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研究生:張志豪
研究生(外文):Chih-Hao Chang
論文名稱:以擴增實境探討老人跌倒因子
論文名稱(外文):Fall Risk Evaluation for the Elderly using Augmented Reality
指導教授:楊世偉楊世偉引用關係
指導教授(外文):Sai-Wei Yang
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:醫學工程研究所
學門:工程學門
學類:生醫工程學類
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:101
中文關鍵詞:跌倒風險動態干擾虛擬實境
外文關鍵詞:Fall RiskDynamic PerturbationVirtual Reality
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隨著高齡化社會的來臨,國人平均壽命逐年提高,而老年人跌倒的發生率也是隨著年齡增加而增加,相對的影響眾多老年人的健康與生活品質,有鑑於此,跌倒的相關議題已成為現代預防醫學與家庭照護的重要課題。
因此本研究擬建立一套以動態干擾搭配虛擬實境的評估系統,提供完善的視覺、體感覺以及前庭覺的整合刺激,模擬日常生活容易發生跌倒的情境,配合臨床評估、足底壓力與表面肌電訊號量測,收集青年組、健康老年組與具跌倒經驗老年組,共三組其動態姿勢控制的相關變數結果,比較具跌倒經驗老年族群與其他族群於神經傳導、肌肉力量與協同作用的差異性。
三組受試者分別在虛擬實境搭配平板移動干擾下可以看出與單純平台晃動干擾下的差異性,顯示虛擬實境的確可以引發更多姿勢控制上的不穩定性,而在虛擬實境搭配平板移動干擾下,由足底壓力變數中左右方向最大位移量、總移動路徑長以及橢圓面積中皆可以看出跌倒老年組由於姿勢控制的不穩定造成晃動顯著大於健康老年組,在表面肌電訊號中變數中右腳脛骨前肌、左腳脛骨前肌及右腳股四頭肌中的活化時間可以看出跌倒老年組肌肉反應時間顯著晚於健康老年組,均方根變數中以左腳股四頭肌與左腳內側腿後肌可以明顯的看出跌倒老年組在因應干擾時所需的肌力程度顯著大於健康老年組。
本研究在平台晃動搭配虛擬實境干擾下,可以看出跌倒老年組肌肉活化反應較慢,雖使用較大程度的肌力來維持平衡,但仍表現出較大的晃動程度,由此可知加入虛擬實境除了可提昇測試的真實環境外,對於偵測跌倒也是一種有效的評估方式。
Quality improvement of medicare and nutrition has prolonged people's life-span. Combining with the increased age, the percentage of fall experience has increased profoundly. Accordingly, it influenced on the quality of life and health in the elderly. It also had become the critical topic of prevented medicine and home-care.
The purpose of this study is to set up the dynamic perturbation evaluation system combining Virtual Reality, as well as to provide the integrated stimulation with visual, proprioception and vestibular input and to simulate the condition which induces subjects to fall easily just like daily life. Furthermore, using clinical evaluation, center of pressure and EMG to collect the variables related dynamic posture control of young control, fall- and non-fall-experience elderly groups. To investigate the interaction of the nerve conduction, muscle strength and synergy between these three groups. This study would like to develop an effective fall prediction system to induce the unstable of posture control and problems during movements.
During the differences between the perturbation with and without virtual reality in 3 groups, virtual reality could induce more instable on postural control indeed. To compare the differences between 3 groups by the perturbation with virtual reality: FE performed larger amplitude and instability of postural control than NE from MLR, TRW and Ellipse Area under the results of CoP. To concerning the EMG data, FE showed later reaction than NE in onset time during right TA, left TA and right Quadriceps’ response. At the same time, FE used more percentage of muscle power than NE in RMS and integral value of left Qua and Ham.
To sum up for the perturbation evaluation with virtual reality, FE might perform slower muscle reaction and more percentage of muscle power to maintain their stability, but still combined with grander sway. From discussed above, virtual reality was supposed to not only enhance the real environment of test but also be an effective method in detecting and evaluating fall during the elderly.
目錄
摘要 I
Abstract II
目錄 III
圖目錄 VI
表目錄 IX
第一章 前言 1
1.1 研究背景 1
1.2 研究目的 3
第二章 文獻回顧 4
2.1影響老年人跌倒的危險因素 4
2.2身體系統老化對於跌倒風險之相關影響 6
2.2.1肌肉骨骼系統 6
2.2.2穩定策略及協同作用 8
2.2.3感覺系統 10
2.3跌倒的生物力學相關研究 11
2.4虛擬實境 16
第三章 方法 20
3.1 受測者 20
3.1.1 健康青年組 20
3.1.2 健康老年組 21
3.1.3 跌倒老年組 22
3.2 設備及測量工具-虛擬實境動態干擾評估系統 23
3.2.1 動態干擾系統 23
3.2.2 虛擬實境系統 25
3.2.3 評估系統 30
3.3實驗步驟 33
3.3.1 基本問卷調查 33
3.3.2 實驗流程 33
3.4 實驗評估項目及量測變數 35
3.4.1 身高、體重及足部圍度 35
3.4.2 關節活動度量測 35
3.4.3 功能性伸手向前測試變數 35
3.4.4 平板式足底壓力量測變數 35
3.4.5 表面肌電訊號量測變數 39
第四章 結果 40
4.1受測者基本資料 40
4.2平板式足底壓力量測變數 41
4.2.1 足底壓力中心在左右方向最大的位移量 41
4.2.2 足底壓力中心在前後方向最大的位移量 44
4.2.3 足底壓力中心總移動路徑長 47
4.2.4 足底壓力中心速度第一個與第二個尖峰值的發生時間 50
4.2.5 足底壓力中心橢圓面積 53
4.2.6 足底壓力中心前後方向軌跡圖 56
4.3.7 雙側足底壓力中心的承重比軌跡圖 59
4.3表面肌電訊號量測變數 63
4.3.1 表面肌電訊號的活化時間 63
4.3.2 表面肌電訊號的均方根 66
第五章 討論 92
5.1單純平台晃動干擾與虛擬實境搭配平台晃動干擾 92
5.2 平板式足底壓力量測變數 93
5.2.1 足底壓力中心在左右方向最大的位移量 93
5.2.2 足底壓力中心在前後方向最大的位移量 93
5.2.3 足底壓力中心總移動路徑長 94
5.2.4 足底壓力中心速度第一個與第二個尖峰值的發生時間 94
5.2.5 足底壓力中心前後方向軌跡圖 95
5.2.6 足底壓力中心橢圓面積 95
5.2.7 雙側足底壓力中心的承重比軌跡圖 95
5.3 表面肌電訊號量測變數 96
5.3.1 表面肌電訊號的活化時間 96
5.3.2 表面肌電訊號的均方根 96
第六章 結論 97
參考文獻 98
參考文獻
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