臺灣博碩士論文加值系統

在臨床上， 證據顯示半身麻痺使用輪椅人口的半數以上皆患有肩部酸痛
之情形。 而由於手臂有限度的工作能力，以致輪椅之驅動的機械效益非
常低，僅約 10% 。因此仔細評估輪椅本身之機構設計、可動性及與使用
者彼此之間的交互關係， 繼而提高輪椅驅動的機械效率及探討出輪椅的
最佳驅動方式， 進一步指導使用者之驅動技巧，以避免一些如肩肘角過
大而導致肌肉拉傷等傷害，乃非常重要之課題。本研究之目的乃有系統的
建立完整上肢運動模型， 並利用最新穎影像為基礎的三維運動分析系統
， 來分析九位男性受試者在跑步機上驅動輪椅時， 他們的肩關節、肘關
節、腕關節的三維運動模式，以作為臨床上指導學習操作輪椅之參考及日
後分析生物動力學的基礎， 同時並分析五種不同直徑之手推輪對各關節
運動的影響以提供輪椅本身之機構設計的參考。由本文中自行建立之上肢
運動模型來實驗及計算分析上肢各關節運動， 其結果符合實際上肢運動
方式，並且藉著尤拉角將三維運動完整地表示出來。 同時實驗結果顯示
，肘關節之角運動範圍與手推輪直徑大小有正變之關係且部分受試者有過
大之 radius deviation ， 其表示往復式地長期驅動輪椅可能會發生
carpal tunnel 之問題。至於肩部運動方面，並無明顯之結果可表示出酸
痛發生之原因， 因此日後進一步研究動力學問題，探討肌肉、關節之真
實負荷狀況， 將能更了解肩部酸痛及運動傷害發生之主因。

Clinically, more than half of the wheelchair users often
suffer from shoulder pain. Because of the limited work
capacity of the arms, the mechanical efficiency of the
wheelchair self-propulsion is only about 10\%. Therefore,
evaluating the mechanism design and the mobility of the
wheelchair and the interaction between users and wheelchairs
plays an important role to improve the mechanical efficiency of
wheelchair propulsion. A biomechanical model is a valuable
tool to determine the optimal movement pattern of propul-
sion in order to avoid muscle strain resulting from abnormal
range of motion of the shoulder and elbow joints. The object
of this study was to establish the kinematic models of upper
limbs. By image based motion analysis system, the movement
pattern of the shoulder, elbow and wrist joint of nine male
subjects during propelling the wheelchair on the treadmill
were collected and analyzed. The results serve as the basis
of the further kinetic analysis and the guide of wheelchair
propul- sion for the beginners. At the same time, this
study was to compare the effects of hand rim diameter on
movement patterns of upper extremity in order to serve as
references for wheelchair''s mechanism design. The result
completely described the three-dimension kinematic
character- istics and real movements of upper limbs. The
range of motion of the elbow joint was proportional to the
diameter of the hand rim. And some subjects had large
radius deviation, which implicitly indicated that repetitive
wheelchair propulsion for a long time may lead to the
occurrence of carpal tunnel. From the examination of the
shoulder movement, there is no obvious indication about
shoulder pain. Therefore, a further study to calculate the
forces and moments of the joints and muscles might be
necessary.

Cover
Contents
Abstract
Acknowledgments
Contents
List of Tables
List of Figures
Nomenclature
Chapter 1.Statement of The Problem
1.1 Introduction
1.2 Clinical Problem
1.3 Wheelchair propulsion
1.4 Studies of Wheelchair Propulsion Biomechanics
1.5 Specific Aims
1.6 Thesis Organization
Chapter 2.An Instrumented Wheel For Kinetic Analysis of Wheelchair Propulsion
2.1 Introduction
2.2 Materials and Methods
2.2.1 Instrumented Wheel Design
2.2.2 System Validation and Testing
2.3 Results
2.4 Discussion
Chapter 3.Three-dimensional Kinematic Model of The Upper Extremity For Studying Wheelchair Propulsion
3.1 Introduction
3.2 Methods
3.2.1 Kinematic Models
3.2.2 Joint movement
3.3 Experimental Measurement
3.4 Results
3.5 Discussion
Chapter 4.Three-dimensional Dynamic Model of The Upper Extremity During Wheelchair Propulsion
4.1 Introduction
4.2 Methods
4.2.1 Dynamic Model
4.2.2 Kinematics
4.2.3 Kinetics
4.2.4 Sensitivity of Anthropometric Data
4.3 Experiments
4.4 Results
4.5 Discussion
Chapter 5.Joint Loading of The Upper Extremity in Manual Wheelchair Propulsion
5.1 Introduction
5.2 Methods
5.2.1 Kinematics
5.2.2 Kinetics
5.2.3 Maximum Isometric Voluntary Strength
5.3 Experiments
5.4 Results
5.5 Discussion
Chapter 6.Summary and Conclusion
6.1 Overview of Conclusion
6.2 Limitations of Present Work
6.3 Recommendation For Future Research
Appendix
Bibliography
Others