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研究生:吳敦旨
研究生(外文):Tun-Chin Wu
論文名稱:肘關節與肩關節不同能量吸收對比對跌倒時上肢的影響
論文名稱(外文):Effect of Different Energy Absorptance between Elbow Joint and Shoulder Joint on Upper Extremity during Falls
指導教授:周有禮周有禮引用關係
指導教授(外文):You-Li Chou
學位類別:碩士
校院名稱:國立成功大學
系所名稱:醫學工程研究所碩博士班
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:2002
畢業學年度:90
語文別:中文
論文頁數:63
中文關鍵詞:跌倒能量吸收對比肘關節肩關節
外文關鍵詞:Shoulder jointElbow jointEnergy absorptanceFall
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中文摘要

前傾跌倒過程中,肩關節與肘關節為主要緩衝耗能的關節。本實驗的目的即在探討肘關節與肩關節間不同能量吸收對比對上肢骨骼系統的影響。
本研究共邀請15位無任何上肢傷殘病史的男性受測者參與實驗計畫,其平均年齡為24.5±1.9歲,平均身高為170.1±4.0公分,平均體重則為65.7±6.9公斤。
實驗組別共分為三組:肘關節使力組(只有肘關節刻意使力)、控制組(肘關節與肩關節皆不刻意使力)與肩關節使力組(只有肩關節刻意使力)。藉由不同關節使力達到各關節吸收能量的不同,由肩關節的關節吸收能量除以肘關節的關節吸收能量得到不同關節能量吸收對比,再對各組上肢的受力情形加以分析比較。
在此次跌倒高度為五公分的實驗中,結果顯示以肘關節使力組
(能量吸收對比為1.5) 有較佳的關節能量分配,肘關節使力組有較小的能量吸收比,顯示肘關節能有效降低肩關節衝擊能量吸收的負荷。而關節肌肉的拮抗作用增強關節等效彈簧與等效阻尼的效應,增加關節對衝擊負載的緩時間,達到吸收更多衝擊能量的效果。
關鍵詞:跌倒、能量吸收對比、肘關節、肩關節
Abstract

Objective: Elbow joint and shoulder joint play important roles to absorb impact energy during falls. This study is in order to determine the best energy distribution between elbow joint and shoulder joint.

Design:Subjects were asked to perform forward fall and followed by elbow flexion motion in different group: elbow effect group (only elbow contract), control group (elbow and shoulder not contract purposely) and shoulder effect group (only shoulder contract).

Background:A fall onto the outstretched hand is an important cause of upper extremity injury. Elbow and shoulder flexion can absorb more impact energy to prevent injury. However, the impact energy distribution was different by elbow contract or shoulder contract.

Method:Fifteen healthy young male subjects, with an average age of 24 years, were studied. The kinematics and kinetics of the upper extremity were investigated under different group.
Results:The loading biomechanics of upper extremity differed with joint contract. Joint contract can increase times to absorb impact energy.

Conclusions:In this study, energy absorptance at elbow effect group
( =1.5) have he best energy distribution. Small energy absorptance can reduce the loading of shoulder joint. Joint muscle contract can increase the damping and stiffness effect.

Keywords:Fall;Energy absorptance;Elbow joint;Shoulder joint
目錄

中文摘要...........................................................................................Ⅰ
英文摘要.......................................................................................…Ⅱ
誌謝………………………………………...………………………Ⅳ
目錄..................................................................................................Ⅴ
內文目錄..........................................................................................Ⅵ
圖目錄.............................................................................................. Ⅹ
表目錄............................................................................................... ⅩⅡ
符號說明..........................................................................................ⅩⅢ

內文目錄

第一章 緒論……...............................................................................…...1
1.1前言...........................................................................................1
1.2文獻回顧...…........................................................................…4
1.3研究動機….....…..................................................................…8
1.4實驗假說........….....……....................................................…..9

