臺灣博碩士論文加值系統

在高齡化的社會中，老年人跌倒問題也逐漸受到注重，跌倒問題也越來越嚴重，減少跌倒的風險為首要之務，必須找出適合老年人個人化的運動方式去提升個人平衡力，以達到強健老年人體魄之目的，本研究針對十八名老年人，男性十一名、女性七名，透過太極步訓練，探討老年人在太極步訓練下對於平衡能力的影響，同時量測一分鐘的壓力中心點訊號及肌電訊號，利用傳統指標、多尺度熵、多元多尺度熵、希伯特─黃轉換分析壓力中心點訊號，去判別12週太極步訓練對於老年人平衡能力的變化，可了解平衡能力是否有透過太極步訓練得到提升，並利用同步性分析探討肌肉與平衡的關聯性，最後再利用傳統步態功能性測試，六分鐘行走測試與起身行走測試，透過行走的距離與速度，可了解透過太極步訓練平衡能力的改變。
由數據分析結果顯示COP訊號在多尺度熵左右方向(ML)第一次實驗複雜度數值為5.651±2.22，第六次實驗複雜度數值為6.687±2.122；前後方向(AP)第一次實驗複雜度數值為7.386±2.406，第六次實驗複雜度數值為9.318±2.397，當複雜度數值第六次實驗高於第一次實驗，代表複雜度提升，適應外在環境能力提高，也表示平衡能力之進步，且透過統計檢定多尺度熵(MSE)分析在前後方向(AP)具顯著性(p-value<0.05)。在同步分析前後與左右方向COP訊號之多元多尺度熵(MMSE)分析方法上，第一次複雜度數值為13.095±1.887，第六次實驗複雜度數值為14.577±1.433，第六次實驗複雜度也是高於第一次實驗之複雜度，統計檢定多元多尺度熵分析具有顯著性(p-value<0.05)。COP傳統指標分析上則無顯著性差異且無一致性之變化。
在EMG訊號分析方面，所量測小腿四條肌肉，左右腳脛前肌與左右腳腓腸肌，可從傳統指標(RMS)看出其施力大小，並透過施力大小與複雜度數值做相關性比較，去瞭解當肌肉施力增大或減小，是否會影響複雜度提升或下降，結果顯示實驗一與實驗六RMS值並無顯著差異，相關性也無一致性。可利用經驗模態分解法得知低頻的肌電訊號與COP的頻率範圍較為接近，並利用相近之頻率帶進行同步性分析，第一次實驗四條肌肉EMG訊號與COP訊號同步性指標數值約為0.003至0.008，第六次實驗數值約為0.006至0.01，但結果在統計上無顯著性之差異。從EMG訊號則觀察不出平衡能力改善之趨勢。
傳統步態功能性測試結果顯示，起身行走測試為測試從椅子上起身向前走之行走速度，第一次實驗秒數為16.195±6.124，第六次實驗秒數為13.74±3.14，起身行走秒數小於20秒表示有獨立自主行走之能力。六分鐘行走測試為測試行走距離之遠近，第一次實驗距離為262.756±61.603公尺，第六次實驗為305.052±72.974公尺，統計檢定六分鐘行走測試具有顯著性(p-value<0.05)，步行距離越遠，代表步態趨於穩定，平衡能力的提升。

