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研究生:蔡豐隆
研究生(外文):Feng-Long Cai
論文名稱:彈簧式動態減壓座墊對於脊髓損傷患者臀部壓力分佈之影響
論文名稱(外文):The effect of dynamic cushion system with spring elements on buttock pressure distribution in patients with spinal cord injury
指導教授:鄧復旦鄧復旦引用關係謝瑞香陳文斌陳文斌引用關係
指導教授(外文):Fuk-Tan TangJui-Hsiang HsiehWeng-Pin Chen
學位類別:碩士
校院名稱:中原大學
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:2009
畢業學年度:97
語文別:中文
論文頁數:132
中文關鍵詞:脊髓損傷壓瘡動態減壓座墊臀部有限元素模型
外文關鍵詞:Spinal cord injuryPressure soresDynamic cushion systemButtockFinite element model
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多數脊髓損傷患者由於脊髓神經組織遭受到嚴重破壞,使得由大腦發出的運動控制訊息無法順利傳遞,造成活動能力下降而需長時間仰賴輪椅活動,導致臀部壓瘡形成機率大為提高。本研究改良過往所開發之彈簧式動態減壓座墊系統重量過重之缺失,改採剛性較高之塑膠材料製成,並針對脊髓損傷病患進行臀部壓力量測,以評估動態減壓座墊系統對於壓瘡生成預防之效益。
本研究徵召30位脊髓損傷患者(實驗組)與20位健康受測試者(控制組)進行臀部壓力量測,並且比較不同勁度之彈簧(剛體、6.37 N/mm及10.37 N/mm)對於臀部壓力分佈之影響。此外,以自行開發之軟組織力量位移量測儀所獲得之臀部組織材料特性,配合三維動作分析系統取得之板座移動軌跡作為邊界條件,進行臀部有限元素分析及結果驗證,探討乘坐彈簧式動態減壓座墊系統臀部皮膚、脂肪及肌肉組織之所承受之負載。
臀部壓力量測實驗結果顯示,脊髓損傷患者乘坐於低勁度彈簧座墊系統相較於剛體支撐,可降低坐骨結節下方皮膚表層之最大平均壓力13.77 %、壓力峰值28.01 %以及壓力-時間積分值14.58 %。而由有限元素分析之結果可以發現,臀部脂肪與肌肉組織之壓力、剪應力及蒙麥斯應力分佈亦會隨著座墊系統的擺動而產生高低起伏之週期變化。因此,搭配低勁度彈簧之動態減壓座墊系統不僅可以降低臀部坐骨結節下方皮膚表層之壓力與減少壓力負載累積,並且可能改變深層組織之應力分佈,而降低壓瘡之形成之機率。
Patients with paraplegic spinal cord injuries (SCI) need to spend long hours each day sitting on their wheelchair cushions. However, long-term sitting on the wheelchair may raise the probability of pressure sore formation. Many conventional cushion systems are also heavy in weight. As a result, we have developed a rigid plastic dynamic cushion system that is lighter in weight and designed for the purpose of pressure sore prevention. In addition, the efficacy of pressure sore prevention of this cushion system was also evaluated by measuring the buttock pressures in spinal cord injury patients.
Thirty SCI patients (experimental group) and 20 age matched healthy subjects (control group) were recruited to compare the effect of different cushion stiffness (rigid, 6.37 N/mm and 10.37 N/mm) on the buttock pressure distribution. For the finite element analysis of the buttock, the material property was determined by the soft tissue loading-displacement measuring device, and the boundary condition was considered as the sway trajectory of cushion system. The results of finite element analysis were validated and could be used to investigate the loading sustained by the skin, fat and muscle tissues of the buttock.
