跳到主要內容

臺灣博碩士論文加值系統

(44.200.86.95) 您好!臺灣時間:2024/05/30 01:59
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果 :::

詳目顯示

我願授權國圖
: 
twitterline
研究生:詹其展
研究生(外文):Chi Jhan Jhan
論文名稱:運動強度與氧氣補償適應控制跑步機開發測試及 漸進式氣道負壓呼吸肌訓練療效臨床評估
論文名稱(外文):Development of exercise intensity and oxygen compensation adaptive control treadmill and clinical evaluation of progressive resistance inspiratory muscle training for OSAS patientsDevelopment of exercise intensity and oxygen compensation adaptive control treadmill and clinical evaluation of progressive resistance inspiratory muscle training for OSAS patients
指導教授:李明義李明義引用關係
指導教授(外文):M. Y. Lee
學位類別:碩士
校院名稱:長庚大學
系所名稱:醫療機電工程研究所
學門:工程學門
學類:機械工程學類
論文種類:學術論文
論文出版年:2014
畢業學年度:102
論文頁數:106
中文關鍵詞:阻塞性肺疾氧氣補償睡眠呼吸中止症氣道負壓
外文關鍵詞:COPDoxygen compensationOSASairway resistance. Resistance
相關次數:
  • 被引用被引用:0
  • 點閱點閱:153
  • 評分評分:
  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:0
目錄
長庚大學博(碩)士學位論文指導教授推薦書
長庚大學博(碩)士學位論文口試委員會審定書
致謝頁 iii
中文摘要 iv
英文摘要 v
目錄 vi
圖目錄…………………………………………………………..x
表目錄………………………………………………………….xiii
第一章 研究背景、動機與目的 ....................... 1
1.1 研究背景 ..................................... 1
1.1.1 慢性阻塞性肺疾 .......................... 1
1.1.2 阻塞型睡眠呼吸中止症 .................... 2
1.2 研究動機 ..................................... 3
1.2.1 慢性阻塞性肺疾 .......................... 3
1.2.2 阻塞型睡眠呼吸中止症 .................... 4
1.3 研究目的 ..................................... 4
1.3.1 運動強度與氧氣補償適應控制跑步機開發 .... 4 -vii-
1.3.2 漸進式氣道負壓呼吸肌訓練療效臨床評估 .... 5
1.4 研究工作架構 ................................. 6
1.5 論文架構 .................................... 7
第二章 文獻回顧 ................................... 8
2.1 慢性阻塞性肺疾病相關文獻 ..................... 8
2.2 運動訓練相關文獻 ............................ 10
2.3 肺部復健訓練治療相關文獻 .................... 14
2.4 運動訓練對慢性阻塞性肺部疾病患者的影響 ...... 16
2.5 呼吸與睡眠相關文獻 .......................... 20
2.6 睡眠障礙中止症診斷與症狀 .................... 21
2.7 上呼吸道肌力訓練相關文獻 .................... 23
2.8 肌力量測相關文獻 ............................ 24
2.9 文獻總結 .................................... 24
第三章 運動強度與氧氣補償適應控制跑步機開發測試 .. 26
3.1 雙迴路、雙參數適應控制跑步機設計開發 ........ 29
3.1.1 運動強度控制模組 ....................... 29
3.1.2 氧氣補償適應控制模組 ................... 33
3.1.3 穿戴式心跳與血氧濃度同步量測系統設計開發 36 -viii-
3.1.4 硬/軟體系統整合及人機介面設計 .......... 37
3.2 系統功能驗證 ................................ 39
第四章 漸進式氣道負壓呼吸肌訓練療效臨床評估 ...... 44
4.1 臨床測試實驗目的與假說 ...................... 44
4.1.1 臨床測試實驗目的 ....................... 44
4.1.2 臨床測試實驗假說 ....................... 46
4.2 實驗方法與程序說明 .......................... 47
4.2.1 臨床測試實驗受測者條件、招募方法及數目 . 47
4.2.2 實驗方法及程序說明 ..................... 48
