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研究生:吳孝觀
研究生(外文):Hsiao-Kuan Wu
論文名稱:研發視覺提醒輔具以提升巴金森氏症患者之行走表現
論文名稱(外文):Development of Posterior Walker with Adjustable Visual Cues to Improve Walking Performance for Patients with Parkinson’s disease
指導教授:游忠煌
指導教授(外文):Chung-Huang Yu
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:中文
論文頁數:100
中文關鍵詞:巴金森氏症步態輔具注意力視覺流動
外文關鍵詞:Parkinson's diseasegaitvisual cueattentionoptic flow
相關次數:
  • 被引用被引用:1
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  • 評分評分:
  • 下載下載:50
  • 收藏至我的研究室書目清單書目收藏:0
巴金森氏症所引起的不正常步態,常導致患者行動不便及跌倒的危險,在許多治療巴金森氏症步態的介入方式中,以外在刺激方式最為有效,尤其是地上固定橫線的視覺提醒,可增加巴金森氏症患者的步長與走路速度。研究指出其效果可能有兩種原因,一種是注意力策略改變步長,另一種是視覺流動提供前進感覺,但並沒有研究同時比較過兩者的差異,除此之外,固定橫線方式只能受限於特定的場所做訓練,無法成為可攜式的行動輔具以供患者使用。
本研究中將設計新式多條雷射光可攜式提醒輔具,使其提醒效果能如同於地上之橫線,提供跨越的注意力及視覺流動感受。而方法就是利用光學編碼器測量使用者移動的距離,再透過微控制器控制多組步進馬達,分別改變多組雷射的投射角度,來產生固定位置雷射光。可依需求調整投射的起始距離、間隔距離以及使用的雷射線條數目。為了證實其可行性,收取三位巴金森氏症患者使用此輔具,並以單一受測者交替處理設計研究方法測試,比較不同視覺提醒起始距離及線條數目對於巴金森氏症患者步態的影響。
測試結果發現此視覺提醒輔具介入下確實可以增加患者之行走表現,不論是遠距離或近距離的視覺提醒讓患者步長、速度均有明顯進步,且有降低原本過快步頻的效果,其中以近距離所提供的注意力策略視覺提醒對於步長的影響最為顯著,遠距離線條有較高的步頻表現, 而近距離線條數目越多步長越長,但遠距離線條數的影響則不明顯。
Background: To improve gait performance and safety for patients with Parkinson’s disease, external stimuli or walking aids are used. It was found that visual external stimuli were most effective. However, visual external stimuli mostly were applicable particular places only. Therefore in daily life, there is no effective walking aid for PD patients to use in daily environment.
Purpose: This study developed a wheeled posterior walker equipped with a visual cue generating system. This system can provide visual cue with multiple ground-fixed transverse lines, such that, we can test its performance and apply daily life on patient with Parkinson’s disease..
Methods: Optic rotary encoder was used to measure the moving distance for adjusting the angle of the laser projector to produce the ground-fixed lines. To understand the actual mechanism which enhances a users’ walking ability, we recruited three participants with PD. experiments were performed in different location and different numbers of lines.
Result: Results showed that the new visual cue device system has completed. Gait performance of PD using the visual cue device improved. The short- distance lacer lines induce a remarkable increase in stride length and velocity. Two of the participants increase their stride length, cadence and velocity when using the long-distance laser lines.
中文摘要 I
Abstract II
目錄 III
圖目錄 V
表目錄 VIII
第一章 緒論 1
1-1 研究背景 1
1-2 研究目的 5
第二章 文獻回顧 6
2-1 病理與病徵 6
2-2 步態與姿勢上的問題 8
2-3 治療方法的介入 10
2-4 提醒策略的治療效果 11
2-5 視覺提醒的原理 13
2-6 現有視覺提醒輔具 15
第三章 系統開發及驗證 23
3-1 系統原理 23
3-2 系統架構 27
3-2-1 光學編碼器與解碼器 32
3-2-2 微控制器與PSoC整合系統 35
3-2-3 馬達驅動器與步進馬達 39
3-2-4 綠光雷射模組 44
3-2-5 雷射光投射平台及連結器 45
3-2-6 載具 47
3-3 系統驗證 50
3-3-1 驗證方法 50
3-3-2 系統驗證結果與討論 51
第四章 臨床測試方法 62
4-1 受試者條件 62
4-2 實驗設計 63
4-3 實驗工具 65
4-4 實驗步驟 67
第五章 結果 68
5-1 個案A測試結果 68
5-2 個案B測試結果 73
5-3 個案C測試結果 78
第六章 討論 83
6-1 後拉式助行器的影響 83
6-2 視覺提醒介入的影響 84
6-2-1 近距離線條視覺提醒的影響 88
6-2-2 遠距離線條視覺提醒的影響 89
6-3 本研究限制與未來工作 91
第七章 結論 93
參考文獻 94
附錄一 簡易智能量表MMSE 97
附錄二 UPDRS巴金森症狀衡量表 98
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