Results of buttock pressure measurements showed that the reduction of maximum mean pressure, peak pressure and pressure-time integral beneath the ischial tuberosity were 13.77 %, 28.01 % and 14.58 % when sitting on our newly dynamic cushion system of low stiffness as compared to the conventional rigid support seat cushion. Results of finite element analysis showed that the pressure, shear stress and von Mises stress of fat and muscle were altered cyclically by the sway of the dynamic cushion system. So, the dynamic cushion system with low spring stiffness could reduce not only the skin pressure and the cumulative loading beneath ischial tuberosities, but also alter the stress distribution of deep tissues. Therefore, this device may be used to decrease the occurrence of buttock pressure ulcer formation in patients with paraplegic spinal cord injuries.
目錄
摘要 I
ABSTRACT III
致謝 IV
目錄 V
圖索引 X
表索引 XIV
第一章 緒論 1
1-1 前言 1
1-2 文獻回顧 3
1-2-1 臀部壓力量測實驗 3
1-2-2 生物組織與壓力 6
1-2-3 人體臀部之生物力學有限元素分析 7
1-3 文獻總結 11
1-4 研究目的 12
第二章 基礎理論 13
2-1 臀部之解剖學 13
2-2 壓瘡形成方式 18
2-3 輪椅減壓座墊 23
第三章 材料與方法 25
3-1 研究流程 25
3-2 彈簧式動態減壓座墊之設計 27
3-3 臀部壓力量測實驗 29
3-3-1 受測試者 29
3-3-1-1 脊髓損傷患者 29
3-3-1-2 健康受測試者 29
3-3-2 實驗設備與量測方法 30
3-3-3 實驗流程與方法 31
3-3-4 數值分析與統計 33
3-4 臀部有限元素分析 34
3-4-1 有限元素模型建構 34
3-4-2 材料特性 38
3-4-2-1 人體臀部軟組織材料參數量測 38
3-4-2-2 座墊泡綿材料量測 42
3-4-2-3 材料特性之設定 44
3-4-3 邊界條件 46
3-4-3-1 彈簧式動態減壓座墊擺動軌跡量測 46
3-4-3-2 邊界條件之設定 47
第四章 結果 49
4-1 臀部壓力量測實驗結果 49
4-1-1 人體計測參數 50
4-1-1-1 脊髓損傷患者人體計測參數 50
4-1-1-2 健康受測試者人體計測參數 50
4-1-1-3 受測試者人體計測參數間差異性 53
4-1-2 最大平均壓力(Maximum Mean Pressure, MMP) 54
4-1-2-1 脊髓損傷患者左右邊臀部坐骨結節下方之最大平均壓力 54
4-1-2-2 脊髓損傷患者臀部最大平均壓力值受彈簧勁度差異之影響 56
4-1-2-3 健康受測試者左右邊臀部坐骨結節下方之最大平均壓力 57
4-1-2-4 健康受測試者臀部最大平均壓力值受彈簧勁度差異之影響 59
4-1-3 壓力峰值(Pressure Peak) 60
4-1-3-1 脊髓損傷患者左右邊臀部坐骨結節下方之壓力峰值 60
