臺灣博碩士論文加值系統

隨者社會福利制度的健全與人民所得提高，下肢障礙患者對戶外休閒活動的需求亦與日俱增。以傳統手動輪椅而言，其機械效率甚低與長期使用所伴隨的運動傷害，故在戶外活動的需求下發展出其他形式手動輪椅。

文獻對於不同上肢驅動輪椅的模式的比較中，手搖曲柄三輪車在機械效率與預防上肢運動傷害的表現最佳，但市售的手搖曲柄三輪車在設計上仍有尺寸固定、收納不易等缺點，值得再加以改善。腦性麻痺患者的神經肌肉表現為下肢障礙者中最複雜的一群主要症狀為運動障礙，該族群大多因肌肉張力異常高造成行走平衡困難，目前的助行器大多針對室內活動設計，並無法滿足腦性麻痺患者於戶外運動的需求。因而本研究衍生出輪椅外掛手搖驅動裝置與腦性麻痺助行器兩設計目標。

本研究所採用的設計方法係利用系統化產品設計開發流程、專家諮詢、生物力學、人因工程、復健醫學原理、CAD/CAE等方法，設計下肢障礙者之行動輔具。輪椅外掛手搖驅動裝置之設計考量構件包括車架連結機構組件、手搖曲柄、前輪、鏈條齒輪機構、變速裝置、煞車裝置。而腦性麻痺助行器之設計包含車架、軀幹支撐架、前後輪、煞車裝置、步態束制帶、彈簧導正器。

兩目標經CAD軟體設計完成後進行模擬載重分析，結果顯示輪椅外掛手搖驅動裝置與腦性麻痺三輪車之支承骨架應力最小安全係數分別為2與1.1，作為施工之參考。後繪製工程圖進行原型機製作，實體重量分別為12.3公斤與14.7公斤，經初步測試均可達到設計要求。兩項設計達到的共同功能包含：可調整配合使用者姿態、適應戶外粗糙的地面路況、便於攜出戶外進行運動及無需工具直接組裝。其中輪椅外掛手搖驅動裝置達成的特定功能包含：降低驅動手動輪椅對上肢的傷害、提高輪椅驅動之機械效率、變速功能等，腦性麻痺助行器達成的特定功能包含：刺激使用者向前推蹬、協助使用者維持平衡、給予導正方向之外力、矯正剪刀腳姿態等。本研究未來應朝向實機測試與結機構系統最佳化之方向進行。

The improved social welfare and increasing GNP are encouraging outdoor exercise/recreation and mobility for persons with lower-limb disability. The conventional wheelchairs (WCs) with hand-rim propulsion has two major drawbacks with less mechanical efficiency and upper-limb injury for long term use. There are arm-crank propulsion (ACP), lever drive, and tri-cycle designs for outdoor mobility aid instead of conventional design. Several researches indicated that the ACP mode is definitely providing better mechanical efficiency and less upper-limb injury by comparing with other propulsion modes in manual wheelchairs. Commercial ACP wheelchairs have still some defects including fixed-size, inconvenient storage, and etc., therefore; improved design of ACP WCs is still warrant. The poor gait performance is the main characteristic of cerebral palsy patients, who are the group demonstrating the most complex neuromuscular impairments in lower-limb disabilities. Abnormal muscle tone and reflex always lead them difficultly to maintain body balance during walking. Most walkers are designed for indoor use in which provides insufficient support for outdoor exercise. Therefore, this research and development is aimed to design two mobility-aided devices: (1) a Wheelchair-Mounted Arm-Crank Propulsive Device (WMACPD) for manual wheelchairs; and (2) a Tri-cycle Walker (TCW) for the Cerebral Palsy.

In addition to expert intelligence, ergonomics, biomechanics, rehabilitation principles and CAD/CAE, Systematic Product Developing Process are applied to this design research. First, the WMACPD design includes frame-connection mechanism, gear-chain mechanism, front wheel, cranks, gear clutch and braking device. Secondly, the TCW design consists of frame, trunk supporters, wheels, braking device, gait-restricted belt and spring guider.

The overall structure and mechanical components is initially designed via a CAD software, then a finite element modeling is applied to simulate the weight-bearing characteristics. The results of finite element analysis show minimum safety factors of WMACPD and TCW are 2 and 1.1, respectively. The two prototypes are completed and the weights are 12.3kg and 14.7kg, respectively. These devices are functional well to meet the design criteria of adjustable fitting, outdoor use, easy transfer and assemble. The advantages of Wheelchair-Mounted Arm-Crank Propulsive Device include preventing the upper extremity injury from propelling hand-rim wheelchairs, increasing the mechanical efficiency of manual wheelchair propulsion, adjustable speed, and etc. The advantages of Cerebral Palsy Walker include facilitating users to tread forward, supporting users to maintain body balance, guiding straight-forward, and anti-adduction legs. The future works of this research are recommended to clinical test and mechanical optimal design.

摘要………………………………………………………………………I
Abstract…………………………………………………………………II
誌謝……………………………………………………………………IV
目錄……………………………………………………………………V
圖目錄…………………………………………………………………VII
表目錄…………………………………………………………………XI

第一章 緒論
1.1下肢障礙……………………………………………………………2
1.1.1下肢障礙成因………………………………………………2
1.1.2常用行動輔具簡介…………………………………………3
1.1.3下肢障礙者行動輔具之選擇………………………………7
1.2手動輪椅……………………………………………………………8
1.2.1手動輪椅使用者……………………………………………8
1.2.2手動輪椅基本元件與架構…………………………………8
1.2.3傳統手動輪椅驅動模式對上肢的傷害……………………9
1.2.4手動輪椅驅動模式比較……………………………………11
1.2.5手搖曲柄驅動裝置發展現況………………………………15
1.3助行器………………………………………………………………20
1.3.1助行器型態…………………………………………………20
1.3.2腦性麻痺……………………………………………………23
1.3.3腦性麻痺患者戶外使用之助行器功能選擇………………24
1.4研究動機與目標……………………………………………………25

第二章 系統設計與材料方法
2.1設計流程與目標設定………………………………………………27
2.2輪椅外掛手搖驅動裝置設計………………………………………28
2.2.1系統結構……………………………………………………29
2.2.2驅動裝置……………………………………………………37
2.2.3傳動系統……………………………………………………39
2.3腦性麻痺助行器設計………………………………………………44
2.3.1系統結構……………………………………………………45
2.3.2驅動傳動裝置………………………………………………51
2.3.3輔助裝置……………………………………………………52

第三章結果與討論
3.1設計結果…………………………………………………………53
3.2有限元素分析模擬結構負載………………………………………56
3.2.1輪椅外掛手搖驅動裝置之結構負載分析模擬………………57
3.2.2腦性麻痺助行器之結構負載分析模擬……………………60
3.3原型機及初步測試…………………………………………………63
3.3.1輪椅外掛手搖驅動裝置原型機成品………………………63
3.3.2腦性麻痺助行器原型機成品………………………………65

第四章 結論與未來展望
4.1結論…………………………………………………………………68
4.2未來展望……………………………………………………………68

參考文獻………………………………………………………………69

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