Due to the balance ability, the risk of the elderly fallers is the highest priority in an aging society. Therefore, the way of personal exercises need to improve the balance force for elderly.The subject of the Tai Chi training were eighteen participants, including eleven male and seven female.
While measuring the center of pressure (COP) and Electromyography (EMG) signals for one minute, it’s applied for the analysis of traditional index, multi-scale entropy (MSE), multivariate multi-scale entropy (MMSE), Hibbert -Huang transform (HHT). The study of the Tai Chi steps improve the postural stability for the elderly during 12 weeks. Finally , the research of walking distance and speed used by Six minutes walk and Timed up and go.
The result of data analysis showed that the COP signals in the ML direction,the complexity index of the first experiment is 5.651 ± 2.22, the complexity index of the sixth experiment is 6.687 ± 2.122; The AP direction complexity index of the first experimental is 7.386 ± 2.406, the complexity index of the sixth experiment is 9.318 ± 2.397. The multi-scale entropy (MSE) analysis in the AP direction with a significant (p-value <0.05). Multivariate multi-scale entropy (MMSE) analytsis, the complexity index of the first experiment is 13.095 ± 1.887；the Complexity index of the sixth experiment is 14.577 ± 1.433, and Multivariate multi-scale entropy (MMSE) analysis with a significant (p-value <0.05) .
In the EMG signal analysis, the four muscles of leg are measured from the correlation values of EMG traditional index and Complexity index, the results showed that the experiment one and the EMG traditional index of six experiments there was no difference with correlation and consistency. The available method is applied to closer range of the EMG and COP lower frequencies. The Synchronization index between the first experiment of EMG signal and the first experiment of COP signal is approximately about 0.003 to 0.008；the sixth experiments about 0.006 to 0.01, but the results were no statistically significant differences.
The results of Timed up and go were showed the number of the times for the first experiment was 16.195 ± 6.124, the number of times for the sixth experiment 13.74 ± 3.14. The times of Timed up and go is less than 20 seconds indicates the ability to walk independently. Six minutes walk test distance walking distance for the trainning, the first test distance of 262.756 ± 61.603 meters, the sixth experiment was 305.052 ± 72.974 meters, statistical tests on the six minutes walk test showed a statistically significant (p-value <0.05). The increase distance indicates a better postural stability under the six minutes walk test .

目錄
摘要 iii
Abstract v
誌謝 vii
第一章 緒論 1
1.1 研究背景 1
1.2 研究動機 2
1.3 研究目的 3
1.4 研究流程 4
第二章 文獻探討 6
2.1 平衡 6
2.2 太極步 6
2.2.1 太極拳適合老年人之運動 6
2.2.2 太極拳對於下肢肌力影響 7
2.2.3 太極步訓練 8
2.3 壓力中心點(COP) 9
2.4 肌電訊號(EMG) 12
2.5 希伯特黃轉換 13
2.6 多尺度熵(MSE) 14
2.7 多元多尺度熵(MMSE) 15
2.8 相似度 16
2.9 同步性指標 16
2.10 步態功能性評估 17
第三章 研究方法 19
3.1 實驗介紹 19
3.1.1 研究對象 19
3.1.2 實驗儀器設備 19
3.1.3 實驗流程 20
3.2 分析流程 25
3.3 分析方法 26
3.3.1 希伯特黃轉換 26
3.3.2 經驗模態分解法 27
3.3.3 希伯特轉換 29
3.3.4 複數平面 31
3.3.5 多尺度熵 33
3.3.6 多元多尺度熵(MMSE)分析 36
3.3.7 COP傳統指標 39
3.3.8 EMG傳統指標 42
3.3.9 相似度指標 43
3.3.10同步性指標 46
第四章 實驗結果與討論 48
4.1 步態功能性測試 48
4.1.1 起身行走測試 48
4.1.2 六分鐘行走測試 49
4.2 COP數據分析 51
4.2.1 MSE分析 51
4.2.2 MMSE分析 53
4.2.3 MSE與MMSE比較 55
4.2.4 HHT分析 56
4.2.5 訊號重建之MMSE分析(IMF頻率<2Hz) 57
4.2.6 COP傳統指標 58
4.3 EMG訊號分析 69
4.3.1 RMS分析 69
4.3.2RMS與COP(MMSE)相關性比較 75
4.3.3HHT分析 76
4.3.4同步性分析 78
4.4小結 80
4.5討論 82
4.5.1數據分析所觀察 82
4.5.2實驗過程所觀察 84
4.5.3長期照護機構老年人運動習慣 87
第五章 結論與後續研究 88
5.1 結論 88
5.2 後續研究 90
參考文獻 91
附錄 97

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