4.3 漸進式氣道負壓呼吸肌訓練臨床實驗設備配置 .... 50
4.3.1 呼吸生理量測模組 ....................... 51
4.3.2 肌動圖監測模組 ......................... 53
4.3.2 資料擷取模組 ........................... 55
4.4 臨床實驗數據統計分析 ........................ 58
4.4.1 氣道阻力與呼吸肌群肌動圖均方根值相關性分析
............................................. 58
4.4.2 氣道阻力誘發呼吸肌肌動圖均方根值敏感度分析
............................................. 60 -ix-
4.4.3 氣道阻力呼吸肌肌動圖均方根值放大倍率分析 64
4.4.4 氣道阻力、肌動圖均方根值及每分鐘通氣量相關
分析 ......................................... 67
4.4.5 氣道阻力與呼吸頻率變化分析 ............. 69
4.4.6 病患克服氣道阻力改善分析 ............... 70
4.4.7 病患嗜睡指數(AHI)改善分析 .............. 71
4.4.8 病患問卷調查分析 ....................... 72
第五章總結與未來研究方向 ......................... 75
5.1 總結 ....................................... 75
5.2 未來研究方向 ................................ 75
參考文獻 ......................................... 77
附 錄 ............................................ 83
圖目錄
圖1 硬體架構示意圖……………………………………………………5
圖2 研究工作架構……………………………………………………7
圖3 COPD病理機制圖…………………………………………………9
圖4 設備系統控制流程圖……………………………………………27
圖5 硬體設計概念架構圖……………………………………………28
圖6 NI公司量測與自動化(Measurement and automation)設計工具
程式軟體操作介面………………………………………………32
圖7-1 利用心跳數控制之調變法則……………………………………………………………………33
圖7-2 跑步機控制介面螢幕…………………………………………33
圖8 製氧機……………………………………………………34
圖9-1 供氧設備(正面) ………………………………………………35
圖9-2 供氧設備(控制電路板) ……………………………35
圖10 市售無線式生理訊號量測系統……………………………36
圖11-1 監測生理訊號之人機介面(正面) ……………………………37
圖11-2監測生理訊號之人機介面(背部) ……………………………37
圖12 個人基本資料之人機介面圖……………………………38
圖13 參數設定之換算運動強度介面圖……………………………38
圖14 運動強度與氧氣補償之操作介面圖……………………………39
圖15 生理訊號參數之監測電路介面圖………………………………39
圖16 控制電壓與對應電流圖…………………………………………41
圖17 供氧系統模組…………………………………………42
圖18 人機介面操作圖…………………………………………42
圖19-1 供氧驗證測試(正面) ………………………………………43
圖19-2供氧驗證測試(背面) ………………………………………43
圖 20-1 漸進式準則…………………………………………………50
圖20-2 穩定式準則………………………………………50
圖21 漸進式氣道負壓呼吸肌訓練療效評估架構圖….51
圖22 吸氣肌肉訓練器………………………………………53
圖23吸氣肌肉訓練器作動機制圖…………………………53
圖24 肌動圖訊號分析流程圖…………………………54
圖25 肌動圖黏貼各呼吸肌之位置圖……………54
圖26 PowerLab上各儀器連接通道圖……………57
圖27 PowerLab上各呼吸生理參數訊號與MMG訊號圖…………57
圖28 完整實驗規範圖………………………………………58
圖29 氣道阻力與呼吸肌群肌動圖均方根值相關性圖……………60
圖30 病患病患(#01)氣道阻力誘發呼吸肌肌動圖均方根值敏感度圖………………………………………………………………………63
圖31 10 病患(#06) 氣道阻力誘發呼吸肌肌動圖均方根值敏感度表………………………………………………………………………63
圖32七位病患之氣道阻力誘發呼吸肌肌動圖均方根值敏感度圖.....63
圖33病患(01)之氣道阻力呼吸肌肌動圖均方根值放大倍率量圖………………………………………………………………………66
圖34病患(06)之氣道阻力呼吸肌肌動圖均方根值放大倍率量圖………………………………………………………………………66
圖35七位病患之氣道阻力呼吸肌肌動圖均方根放大倍率量圖………………………………………………………………………67
圖36 編號06病患之氣道阻力、肌動圖均方根值及每分鐘通氣量相關分析圖…………………………………………………………………68
圖37七位病患之氣道阻力、肌動圖均方根值及每分鐘通氣量相關分析圖……………………………………………………………………68
圖38嗜睡量表(ESS)之七位病患調查結果比較圖………………73
圖39睡眠品質量表(PSQI)七位病患調查結果比較圖………………74