4-1-3-2 脊髓損傷患者臀部壓力峰值受彈簧勁度差異之影響 62
4-1-3-3 健康受測試者左右邊臀部坐骨結節下方之壓力峰值 63
4-1-3-4 健康受測試者臀部壓力峰值受彈簧勁度差異之影響 65
4-1-4 臀部壓力值變化 66
4-1-4-1 脊髓損傷患者臀部壓力值變化 66
4-1-4-2 健康受測試者臀部壓力值變化 68
4-1-5 壓力-時間積分值(Pressure-Time Integrals) 70
4-1-5-1 脊髓損傷患者左右邊臀部坐骨結節下方之壓力-時間積分值 70
4-1-5-2 脊髓損傷患者臀部壓力-時間積分值受彈簧勁度差異之影響 72
4-1-5-3 健康受測試者左右邊臀部坐骨結節下方之壓力-時間積分值 73
4-1-5-4 健康受測試者臀部壓力-時間積分值受彈簧勁度差異之影響 75
4-1-6 壓力中心(Center of Pressure, COP) 軌跡移動最大距離 76
4-1-6-1 脊髓損傷患者之壓力中心軌跡移動最大距離 76
4-1-6-2 健康受測試者之壓力中心軌跡移動最大距離 78
4-2 臀部有限元素分析結果 80
4-2-1 有限元素分析模型收斂測試 80
4-2-2 有限元素分析結果與實驗數值之驗證 82
4-2-3 壓力(Pressure) 84
4-2-3-1 臀部表層皮膚壓力 84
4-2-3-2 臀部深層組織壓力 87
4-2-4 最大剪應力(Maximum Shear Stress) 89
4-2-5 蒙麥斯應力(Von Mises Stress) 91
第五章 討論 93
5-1 臀部壓力量測實驗 93
5-1-1 實驗參數 93
5-1-2 脊髓損傷患者臀部壓力 94
5-1-3 脊髓損傷患者之發病時間差異 96
5-1-4 健康受測試者臀部壓力 98
5-1-5 脊髓損傷患者與健康受測試者臀部臀部壓力差異 100
5-1-6 脊髓損傷患者與健康受測試者臀部壓力中心差異 101
5-2 臀部有限元素分析 103
5-2-1 有限元素分析與臀部壓力量測實驗結果比較 104
5-2-2 臀部軟組織負載情形 106
5-2-3 臀部之生物力學探討 108
5-2-4 彈簧支撐之效益 109
第六章 結論 110
第七章 未來展望 111
參考文獻 112

圖索引
圖 2-1 骨盆 15
圖 2-2 右股骨 16
圖 2-3 下肢肌肉 17
圖 2-4 壓瘡常見的生長部位 18
圖 2-5 壓瘡形成的階段 21
圖 3-1 研究架構流程圖 26
圖 3-2 彈簧式動態減壓座墊實體設計圖 27
圖 3-3 彈簧式動態減壓座墊實體設計展開圖 27
圖 3-4 彈簧式動態減壓座墊擺動示意圖 28
圖 3-5 彈簧式動態減壓座墊實體成品 28
圖 3-6 NOVEL PLIANCE SYSTEM壓力量測設備 30
圖 3-7 氣壓壓力校正器 30
圖 3-8 臀部壓力量測流程 32
圖 3-9 臀部坐骨結節下方左右分區 33
圖 3-10 壓力中心左右與前後方向最大移動距離 33
圖 3-11 臀部MRI影像 35
圖 3-12 右邊臀部模型 35
圖 3-13 臀部坐姿有限元素模型 35
圖 3-14 臀部骨盆-股骨有限元素模型 36
圖 3-15 臀部肌肉層有限元素模型 36
圖 3-16 臀部脂肪層有限元素模型 36
圖 3-17 臀部皮膚層有限元素模型 37
圖 3-18 軟組織力量位移量測儀搭配超音波量測系統 38
圖 3-19 荷重元前端裝置超音波探頭 39
圖 3-20 軟組織應力-應變量測系統 39
圖 3-21 人體臀部軟組織應力-應變曲線圖 40
圖 3-22 豬肉組織 41
圖 3-23 量筒 41
圖 3-24 電子微量天平 41
圖 3-25 INSTRON 8511 型材料試驗機 42
圖 3-26 記憶泡棉標準尺寸 42
圖 3-27 記憶泡綿材料應力-應變曲線 43
圖 3-28 軟組織之平滑線段斜率 44
圖 3-29 泡綿之平滑線段斜率 45
圖 3-30 VICON 460三維動作擷取設備 46
圖 3-31 座墊擺動分析 46
圖 3-32 臀部有限元素動態分析之邊界條件 48
圖 4-1 脊髓損傷患者臀部左右邊最大平均壓力差異 54
