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研究生:吳傚瑛
研究生(外文):Siao-Ying Wu
論文名稱:虛擬改裝機車模擬器訓練對脊髓損傷病人之效果探討
論文名稱(外文):The effects of using a modified motorcycle simulator training for the spinal cord injury patient
指導教授:陳俊忠陳俊忠引用關係
指導教授(外文):Jin-Jong Chen
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:物理治療暨輔助科技學系
學門:醫藥衛生學門
學類:復健醫學學類
論文種類:學術論文
論文出版年:2009
畢業學年度:97
語文別:英文
論文頁數:129
中文關鍵詞:虛擬實境脊髓損傷物理治療改裝機車
外文關鍵詞:Virtual realityspinal cord injuryphysical therapymodified motorcycle
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在台灣,脊髓損傷患者以每年一千兩百個人的速度在增加。一些研究發現,擁有工作跟交通工具的脊髓損傷者,他們的自我概念比起其他的脊髓損傷者比較正向。在台灣,改裝機車是最常被脊髓損傷患者使用的交通工具。這個研究的主要目的,是探討使用改裝機車的虛擬實境模擬器,進行脊髓損傷患者訓練計畫的效果。研究方法:共有五個脊髓損傷者參與這項研究。這些受測者在一個月之中,會接受總共十次,每次30分鐘的訓練。然後在訓練前、訓練中、以及訓練後會測驗這些受測者的改裝機車騎駛的表現、平衡能力並填寫問卷來評估虛擬改裝機車模擬器訓練計畫的訓練效果。但是因為出院或轉院的緣故,只有三位受測者完成十次訓練。結果與討論:實驗結果顯示,在接受虛擬改裝機車模擬器的訓練計畫之後,在虛擬實境的環境下與在真實世界中的騎駛改裝機車的表現與平衡能力有獲得改善。而施測問卷中,受測者的愉悅度、自信心與動機,在接受過虛擬實境的訓練計畫之後也有獲得明顯的增加。整個訓練過程中沒有發現任何的模擬器暈眩或者是任何其他的副作用。結論:在經過虛擬改裝機車模擬器的訓練之後,騎駛改裝機車的表現與平衡能力都有獲得改善,而且虛擬實境的訓練效果似乎也可以轉移到真實的世界之中的實地測驗。顯示:使用為脊隨損傷患者設計的虛擬改裝機車模擬器進行評估與訓練,應該是可行並且有用的。
Spinal cord injuries (SCI) patients increase by 1200 people/ year in Taiwan. Some studies found that SCI patients who have jobs and transportation had more positive self-concept. Modified motorcycles are the most popular transportation tools used by SCI patients in Taiwan. The purpose of this study is to investigate the training effects of a motorcycle riding training program with modified motorcycle virtual reality simulator (MCVRA) for the spinal cord injury patients. Methods: Five SCI subjects were included in this study. They received ten 30-minutes training sections in one month, and the riding performance, balance ability and questionnaires were measured before and after 5 and 10 training sections to evaluate the program effects. However, only three subjects completed 10 training sections due to discharge or being transferred. Results and Discussion: Results revealed that the riding performance and balance ability under VR environment and on road test were improved after the MCVRA. The subject’s enjoyment, confidence and motivation of motorcycle riding also increased dramatically after the MCVRA. No cyber-sickness or other side-effects was noted during the training program. Conclusion: The riding performance and balance ability would be improved after VR training and the training effects seem able to be transferred to the real world road. Trained and assessed with MCVRA designed for SCI should be feasible and useful.
TABLE OF CONTENTS
Acknowledgements…………………………………………………….Ⅰ
Table of Contents………………………………………………………Ⅱ
List of Tables………………………………………………………..…Ⅴ
List of Figures………………………………………………………….Ⅶ
List of Appendix……………………………………………………......Ⅹ
摘要……………………………………………………...……………..Ⅺ
Abstract…………………………………………………………………Ⅻ
CHAPTER 1 INTRODUCTION
1.1 Background and Motivation………………………………………1
1.2 Purposes………………………………………………………….2
1.3 Research Hypothesis……………………………………………....2
1.4 Significance of Study………………………………………………2

CHAPTER 2 LITERATURE REVIEW
2.1 Spinal Cord Injury ……………………………………………….3
2.2 Balance ability of SCI……………………………………………..7
2.3 VR related studies………………………………………………..10

CHAPTER 3 MATERIAL AND METHODS
3.1 Study design…………………………………………………….14
3.2 Subjects…………………………………………………………14
3.3 Instrumentation………………………………………………….15
3.4 Intervention……………………………………………………...23
3.5 Measurements……………………………………………………23
3.6 Procedure………………………………………………………...24
3.7 Statistical analysis………………………………………………...24
CHAPTER 4 RESULTS
4.1 Basic data………………………………………………………...26
4.2 VR riding performance test……………………………………….26
4.3 Balance control ability test………………………………………...28
4.4 On road riding performance test…………………………………..30
4.5 Questionnaire…………………………………………………….30
CHAPTER 5 DISCUSSION…………………………………………..32
5.1 Characteristics of subjects…………………………………………33
5.2 Riding Performance in different sections…………………………...34
5.3 Balance ability……………………………………………………37
5.4 Enjoyment and Desire…………………………………………….40
5.5 Realism and Cybersickness………………………………………40
5.6 Limitations………………………………………………………41
CHAPTER 6 CONCLUSION………………………………………..44

