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研究生:林秀真
研究生(外文):Hsiu-Chen Lin
論文名稱:結合運動學測量與肌電圖評估中風痙攣病患之動作功能
論文名稱(外文):Evaluation of movement pattern of spastic stroke patients using electromyographic and kinematic measurements
指導教授:陳家進、張冠諒
指導教授(外文):Jia-Jin Chen、Guan-Liang Chang
學位類別:碩士
校院名稱:國立成功大學
系所名稱:醫學工程學系
學門:工程學門
學類:綜合工程學類
論文種類:學術論文
論文出版年:1996
畢業學年度:84
語文別:中文
論文頁數:86
中文關鍵詞:中風運動學肌電圖
外文關鍵詞:StrokekinematicsEMG
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臨床上,運動功能的評估多由有經驗的臨床者由肉眼觀察,以判定其恢復
程度。本實驗的目的即在於利用同步的肌電訊號及運動學資料來客觀評估
中風病人的運動功能。實驗收集單側偏癱患者與正常受測者的資料用以比
較。中風患者不僅接受臨床分期的評估方式,並選取臨床常用來評估病態
協同動作,兩側下肢均重複做十次,以量化因中樞神經受損導致兩側的差
異。在動作測試同時擷取肌電訊號與三度空間運動學資料,肌電資料以一
千赫茲的取樣頻率並處理成線性封波,之後以動作資料作為參考將之正規
化,重複十次平均後以代表動作模式的肌肉活化。而運動學資料由三度空
間定位軌跡儀測量,記錄四個接收器的位置與方位,反推回當時各部分的
局部座標系,計算各關節角度,運動學取樣頻率可達每個頻道約30赫茲。
實驗中採用關節空間分析關節角度軌跡,選擇分析評估動作型態中,常出
現的典型協同動作組成,來描繪其動作型態。實驗結果顯示,肌電圖活化
模式兩側在活化時序與大小上都有改變,表示中風病人患側仍有不正常的
運動控制;關節空間分析發現動作時各角度之間存在相當一致的線性關係
,而兩側肢體之間的相似性,也正說明了中樞控制肢體間的動作協同仍存
在,但部分患者,因患側肢體無法平順的動作,使關節空間的軌跡改變。
本研究中所採用的評估方法,較臨床觀察更敏感,並可將中樞控制的動作
型態特徵予以客觀具體的描述出來,因而可做為一個科學的臨床評估工具

In clinics, the motor recovery of the stroke patient is usually
evaluated by the observation of experienced clinicians. The aim
of this study is to integrate the muscle activities and the 3D
kinematics data to quantitative and objective assess the motor
function. The stroke patients were recruited from the National
Cheng Kung University Hospital. Normal subjects were also re-
cruited as norm data and comparison. The motor function of the
patient was first evaluated by Brunnstrom assessment form. For
quantitative assessment, The flexion and extension movement
patterns of lower limb which were frequently used in clinical
assessment for abnormal synergy pattern were conducted repeat-
edly to show the extent of abnormal synergy dominance. All
subjects complete ten flexion and extension movements for both
lower limbs. During movement tests, the EMG and 3D kinematic
data were recorded simultaneously. The raw EMG signals were
digitized at sampling rate 1 kHz, then were processed into a
linear envelop (LE) which was further normalized by the kine-
matics data as a time reference. The EMG LE''s were averaged to
represent phasic muscle activity patterns. The 3-D kinematics
data of lower limbs were obtained by 3Space Motion Tracker
System. During movements, the signals were send via RS-232
interface at sampling rate 30 Hz for each receiver. The joint
angle trajectories were then analyzed into joint space. In this
study, the EMG analysis indicated most spastic patient''s
affected limb was still dominated by the lesion brain. Joint
space analysis finds the linear relationship binding all joint
angles during the motion. And the similarity between both limbs
indicated the control of CNS in joint synergy still preserve,
but, in some profoundly cases, we can found the pattern had
been distorted by clumsy movement of the affected limb. The
ultimate goal is develop a quantitative method for the assess-
ment of motor function for stroke patient and the design
therapeutic measure for
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