圖 4-2 健康受測試者臀部左右邊最大平均壓力差異 57
圖 4-3 脊髓損傷患者臀部左右邊壓力峰值差異 60
圖 4-4 健康受測試者臀部左右邊壓力峰值差異 63
圖 4-5 脊髓損傷患者臀部壓力值變化之差異 66
圖 4-6 健康受測試者臀部壓力值變化之差異 68
圖 4-7 脊髓損傷患者臀部左右邊壓力-時間積分值差異 70
圖 4-8 健康受測試者臀部左右邊壓力-時間積分值差異 73
圖 4-9 脊髓損傷患者左右與前後方向之壓力中心軌跡最大距離 76
圖 4-10 健康受測試者左右與前後方向之壓力中心軌跡最大距離 78
圖 4-11 臀部有限元素模型網格之差異 80
圖 4-12 臀部收斂結果 81
圖 4-13 有限元素分析結果與先前研究臀部壓力量測實驗數值之驗證 82
圖 4-14 有限元素分析結果與本研究臀部壓力量測實驗數值之驗證 83
圖 4-15 臀部皮膚層壓力分佈情形 84
圖 4-16 臀部表層皮膚壓力 86
圖 4-17 臀部之壓力分佈情形 87
圖 4-18 臀部脂肪層壓力 88
圖 4-19 臀部肌肉層壓力 88
圖 4-20 臀部之最大剪應力分佈情形 89
圖 4-21 臀部軟組織之最大剪應力 89
圖 4-22 臀部之蒙麥斯應力分佈情形 89
圖 4-23 臀部軟組織之蒙麥斯應力 89
圖 5-1 脊髓損傷患者與健康受測試者人體計測參數 89
圖 5-2 脊髓損傷患者乘坐3種不同勁度彈簧座墊之臀部壓力差異 89
圖 5-3 脊髓損傷患者發病時間長短之臀部壓力差異 89
圖 5-4 坐姿限制造成壓力中心移動距離之差異 89
圖 5-5 脊髓損傷患者與健康受測試者壓力-時間積分值差異 89
圖 5-6 脊髓損傷患者與健康受測試者臀部壓力中心移動範圍 89
圖 5-7 臀部軟組織負載分佈 89

表索引
表 3-1 臀部模型元素及節點數 37
表 3-2 人體臀部軟組織應力-應變值 40
表 3-3 記憶泡綿材料之應力-應變值 43
表 3-4 臀部軟組織材料參數 45
表 3-5 臀部有限元素動態分析之邊界條件 48
表 4-1 脊髓損傷患者人體計測參數 51
表 4-2 健康受測試者人體計測參數 52
表 4-3 脊髓損傷與健康受測試者的人體計測數 53
表 4-4 人體計測數INDEPENDENT-SAMPLES T TEST 53
表 4-5 脊髓損傷患者之最大平均壓力 55
表 4-6 健康受測試者之最大平均壓力值 58
表 4-7 脊髓損傷患者之壓力峰值 61
表 4-8 健康受測試者之壓力峰值 64
表 4-9 脊髓損傷患者臀部壓力值之變化 67
表 4-10 健康受測試者臀部壓力值之變化 69
表 4-11 脊髓損傷患者之壓力-時間積分值 71
表 4-12 健康受測試者之壓力-時間積分值 74
表 4-13 脊髓損傷患者之壓力中心軌跡移動最大距離 77
表 4-14 健康受測試者之壓力中心軌跡移動最大距離 79
表 4-15 臀部網格細分模型元素及節點數 80
表 4-16 有限元素分析結果與先前研究臀部壓力量測實驗數值 82
表 4-17 有限元素分析結果與本研究臀部壓力量測實驗數值 83
表 4-18 臀部皮膚層壓力 85
表 4-19 臀部脂肪層壓力 88
表 4-20 臀部肌肉層壓力 88
表 4-21 臀部軟組織之最大剪應力 89
表 4-22 臀部軟組織之蒙麥斯應力 89
[1]九十七年第六週內政統計通報 (96年底列冊身心障礙者人數統計),網址www.moi.gov.tw,中華民國9 7年九月擷取。
[2]Clark, F. A., Jackson, J.M., Scott, M. D., Carlson, M. E., Atkins, M . S., Uhles-Tanaka, D., Rubayi, S., 2006, “Data-based models of how pressure ulcers develop in daily-living contexts of adults with spinal cord injury”, Archives of Physical Medicine and Rehabilitation, 87, 1516-1525.
