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研究生:張家誠
研究生(外文):Chang, Chia-Cheng
論文名稱:輪椅驅動時座椅位置在上肢生物力學之效應
論文名稱(外文):The Effect of Seat Position on Biomechanics of Upper Extremity in Wheelchair Propulsion
指導教授:蘇芳慶蘇芳慶引用關係
指導教授(外文):Fong-Chin Su
學位類別:碩士
校院名稱:國立成功大學
系所名稱:醫學工程研究所
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:1998
畢業學年度:86
語文別:中文
論文頁數:120
中文關鍵詞:輪椅生物力學座椅位置
外文關鍵詞:wheelchairbiomechanicsseat position
相關次數:
  • 被引用被引用:10
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對於長期操作手推輪椅的使用者而言,上肢關節的過度使用傷害(
overuse injury) 是明顯而常見的。過去文獻也證實輪椅使用者的肩部以
及腕部的疼痛與手推輪椅的使用有著顯著的相關性。大部分的研究將輪椅
驅動時的上肢運動簡化為二維的運動,忽略了上肢實際的複雜運動,而其
結果也顯示了三維運動分析的必要性。 輪椅的機構設計與輪椅的驅動
方式有密切的交互關係。而輪椅座椅是介於使用者與輪椅間的重要介面,
讓使用者得以提供輪椅前進所需力量,改變座椅相對位置會對使用者的驅
動情形有所影響。本研究的目的是要了解座椅位置改變對上肢在輪椅驅動
時的運動學與動力學的影響。我們的假說認為座椅位置改變對兩者都會有
影響。 十三位健康青年參與本研究,操作一台標準型輪椅與特別設計
用來量測力量與力矩的輪子在水平步道上前進。十九顆反光球黏貼在上肢
與輪框上,即可利用ExpertVisionTM 動作分析系統擷取上肢在空間中的
位置,配合輪子收集到的資料,用以計算肢段間產生的力量與力矩。
個別關節間產生的力矩值,在本研究中以 輪椅趨動力量比率
(wheelchair propulsion strength rating, WPSR) 來表示。WPSR是指輪
椅驅動時產生最大力矩值與最大等長收縮產生的力矩值的比例,我們認為
此亦可代表關節承受負荷的比例。最大等長收縮力矩是經由Kin-ComTM 測
力器所收集而得。 本研究使用多變數的統計分析方法來檢驗座椅位置
的兩個相依變數,椅高與輪軸前後位置,對所有的運動學與動力學參數的
影響。座椅位置改變的效應在某些的運動學與動力學參數上顯現出來,但
對時間參數與驅動效率則無影響。 本研究的結果支持先前的假說,座
椅位置改變會影響上肢在輪椅驅動時的運動學與動力學。而肩部與腕部的
高WPSR(輪椅趨動力量比率)值與上肢疼痛常發生的位置相吻合亦讓我們肯
定它的實用性。輪椅驅動的動作模式在三維動作分析系統的協助下,運動
學與動力學方面的描述都更加的完整。這些結果將有助於了解輪椅驅動過
程中上肢活動的情形與傷害發生的原因,深具臨床參考之意義。
Overuse injury (repetitive strain injury) of upper extremity
is remarkably common in individuals who use manual wheelchair as
daily living. Previous studies have related the long-term
wheelchair propulsion with the upper extremity injuries. Most
published studies simplified the movement of upper extremity via
two-dimensional description and their results have indicated the
need of three-dimensional analysis. Seat of wheelchair is an
important interface in providing the force needed for propelling
the wheelchair. Different seat position will change the
interface of users and the wheelchair. The purpose of this study
is to investigate the effect of seat position changes on the
kinematics and kinetics of upper extremity with full three-
dimensional description. A 3 by 3 matrix of seat positions was
used. We hypothesize that the differences in kinematics and
kinetics of upper extremity appeared at different seat position.
Thirteen ambulatory men were instructed to propel the wheelchair
on the level ground. A standard type manual wheelchair with an
instrumented wheel consists of a six-component load cell was
used to collect the forces and moments applied on the handrim by
users directly. Several reflective markers were placed on the
subject used to define the segments of upper extremity for
calculating joint kinematics and kinetics of upper extremity via
the inverse dynamics method. ExpertVisionTM system was used to
collect the trajectory data of the markers while the subject was
propelling the wheelchair on the level ground. The isolated
joint moment data collected in this study were expressed in
terms of a wheelchair propulsion strength rating (WPSR). The
WPSR is defined as the ratio between joint moment generated
during propulsion and that generated during a maximum isometric
strength test at each direction, as an index indicating the
percentage of loading. The maximum isolated isometric moments of
each subject were evaluated by the Kin-ComTM AP dynamometer.
Multivariate ANOVA was used to analyze all parameters in
relation to the seat height and seat axle horizontal position.
Comparisons were made for the individual effect of seat height
and seat axle horizontal position, also the interaction of these
two factors. The effect of seat position changes appeared
significantly for joint range of motion and WPSR, but no
significant difference found in temporal parameters and
propulsion efficiency. The movement pattern of wheelchair
propulsion can be described more detail by the three-dimensional
data-acquisition system, both in kinematics and kinetics. This
study supports the hypothesis that the kinematics and kinetics
of wheelchair propulsion would be affected by seat position
changes. High WPSR in the shoulder and wrist joints match the
high incidence of shoulder and wrist over-use injury.
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