臺灣博碩士論文加值系統

過去幾年，本研究室已成功發展一部上臂(肩肘)復健用機器人並且完成初步臨床測試。此上臂復健專用機器手臂可實施導引病人上肢肘關節做屈曲、伸直的動作及肩關節做平行內縮、平行外展的動作，且可依所量測病人動作狀況給予助力或阻力以幫助病人完成復健動作，同時我們也發展出分析資料的計算程序以提供量化參數做為治療成果的指標，並驗證復健機器人的可行性。
目前中風病人的復健治療，是由物理治療師以徒手或輔具施予適當的阻力或助力，以誘發其原有的自主功能，最後再依據復健醫師主觀評估病人的復健療效。在本研究中，吾人發展一套復健治療流程，利用現有的肘關節復健機器人系統配合本研究室先前所發展的的關節剛性指標和客觀的運動軌跡均方根誤差閥值來取代物理治療師的手法和評估方式，初步結果顯示利用復健機器人之治療流程對病人具有療效。
本研究另外在肘關節復健機器人上增加量測前臂旋轉扭矩之機構以及增加肌電訊號子系統，在病人追蹤圓形軌跡的運動中，透過機器人上的六軸測力計量得前臂旋轉扭矩及病人與機器人接觸點的位置與力量資料，由逆運算得到前臂旋轉的扭矩，初步可判定受測者在圓周運動中是否產生旋前或旋後的不協調出力。總之，本研究驗證了機器人在長期復健治療上的可行性，且新增的分析前臂旋轉扭矩可發展更完整的復健成效指標。

In our previous study, a parallel robot was developed for neuro-rehabilitation of the upper extremity. The robot is designed for two-dimensional motion in a planar workspace and for applications in the flexion and extension of elbow joints. A fuzzy logic controller was implemented to realize the position and force control such that the robot could apply either resistant or assistant force on the subject’s wrist when upper limb was performing circular movement on the horizontal plane. An assessment technique that measured the dynamic stiffness of the subject at the robot/wrist interface was also developed.
The goals of this thesis are two fold. The first is to employ the rehabilitation robot to perform various treatment protocols on stroke patients. The progress of neuro-rehabilitation is evaluated by the quantitative assessment technique developed in our previous work. The second is to design a subsystem for measuring rotary torque of the forearm and an EMG measuring system. The first refinement enables us to investigate the effects of rehabilitation on the tendency of forearm pronation in stroke patients, which may facilitate establishing new evaluation parameters. The second modification extends our understanding of exertion pattern of the patients during the movements.
The treatment results of five patients showed that the treatment protocol is effective. The rotational torque of forearm can be obtained by transforming the moment measured by the load cell located at the end effector of robot. The pronation/supination moment may be utilized as a new index for evaluating the motor controllability of subjects.

中文摘要 …………………………………………………………………i
英文摘要 …………………………………………………………………ii
誌謝 ………………………………………………………………………iii
目錄 ………………………………………………………………………iv
圖目錄 ……………………………………………………………………vii
表目錄 ……………………………………………………………………x
符號表 ……………………………………………………………………xi
第一章 緒論 ………………………………………………………………1
1-1前言 ……………………………………………………………………1
1-1-1 中風病人復健 ………………………………………………1
1-1-2 神經物理治療 ………………………………………………3
1-2文獻回顧 ………………………………………………………………5
1-3研究動機與目的 ………………………………………………………7
第二章 研究方法與實驗 …………………………………………………9
2-1復健機器人系統 ………………………………………………………9
2-1-1機器人結構 ………………………………………………………9
2-1-2運動軌跡路徑 ……………………………………………………11
2-1-3 EMG電極 …………………………………………………………12
2-2機器人改良 ……………………………………………………………14
2-2-1測力計之校正 ……………………………………………………14
2-2-2電子量角器之校正 ………………………………………………17
2-2-3夾具與編碼器 ……………………………………………………17
2-3復健治療流程 …………………………………………………………19
2-3-1治療流程圖 ………………………………………………………19
2-3-2運動軌跡均方根誤差閥值 ………………………………………21
2-3-3受測者上肢關節控制動剛性評估 ………………………………23
2-4上肢圓周運動下前臂旋轉扭矩量測 …………………………………24
2-5實驗設計 ………………………………………………………………29
2-5-1運動控制實驗 ……………………………………………………29
2-5-2治療實驗 …………………………………………………………29
2-5-3前臂旋轉扭矩實驗 ………………………………………………29
2-5-4實驗程序 …………………………………………………………30
第三章 結果與討論 ………………………………………………………32
3-1運動控制實驗結果 ……………………………………………………32
3-1-1受測者資料 ………………………………………………………32
3-1-2常人和病人運動控制實驗 ………………………………………33
3-1-3動剛性參數量化指標 ……………………………………………36
3-2治療實驗結果 …………………………………………………………41
3-2-1受測者資料 ………………………………………………………41
3-2-2治療實驗 …………………………………………………………42
3-3上肢圓周運動下前臂旋轉扭矩實驗結果 ……………………………53
3-3-1受測者資料……………………………………………………53
3-3-2上肢圓周運動下前臂旋轉扭矩實驗…………………………54
3-4討論 ……………………………………………………………………67
3-4-1動剛性參數指標………………………………………………67
3-4-2治療前後動剛性參數 ………………………………………………69
3-4-3前臂旋轉扭矩實驗……………………………………………71
第四章 結論與建議 ………………………………………………………72
4-1結論 ……………………………………………………………………72
4-2建議 ……………………………………………………………………73
附錄A ………………………………………………………………………74
參考文獻……………………………………………………………………75

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