[3]Lyder, C. H., 2006, “Assessing risk and preventing pressure ulcers in patients with cancer,” Seminars in Oncology Nursing, 22, 178-184.
[4]Linder-Ganz, E., Engelberg, S., Scheinowitz, M., Gefen, A., 2006, “Pressure-time cell death threshold for albino rat skeletal muscles as related to pressure sore biomechanics.” Journal of Biomechanics, 39, 2725-2732.
[5]Shirado, O., Kawase, M., Minami, A., Strax, T. E., 2004, “Quantitative evaluation of long sitting in paraplegic patients with spinal cord injury,” Archives of Physical Medicine and Rehabilitation, 85, 1251-1256.
[6]Thomas, D. R., 2003, “Are all pressure ulcers avoidable ?,” Journal of the American Medical Directors Association, 4, S44–S48.
[7]Thomas, D.R.,2006, “Prevention and treatment of pressure ulcers,” Journal of the American Medical Directors Association, 7, 46-59.
[8]Makhsous, M., Rowles, D. M., Rymer, W. Z., Bankard, J., Nam, E. K., Chen, D., Lin, F., 2007, “Periodically relieving ischial sitting load to decrease the risk of pressure ulcers,” Archives of Physical Medicine and Rehabilitation, 88, 862-870.
[9]Nixon, J., Nelson, E.A., Cranny, G., Iglesias, C.P., Hawkins, K., Cullum, N.A., Phillips, A., Spilsbury, K., Torgerson, D.J., and Mason, S., on behalf of the PRESSURE trial group, 2006, “Pressure relieving support surfaces: a randomised evaluation,” Health Technology Assessment, 10(22).
[10]Tanimoto, Y., Takechi, H., Nagahata, H., and Yamamoto, H., Member, 1998, “The Study of Pressure Distribution in Sitting Position on Cushions for Patient with SCI(Spinal Cord Injury),” IEEE Transactions on Instrumentation and Measurement, 47(5), 1239-1243.
[11]Tanimoto, Y., Takechi, H., Nagahata, H., and Yamamoto, H., 2000, “Pressure Measurement of Air Cushions for SCI Patients,” IEEE Transactions on Instrumentation and Measurement, 49(3), 666-670.
[12]Ferrarin, M., Andreoni, G., Pedotti, A., 2000,“Comparative biomechanical evaluation of different wheelchair seat cushions,” Journal of Rehabilitation Research and Development, 37(3), 315-324.
[13]Stinson,M.D., Porter-Armstrong,A., Eakin, P., 2003, “Seat-interface pressure: a pilot study of the relationship to gender, body mass index, and seating position,” Archives of Physical Medicine and Rehabilitation, 84, 405-409.
[14]Hamanami, K., Tokuhiro, A., and Inoue, H., 2004, “Finding the optimal setting of inflated air pressure for a multi-cell air cushion for wheelchair patients with s pinal cord injury,” Acta Medica Okayama, 58(1), 37-44.
[15]Eitzen, I., 2004, “Pressure mapping in seating: a frequency analysis approach,” Archives of Physical Medicine and Rehabilitation, 85, 1136-1140.
[16]Agam, L., Gefen, A., 2008, “Toward real-time detection of deep tissue injury risk in wheelchair users using Hertz contact theory”, Journal of Rehabilitation Research & Development, 45(4), 537–550.
