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研究生:周正國
研究生(外文):Chou, Cheng-Kuo
論文名稱:踝關節之運動學分析
論文名稱(外文):Kinematic Analysis of Ankle Joint Complex
指導教授:蘇芳慶蘇芳慶引用關係
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:英文
論文頁數:55
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踝關節主要由脛距關節及距下關節構成。由於解剖位置的緣故,距
骨在足踝關節中的活動,無法以簡單的皮膚標記加以測量。因此傳統
上對於踝關節運動的評估,多來自於X光立體攝影術、屍體解剖實驗、
或是將後足部視為一整個肢段加以研究;如此得到的結果恐怕會過於
粗略,難以反應出踝關節真正細微的活動情形。本實驗乃利用骨骼標
記來探討踝關節在步態週期中及不同平面之原地運動中三度空間角度
的變化情形及旋轉軸的方向。將一平滑鋼釘打入距骨內側並黏上一組
三顆反光球來反映距骨之活動,而脛骨及跟骨則分別以皮膚標記或骨
骼標記之反光球座標系來代表。以不同之標記組合在動態分析實驗室
中步行收集資料,並比較結果。此外並以脛骨,距骨及跟骨三組骨骼
標記,原地在矢狀面、冠狀面及水平面作單軸旋轉運動。所得資料在
ExpertVisionTM系統中定位連接後,載入586個人電腦,以Matlab
語言所寫之程式進行三度空間之運動分析。
結果顯示:
1.經由距骨上的骨骼標記能夠將踝關節申之脛距關節及距下關節運動
情況分別反應出來。而距下關節在著地期之角度變化較小,在離地
期有較大範圍之運動。
2.在跟骨上皮膚標記或骨骼標記所得到之結果有相同之運動趨勢且差 別不大。因此皮膚標記也能忠實反應出跟骨的活動情形。
3.由不同旋轉順序所計算之尤拉角在運動角度較大時確實略有差異,
尤其主要運動軸和第一旋轉軸不同時更明顯;而距下關節因活動範
圍不大,由旋轉順序不同所造成的影響並不顯著。
4.在步態週期及原地運動的過程中,踝關節的運動軸方向變化是漸進
而連續的,且有通過某個相近區域的趨勢。
本實驗所得到的資料分析來自於單一受試者;對於踝關節運動情形能
提供趨勢性的瞭解,並有助於實驗方法及模式的建立。此後若能收集
更多的受試者資料,當更能夠確立踝關節三度空間運動模式,進一步
瞭解足踝部這個精密複雜的構造。
Ankle joint complex, consisting of talocrural and subtalar joints, provides stability and energy exchange for human walking. However, due to poor anatomical accessibility of talus, kinematics and kinetics of ankle joint complex had not been well studied. In the past, ankle motion was simulated with mathematical models and measured by cadaver specimen or using skin marker system. They usually treated ankle joint complex as a single hindfoot segment. Until recently, detailed analysis of subtalar joint motion during stance phase of normal walking was performed with skeletal markers and 3D motion analysis system. The video-based motion analysis system can provide a 3D analysis of joint motion and accurate real time dynamic study could be obtained by its fast sampling rate. With well-fixed smooth pins connected to reflective markers set, soft tissue movement which is more important in those joints with smaller range of motion such as subtalar and midfoot joints can be eliminated. Also, skeletal markers system made possible the kinematic study of small bones and those which cannot be easily approached such as talus, carpal bones and tarsal bones.
We assume ankle joint complex to be a three-segment linkage system and use skeletal marker system to separately evaluate talocrural and subtalar motion. The subject performed three kinds of open kinetic chain motion in sagittal, coronal and transverse planes, and walked in the motion laboratory. The images of markers were collected with six video cameras and digitized by ExpertVisionTM motion analysis system, then downloaded to a 586 PC for calculation of Euler angles and screw axis parameters using appropriate programs coded in MATLAB language. With minimal invasive procedure of inserting a smooth pin into talus, we can separately and accurately evaluate talocrural and subtalar joints kinematics. The pins were removed after experiment and only somewhat soreness sensation around pin holes during walking was noted. There left no significant complication or any sequela. As data showed, skin markers could detect calcaneal motion properly due to relatively small skin movement in this region. There was little translation in ankle joint complex occurred during normal walking.
Although the kinematic data obtained from a single subject in this experiment can tell us the trend of motion of ankle joint complex bothduring walking and in open kinetic chain movement, more information from more subjects is mandatory to draw more definite conclusions. In the meanwhile, kinetic analysis using force plate data and inverse dynamics can supplement kinematic analysis for presenting a comprehensive understanding of the ankle joint complex.
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