REFERENCES………………………………………………………..46


LIST OF TABLES
Table 1 Route descriptions………………………………………………51
Table 2 Riding test elements……………………………………………..52
Table 3 3-km mixed route………………………………………………..53
Table 4 6-km mixed route………………………………………………..54
Table 5 Training Route…………………………………………………..55
Table 6 Balance control ability test protocols………………………………56
Table 7 Training sections………………………………………………….57
Table 8 a. General characteristics of subjects………………………………58
Table 8 b. Descriptive statistics of subjects’ basic data………………………58
Table 9 Riding performance in “U shaped route” …………………………..59
Table 10 Riding performance in “Underpass” – Total section………………..60
Table 11 Riding performance in “Underpass”- Down-hill…………………...61
Table 12 Riding performance in “Underpass”- Up-hill……………………...62
Table 13 Riding performance in “3-km mixed route”- Total section…………63
Table 14 Riding performance in “3-km mixed route”- Straight line…………64
Table 15 Riding performance in “3-km mixed route”- Roadblock…………..65
Table 16 Riding performance in “6-km mixed route” ……………………...66
Table 17 Balance control ability test results- hands off the handle……………67
Table 18 Balance control ability test results- hands on the handle…………68
Table 19 Max voluntary COP displacement in AP direction results……….69
Table 20 On road test results……………………………………………70
Table 21 Simulator sickness Questionnaire………………………………71
Table 22 Enjoyment assessment before training………………………….72
Table 23 Enjoyment assessment after 5 training sessions…………………73
Table 24 Enjoyment assessment after 10 training sessions………………...74
Table 25 Desire questionnaire before training……………………………75
Table 26 Desire questionnaire after 5 training sections……………………76
Table 27 Desire questionnaire after 10 training section……………………77
Table 28 Realism assessment…………………………………………….78
Table 29 Comparison between falls and FLCP record…………………….79

LIST OF FIGURES
Fig. 1 Modified motorcycle virtual reality simulator system…………………80
Fig. 2 Modified motorcycle virtual reality simulator (MCVRA) …………….80
Fig. 3 Scenario elements……………….. ……………….. ……………….81
Fig. 4 Modified motorcycle……………….. ……………….. …………….82
Fig. 5 On road test route……………….. ………………………………...82
Fig. 6 Flow chart of assessment procedure……………….. ………………..83
Fig. 7 Flow chart of procedure……………….. ……………….. …………84
Fig. 8 Summation of COP displacement in each VR riding test section………...84
Fig. 9 Maximal COP displacement in each VR riding test section………………85
Fig. 10 Summation of COP displacement in lateral direction in each VR riding test section……………….. ……………….. …………………..85
Fig. 11 Maximal COP displacement in lateral direction in each VR riding test section……………….. ……………….. ………………………85
Fig. 12 Summation of COP displacement in AP direction in each VR riding test section……………….. ……………………………………...…86
Fig. 13 Maximal COP displacement in AP direction in each VR riding test section……………….. ……………………………………...…86
Fig. 14 Average Speed in each VR riding test section…. ……………………87
Fig. 15 Distance to stop line in U shaped and Underpass VR riding test sections…………………………….………………………………..87
Fig. 16 Riding time in each VR riding test section……………..…..………..88
Fig. 17 Reaction time in Down-hill, Up-hill and Roadblock VR riding test sections………………………………………………………………..88
Fig. 18 Accelerator variation in each VR riding test section ………….……89
Fig. 19 Accelerator variation in Underpass and 3-km mixed route……..……..89
Fig. 20 Break variation in each VR riding test section……………………….89
Fig. 21 Break variation in Underpass and 3-km mixed route…………………90
Fig. 22 Speed variation in each VR riding test section……………..…………..90
Fig. 23 Speed variation in Underpass and 3-km mixed route…………………90
Fig. 24 Steering variation in each VR riding test section……………………..91
Fig. 25 Steering variation in Underpass and 3-km mixed route………………91
Fig. 26 Lateral position variation in each VR riding test section……………..91
Fig. 27 Lateral position variation in Underpass and 3-km mixed route………92
Fig. 28 Mean max of COP displacement in lateral direction….……………..92
Fig. 29 Summation of COP displacement in lateral direction…..……………92
Fig. 30 Max of COP displacement in lateral direction…………………………..93
Fig. 31 Mean max of COP displacement in AP direction…….………………93
Fig. 32 Summation of COP displacement in AP direction….………………..94
Fig. 33 Max of COP displacement in AP direction…..………………………94
Fig. 34 Max functional limits of COP motion…………………………………95
Fig. 35 Max voluntary COP displacement in AP direction, △COPmax……...95
Fig. 36 Improvement effectiveness of maximal voluntary COP motion……….96
Fig. 37 Body acceleration in on road test…….………………………………96
Fig. 38 Motorcycle lateral acceleration in on road test……………………..…....97
Fig. 39 Steering acceleration in on road test….…………………………………97
Fig. 40 Riding time in each on road test section……………………………..98
Fig. 41 Total riding time in route 1 of on road test…………………………..98
Fig. 42 Improvement effectiveness of on road test riding time……………….99
Fig. 43 Enjoyment Assessment before and after training sections……………99
Fig. 44 Desire questionnaire before and after training sections………………99

APPENDIX
APPENDIX 1. 身心障礙者報考汽、機車駕駛執照處理要點……………….100
APPENDIX 2. SIMULATOR SICKNESS QUESTIONNAIRE (SSQ). ……..104
APPENDIX 3. ENJOYMENT ASSESSMENT QUESTIONNAIRE ………..109
APPENDIX 4. DESIRE QUESTIONNAIRE.....................................…………110
APPENDIX 5. REALISM ASSESSMENT QUESTIONNAIRE...............……111
APPENDIX 6. ETHICAL APPROVAL................................................................112
APPENDIX 7. CONSENT FORM.........................................................................113
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