; Bergamasco, M.; Fiorillo, N.; Perfetti, C.C.; Clinical evaluation of rehabilitative procedures by a 1024-sensing elements platform. Engineering in Medicine and Biology Society, 1988. Proceedings of the Annual International Conference of the IEEE , 4-7 Nov. 1988 Pages:1605 - 1606 vol.4
34.Smith, P.A.; Abu-Faraj, Z.O.; Harris, G.F.; Surgical rehabilitation of the planovalgus foot in cerebral palsy Neural Systems and Rehabilitation Engineering, IEEE Transactions on see also IEEE Trans. on Rehabilitation Engineering , Volume: 9 , Issue: 2 , June 2001 Pages:202 — 214
35.Titianova, Ekaterina B.; Mateev, Plamen S.; Tarkka, Ina M. Footprint analysis of gait using a pressure sensor system. Journal of Electromyography and Kinesiology Volume: 14, Issue: 2, April, 2004, pp. 275-281
36.Wervey, R.A.; Harris, G.F.; Wertsch, J.J. Plantar pressure characteri- stics during stair climbing and descent. Engineering in Medicine and Biology society, 1997. Proceedings of the 19th Annual International Conference of the IEEE , Volume: 4 , 30 Oct.-2 Nov. 1997 Pages: 1746 - 1748 vol.4
37.Yu, Bing; Growney, Eric S.; Schultz, Fred M.; An, Kai-Nan ; Calibration of measured center of pressure of a new stairway design for kinetic analysis of stair climbing. Journal of Biomechanics Volume: 29, Issue: 12, December, 1996, pp. 1625-162840.
38.Zequera, M.L.; Solomonidis, S.E.; Vega, F.; Rondon, L.M.; Study of the plantar pressure distribution on the sole of the foot of normal and diabetic subjects in the early stages by using a hydrocell pressure sensor. Engineering in Medicine and Biology Society, 2003. Proceedings of the 25th Annual International Conference of the IEEE , Volume: 2 , 17-21 Sept. 2003 Pages:1874 - 1877 Vol.2
39.Ziad o. Abu-Faraj, Gerald F. Harris, Peter A. Smith,; Surgical Rehabilitation of the Planovalgus Foot in Cerebral Palsy. IEEE TRANSACTIONS ON NEURAL SYSTEMS AND REHABILITATION ENGINEERING, VOL. 9, NO. 2, JUNE 2001
40.Ziad O. Abu-Faraj, Gerald F. Harris,Joseph H. Abler, Jacqueline J.Wertsch, and Peter A. Smith,; A Holter-Type Microprocessor-Based Rehabilitation Instrument for Acquisition and Storage of Plantar Pressure Data in Children with Cerebral Palsy. IEEE TRANSACTIONS ON REHABILITATION ENGINEERING, VOL. 4. NO. 1, MARCH 1996.
41.王志元。以個人數位助理為基礎之腳底壓力量測系統設計。私立中原大學醫學工程學系。碩士論文；2002
42.李志韋。穿鞋行走時足部之生物力學探討。國立成功大學醫學工程研究所。碩士論文；1998
43.陳詩婷。腦中風病患步行時動態足壓承重型態與足壓相關參數之分析。國立臺灣大學物理治療學研究所。碩士論文；2000
44.劉苑玟。不同柺長對中風病患步態之影響：時間及動力學參數分析。國立臺灣大學物理治療學研究所。碩士論文；2000。
45.謝永寧。以拐杖助行之步態記錄器實作。長庚大學電機工程研究所。碩士論文；2001
46.Gait analysis; Butterworth-Heinemann; Whittle Michael
47.如何精通SPSS for Windows統計分析，松崗出版社，李金泉編著
48.http://www.doh.gov.tw/NewVersion/index.asp