臺灣博碩士論文加值系統

精準醫療（Precision Medicine）是以個別化醫療為基礎，整合工程科技改善傳統醫療，復健醫療也逐漸朝向此方向發展，本研究提出人機電和諧設計圖 (Anthro-Mechatronic Harmonious Design Canvas)，依據此模型觀察臨床需求，整合機電技術之方式，找尋精準復健之可能發展方式。本論文以此人機電和諧設計圖開發三種復健領域的創新機電系統，作為促進精準化復健、評估與輔助系統的範例
第一，個別化調整之巴金森氏症患者視覺提醒裝置之復建系統開發，研究據此裝置證實個別化調整對於巴金森氏症患者能誘發出更好的步態表現，且每個患者的適用參數都不同，透過簡易調整視覺提醒方式能可提供臨床上更方便的步態訓練時運用。
第二，手持式關節附屬動作量測儀器之評估系統開發，實現客觀化量臨床上常用之關節附屬動作評估，以輕便手持系統增加臨床之可行性，資料可透過無線傳輸透過手機上傳至雲端儲存，連續紀錄患者之關節附屬動作之變化，可作為後續大數據分析之運用。
第三，前方自動跟隨行走輔助系統之開發，可於使用者周圍自動跟隨，以使用者為中心，前後左右旋轉三個自由度移動，平時可協助載重物，可提供必要時穩定支撐、預防跌倒，此平台未來還可作為個人化醫療平台，載運較大之可攜式精準醫療設備、並提供運動量分析、步態分析…等功能。
本論文提出之人機電和諧設計圖可幫助醫學與工程領域蒐集資訊，加速設計出和諧的人機整合系統，發展出創新精準化復健、評估及輔具系統

Precision medicine is based on personalized medicine and integrates engineering technology to improve traditional medicine in four ways: personalization, quantification, continuity, and prevention. Rehabilitation medicine is gradually developing in this direction. This thesis suggests a model, “Anthro-Mechatronic Harmonious Design Canvas” (AMHD canvas), to develop mechatronic assistive devices with Innovative design methods which contained observing clinical needs and integrating electromechanical technology. This dissertation demonstrated three innovative mechatronic systems in the field of precision rehabilitation.
Firstly, an individualized and adjustable visual cue device was developed to improve the gait performance of patients with Parkinson's disease. The laser lines projected from the wheeled walker could relieve the limits of space and increase the mobility of the gait training system. The newly developed ground-fixed projection of visual cues provided an alternative visual perception that mimics the experience of walking on transverse lines stuck on the ground. Furthermore, personalized parameters of visual cues matching subjects’ gait ability are critical to achieving the largest improvement of stride length for individuals based on our proposed device.
Secondly, a convenient objective reliable clinical assessment device for joint accessory motion test (JAMT) was developed. The aim of this study was to develop a JAMT device which is (a) equipped with multiple probes to truly measure the displacements in the joint, (b) manual handheld to allow evaluators to feel the joint response and to exert the force to the desired magnitude and (c) accounted for errors caused by unsteady hands to provide reliable and consistent results.
Thirdly, for aging prevention, the automatic front-accompanying robot was developed for assisting the user in carrying heavy objects and providing stable support when necessary. This aid was user-oriented design and with the three degrees of freedom mobility. In the future, this robot can also be used as a personalized medical platform to carry larger portable medical equipment and provide functions such as gait analysis.
In conclusion, the AMHD canvas, developed in this dissertation, helps gather information and analyze problems from both engineering and medical domains. The AMHD canvas could also inspire the innovative ideas and speed up the harmonious medical and engineering integration to develop the precision rehabilitative, assessing and assistive technology systems.

Acknowledgments II
Chinese Abstract III
English Abstract IV
Contents VI
List of Figures IX
List of Tables XIV
Chapter 1. Introduction 1
Chapter 2. Development of rehabilitative technology: the novel instrumented walker for individualized visual cue setting for gait training in patients with Parkinson’s disease 10
2.1 Introduction 10
2.2 Materials and Methods 16
2.2.1 Instrumentation 16
2.2.2 Experiment 22
2.3 Results 26
2.4 Discussion 30
2.4.1 Effect of instrument design 30
2.4.2 Effect of usage instructions 33
2.4.3 Effect of visual cue settings 35
2.4.4 Limitations and Future Work 37
2.5 Conclusions 38
Chapter 3. Development of assessing technology: the objective portable measurement device for spinal joint accessory motion test 39
3.1 Introduction 39
3.2 Material and Methods 45
3.2.1 System Design 45
3.2.2 Calibration, parameter identification, and data processing 51
3.3 Methods of System Verification 55
3.3.1 Testing Rig & Computer Modelling 55
3.3.2 Single spring test 57
3.3.3 Spinal simulation test 58
3.4 Result of System Verification 58
3.5 Discussion of System Verification 60
3.5.1 Instrument design 60
3.5.2 Single spring test 60
3.5.3 Spinal simulator test 61
3.6 Method of Clinical Test 63
3.6.1 Procedure and statistic methods 63
3.6.2 Finding force-displacement characteristics 64
3.7 Result of Clinical Test 66
3.8 Discussion of Clinical Test 69
3.8.1 Force-Displacement Characteristic 69
3.8.2 Measuring error caused by manual operation 70
3.9 Limitation and future work 73
Chapter 4. Development of assistive technology: the front accompanying robot for assisting the older person to go out 74
4.1 Introduction 74
4.2 Method 79
4.2.1 Design concept and user analysis 79
4.2.2 Firmware development and control Algorithm 82
4.2.3 System development 87
4.2.4 System programming 94
4.3 Methods of System Verification 96
4.3.1 Testing method 96
4.3.2 Testing environment 97
4.4 Result of System Verification 98
4.4.1 Single direction 98
4.4.2 Multiple tasks 106
4.5 Conclusion and future application 110
Chapter 5. Conclusion 111
Reference 113
Abbreviations 120

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