第二章 實驗理論..............................................…........….……….....…10
2.1實驗假設…….........................................................................10
2.2反光球標記方式.................................................................…10
2.3靜態與動態資料描述….....................................................…12
2.3.1靜態資料….…………………………………………….12
2.3.2動態資料…..….…….…………….........................….....12
2.3.3人體計測資料…..…..…………………..........................13
2.4關節中心........….....……....................................................…13
2.4.1腕關節中心…...………........…......………................….13
2.4.2肘關節中心...…………........…......………................….14
2.4.3肩關節中心..……….…........…......………................….14
2.5座標系定義…………...…......................................................15
2.5.1實驗室座標系..………........…......……….................….16
2.5.2力板座標系..…………........…......……….................….17
2.5.3解剖座標系…………........…......……….......…........….18
2.6運動學分析………………........…......………................…...22
2.6.1質心位置、質心速度與質心加速度.......…................….23
2.6.2關節角度……………........…......………............…...….23
2.6.3角速度與角加速度……...…......……….........….......….26
2.7動力學分析……....….…........................................................29
2.7.1肢段作用力……………….......…..………................….30
2.7.2肢段作用力矩………........…......……….........…......….32
2.7.3關節能量…………...…........…......………................….33

第三章 實驗設備與方法……..........................................................…..34
3.1實驗設備…..........…...........................................................…34
3.1.1硬體設備…...……………………..........................….....34
3.1.2軟體設備………...………………..........................….....36
3.2實驗設計….……..………………………………………..…36
3.2.1人體實驗認許….....…………………………………….36
3.2.2受測者資料……..…...………………………………….37
3.2.3實驗組別…..………...………………………………….37
3.2.4實驗姿勢…..………...………………………………….38
3.2.5實驗流程…..………...………………………………….40
3.2.6問卷調查…..………...………………………………….41
3.3資料收集與處理….………...……………………………….41
3.4統計分析………….………...……………………………….42

第四章 實驗結果……....................................................………………43
4.1實驗參數定義……………........…............…….……………43
4.2能量吸收對比.........................................................................44
4.3關節能量…….........................................................................45
4.4垂直地面反作用力...................................................……......48
4.5關節受力…………………………………………………….50
4.6關節力矩…………..……………………………….......……52
4.7問卷……………...…………………………………………..55

第五章 討論與結論…............................................................................56
5.1能量吸收對比與衝擊能量之吸收….……………………..56
5.2垂直地面反作用力與作用時間的影響…………………...57
5.3關節受力與關節力矩…………………..…………………...58
5.4問卷參考與綜合分析...……………………………………..59
5.5實驗檢討與建議…..….……………………………………..60
5.6結論….……………….……………………………………..61

參考文獻..................................................................................................62

附錄A 人體計測資料…………………………………………………64
附錄B 實驗問卷………………………………………………………65

圖目錄

圖1-1 肘關節破壞試驗之實驗設備示意圖..........................………....4
圖1-2 前傾跌倒實驗........................................……………...5
圖1-3 上肢數學模型.....……….......................................................6
圖2-1 反光球標記位置正面圖................................……………….....11
圖2-2 靜態中立姿勢........................................……………………....12
圖2-3 各座標系主軸方向示意圖.......................................................15
圖2-4 校正架定義實驗室座標系........................................………....16
圖2-5 力板座標系與實驗室座標系方向軸關係圖.......…………….17
圖2-6 軀幹座標系定義.....……….......................................................18
圖2-7 上臂座標系定義..........................................................………..19
圖2-8 前臂座標系定義........................................…………….……...20
圖2-9 手部座標系定義.....……….......................................................21
圖2-10 運動學計算流程圖.....................................................………...22
圖2-11 肩關節尤拉角之旋轉順序..........................................………..23
圖2-12 肘關節與腕關節尤拉角之旋轉順序........…………….……...25
圖2-13 動力學計算流程.....……….......................................................29
圖2-14 上肢各肢段之自由體圖.............................................………...31
圖3-1 實驗設備擺設示意圖................................................................35
圖3-2 懸吊架...............................................…….................................36
圖3-3 實驗起始姿勢(正面)...........................…...................................38
圖3-4 實驗起始姿勢(側面)…………..................................................38
圖3-5 實驗最後姿勢(正面)..........................…........………………....39
圖3-6 實驗流程圖..................................……………………………..41
圖4-1 垂直地面反作用力曲線圖.................…....…………………...44
圖4-2 不同實驗組別下F1、F2之關係圖........…....…………………...49