[17]Bosboom, E.M.H., Bouten, C.V.C., Oomens, C.W.J., Van Straaten, H.W.M., Baaijens, F.P.T., Kuipers, H., 2001, “Quantification and localisation of damage in rat muscles after controlled loading; a new approach to study the aetiology of pressure sores,” Medical Engineering & Physics, 23, 195-200.
[18]Gefen, A., Gefen, N., Linder-Ganz, E., Margulies, S. S., 2005, “In vivo muscle stiffening under bone compression promotes deep pressure sores,” American Society Of Mechanical Engineers, 127, 512-524.
[19]Oomens, C.W.J., Bressers, O.F.J.T., Bosboom, E.M.H., Bouten, C.V.C. and Bader, D.L., 2003, “Can loaded interface characteristics influence strain distributions in muscle adjacent to bony prominences?,” Computer Methods in Biomechanics and Biomedical Engineering, 6(3), 171–180.
[20]Linder-Ganz, E., Shabshin, N., Itzchak, Y., Gefen, A., 2007, “Assessment of mechanical conditions in sub-dermal tissues during sitting: A combined experimental-MRI and finite element approach”, Journal of Biomechanics, 40, 1443–1454.
[21]Mohsen, M., Lim, D., Hendrix, R., Bankard, J., Rymer, W. Z., and Lin, F., 2007, “Finite element analysis for evaluation of pressure ulcer on the buttock: development and validation”, IEEE Transactions on Neural Systems and Rehabilitation Engineering, 15(4), 517-525.
[22]Linder-Ganz,E., Shabshin, N., Itzchak, Y., Yizhar, Z., Siev-Ner, I., Gefen, A., 2008, “Strains and stresses in sub-dermal tissues of the buttocks are greater in paraplegics than in healthy during sitting.” Journal of Biomechanics, 41, 567–580.
[23]Wagnac, É. L., Aubin, C. É., and Dansereau, J., 2008, “A New Method to Generate a Patient-Specific Finite Element Model of the Human Buttocks”, IEEE Transactions on biomedical engineering, 55(2), 774-783.
[24]張岳星,2008;“彈簧式動態減壓座墊對於人體臀部生物力學效應之評估”,中原大學生物醫學工程所碩士學位論文。
[25]Giangregorio, L., and McCartney, N., 2006, “Bone loss and muscle atrophy in spinal cord injury: epidemiology, fracture prediction, and rehabilitation strategies,” Journal of Spinal Cord Medicine, 29, 489–500.
[26]Martini, Bartholomew, 林自勇,鄧志娟,鄭麗菁,蔡佳蘭,連文彬,2007,解剖生理學,全威圖書有限公司。
[27]游祥明,宋晏仁,古宏海,傅毓秀,林光華,2000,解剖學,匯華圖書出版有限公司。
[28]馮琮涵,徐國成,韓邱生,舒強,于洪昭,2004,局部解剖學彩色圖譜,新文京開發出版股份有限公司。
[29]McKinley, M., O’Loughlin, V. D., 2006, “Human Anatomy,” McGRAW-HILL International Edition.
[30]Defloor, T., Schoonhoven, L., Katrien, V., Weststrate, J., and Myny, D., 2006, “Reliability of the european pressure ulcer advisory panel classification system,” Journal of Advanced Nursing, 54(2), 189-198.
[31]Freedberg, I., Eisen, A., Wolff, K., Austin, K., Goldsmith, L., Katz, S., 1999, “Fitzpatrick’s dermatology general medicine”, 1(5), New York: McGraw-Hill; 133, 1539–54.
[32]Vyhlidal. S. K., Moxness, D., Bosak, K. S., Van Meter, F. G., Bergstrom, N., 1997, “Mattress Replacement or Foam Overlay? A Prospective Study on the Incidence of Pressure Ulcers,” Applied Nursing Research, 10(3), 111-120.
[33]Still, J. M., Wilson, J., Rinker, C., Law. E., Beretta, C.C., 2003, “A retrospective study to determine the incidence of pressure ulcers in burn patients using an alternating pressure mattress,” Burns, 29, 505-507.