表目錄

表4-1 總能量吸收對比…….............….......................................……45
表4-2 能量吸收值之比較…………..................................……46
表4-3 不同時期關節能量吸收百分比…………................................47
表4-4 能量吸收對變化…………………………………….....…......48
表4-5 碰撞起始點到各時間點之時間間隔….…………….....…......50
表4-6 T1時肘關節與肩關節之關節受力………………….....…......51
表4-7 T2時肘關節與肩關節之關節受力………………….....…......52
表4-8 T1時肘關節與肩關節之關節力矩………………….....…......53
表4-9 T2時肘關節與肩關節之關節力矩………………….....…......54
表4-10 問卷評分........…..........………………………………………..55
表A1 肢段質心位置……………..........................……......................64
表A2 肢段質量.....…...……………………………............................64
表A3 肢段轉動慣量.................…………………………………….64
參考文獻

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2.Schneider E.L., Guralnik J.M., The aging of America. Impact on health care costs. Jama 1990; 263(17): 2335-40.
3.Melton L.J.III, Epidemiology of fractures, in Osteoporsis: Etiology, Diagnosis, and Management, B.L. Riggs, Melton, L.J. III, Editor. 1988, Raven Press: New York. p. 111-131.
4.Iskrant A.P., Joliet P.V., Accidents and Homicide. Harvard University Press, Cambridge. 1968.
5.Inkelis S.H., Stroberg A.J., Keller E.L., Christenson PD. Roller skating injuries in children. Pediatric Emergency Care 1988; 4(2): 127-32.
6.Hsiao E.T., Robinovitch S.N., Common protective movements govern unexpected falls from standing height. Journal of Biomechanics 1998; 31(1): 1-9.
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8.Rockwood C.A., Jr., WILKENS K.E., King R.E., Fractures in Children. J.B. Lippencott, Philadephia, P.A, 1984.
9.Amis A.A., Miller J.H., The mechanisms of elbow fractures: an investigation using impact tests in vitro. Injury 1995; 26(3): 163-8.
10.Carlsoo S., Johansson O., Stabilization of, and load on, the elbow joint in some protective movements. Acta Anat 1962, 48-224.
11.Chiu J., Robinovitch S.N., Prediction of upper extremity impact forces during falls on the outstretched hand. Journal of Biomechanics 1998; 31(12): 1169-76.
12.Chou Y.L., Chou P.H., Lin C.J., Lin C.F., Lou S.Z., The Biomechanical Analysis of Impact Forces of Upper Extremity on a Fall. in Proceeding of Annual Symposium of Formosan Biomechanics Socity. ;K-3-1 - K-3-2; 1999. Taipei, Taiwan.
13.Chou P.H., Chou Y.L., Lou S.Z., Lin C.J., Chiu C.F., Su F.C., The effect of elbow flexion on impact forces of upper extremity on a fall. in Proceeding of the 24th National Conference on Applied and Theoretical Mechanics. K-3-1 - K-3-2; 2000. Chungli, Taiwan, ROC.
14.Chou P.H., Chou Y.L., Lin C.J., Shi Y.C., Huang G.F., Su F.C.,Wu T.C., Biomechanical Analyses for the Effects of Elbow Initial Flexion Angleson Upper Extremity during A Fall. in Proceeding of 25th National Conference on Theoretical and Applied Mechanics. K-1; 2001, Taichung, Taiwan, ROC.
15.Dempster W.T., Space requirements of the seated operator, in OH : Wright-Patterson Air Force Base. 1955, Dayton. 55-159.
16.Leva Pd., Joint center lingitudinal positions computed from a selected subset of Chandler's data. Journal of Biomechanics 1996; 29: 1231-1233.
17.Woltring H.J., A FORTRAN package for generalized, cross-validatory spline smoothing and differentiation. Advanced Engineering Software 1986; (8): 104-13.
18.Morrey B.F., An K.N., Storronont T.J., Force tramsmission throught the radial head. Journal of Bone and Joint Surgery 1988; 70A: 250-56.
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