[34]復康資源協會,www.rehabaid.org。
[35]顧乃平. 蔡麗雲. 賴允亮 總校閱,2004,安寧緩和護理學,華格納企業有限公司。
[36]Lands, E., 1930, “Micro-injection studies of capillary blood pressure in human skin,” Heart, 15, 209-228.
[37]Risk Assessment and Prevention of Pressure Ulcers, Toronto: Registered Nurses Association of Ontario, March 2005.
[38]Special focus: pressure ulcers, Physicians' Information and Education Resource, 10-11.
[39]Stockton, L., Rithalia, S., 2007, “Is dynamic seating a modality worth considering in the prevention of pressure ulcers?,” Journal of Tissue Viability, 17, 15-21.
[40]Sumiya, T., Kawamura, K., Tokuhiro, A., Takechi, H., Ogata, H., 1997, “A survey of wheelchair use by paraplegic individuals in Japan. Part 1: Characteristics of wheelchair cushions,” Spinal Cord, 35, 590-594.
[41]DiGiovine, C. P., Cooper, R. A., Fitzgerald, S. G., Boninger ,M. L., Wolf ,E. J., Guo, S., 2003, “Whole-Body Vibration During Manual Wheelchair Propulsion With Selected Seat Cushions and Back Supports,” IEEE Transactions on Neural Systems and Rehabilitation Engineering, 11(3), 311-321.
[42]輔具資源入口網,內政部多功能輔具資源整合推廣中心,2007,repat.moi.gov.tw。
[43]Prevention and treatment, 2005, National Institute for Clinical Excellence Pressure Ulcers, Clinical guideline 29, London: NICE.
[44]Coggrave, M.J., Rose, L.S., 2003, A specialist seating assessment clinic: changing pressure relief practice. Spinal Cord, 41, 692e5.
[45]Kernozek, T.W., Lewin, J.E., 1998, “Seat interface pressures of individuals with paraplegia: influence of dynamic wheelchair locomotion compared with static seated measurements,’’ Archives of Physical Medicine and Rehabilitation, 79, 313-316.
[46]Designation: D575–91, 2001, Standard Test Methods for Rubber Properties in Compression, ASTM.
[47]Sun, Q., Lin, F., Al-Saeede, S., Ruberte, L., Nam, E., Hendrix, R., and Makhsous, M., 2005, “Finite element modeling of human buttock-thigh tissue in a seated posture,” Bioengineering Conference, Colorado, 22–26.
[48]Cheng, Z., Smith, J. A., 2007, “Considerations and experiences in developing a finite element buttock model for seating comfort analysis,” Biomechanics Branch, Biosciences and Protection Division.
[49]莊芝菁,1991,“自誘性位移的平衡反應於坐與立姿之比較”,中華物療治,16(1)。
[50]Janssen-Potten, Yvonne. J., Seelen, H. A., Drukker, J., Spaans, F., Drost, M. R., 2002, “The effect of footrests on sitting balance in paraplegic subjects,” Archives of Physical Medicine and Rehabilitation, 83, 642-648.
[51]Janssen-Potten, Y.J., Seelen, H.A., Drukker, J., Reulen, J.P., 2000, “Chair configuration and balance control in persons with spinal cord injury,” Archives of Physical Medicine and Rehabilitation, 81, 401-408.
[52]Bouten, C. V., Oomens, C. W., Baaijens, F.P., and Bader, D.L., 2003, “The etiology of pressure ulcers: Skin deep or muscle bound?,” Archives of Physical Medicine and Rehabilitation, 84, 616–619.
[53]Linder-Ganz, E., and Gefen, A., 2004, “Mechanical compression-induced pressure sores in rat hindlimb: Muscle stiffness, histology, and computational models,” Journal of Applied Physiology, 96, 2034–2049.
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