表目錄
表1自覺費力量表……………………………………………………13
表2 慢性疾病狀況運動處方注意事項……………………..………16
表3 慢性阻塞性肺病患者接受運動訓練相關文獻整理表………17
表4 本研究與先前研究之差異對照表……………………………28
表5 控制電壓與對應電流表………………………………………41
表6 病患基本資料表………………………………………………44
表7 未依照實驗規範之原因表……………………………………48
表8 氣道阻力與呼吸肌群肌動圖均方根值相關性係數匯總表..59
表9 病患(#01)氣道阻力誘發呼吸肌肌動圖均方根值敏感度表….61
表10 病患(#06) 氣道阻力誘發呼吸肌肌動圖均方根值敏感度表………………………………………………………………62
表11 七位病患之氣道阻力誘發呼吸肌肌動圖均方根值敏感度表………………………………………………………………62
表12 病患(01)之氣道阻力呼吸肌肌動圖均方根值放大倍率量表………………………………………………………………65
表13病患(06)之氣道阻力呼吸肌肌動圖均方根值放大倍率量表………………………………………………………………65
表14七位病患之氣道阻力呼吸肌肌動圖均方根放大倍率量表………………………………………………………………65
表15 呼吸頻率量測值………………………………………………69
表16 呼吸頻率換算圖………………………………………………69
表17 病患克服氣道阻力改善統計表………………………………70
表18 病患嗜睡指數(AH)改善量表………………………………71
表19 嗜睡量表(ESS)之七位病患調查結果量表………………72
表20 睡眠品質量表(PSQI)七位病患調查結果量表………………73

[1] Bonekat, H. W., &; Krumpe, P. E. (1990). Diagnosisof obstructive sleep apnea. Clinical Reviews of Allergy and Immunology, 8(2-3), 97-213.
[2] 劉勝義 (2004)。臨床睡眠檢查學。臺北市:合記。
[3] Carney, P. R., Berry, R. B., &; Geyer, J. D. (2005).Clinical sleep disorders. Philadephia, PA:Lippincott Williams &; Wilkins.
[4] Yaman, M., Altan, B. Y., Boluk, A., Sezer, M., &; Unlu, M. (2007). Obstructive sleep apnea syndrome symptoms in patients who present to neurology outpatient clinics. Turkiye Klinikleri Tip Bilimleri Dergisi, 27(4), 513-517.
[5] Seneviratne, U., &; Puvanendran, K. (2004).Excessive daytime sleepiness in obstructive sleep apnea: Prevalence, severity, and predictors. Sleep medicine, 5(4), 339-343.
[6] Lopes, C., Esteves, A. M., Bittencourt, L. R. A., Tufik, S., &; Mello, M. T. (2008). Relationship between the quality of life and the severity of obstructive sleep apnea syndrome. Brazilian Journal of Medical and Biological Research, 41, 908-913.
[7] Akashiba, T., Kawahara, S., Akahoshi, T., Omori, C.,Saito, O., Majima, T., &; Horie, T. (2002).Relationship between quality of life and mood or depression in patients with severe obstructivesleep apnea syndrome. Chest, 122(3), 861-865.
[8] Liu, Z., Fu, L., &; Li, L. (2010). Depressive symptom and correlative factors in patients with obstructive sleep apnea-hypopnea syndrome.Journal of Central South University. Medical sciences, 35(10), 1106-1111.
[9] Omachi, T. A., Claman, D. M., Blanc, P. D., &; Eisner, M. D. (2009). Obstructive sleep apnea: A risk factor for work disability. Sleep, 32(6), 791-798.
[10] Kreivi, H. R., Virkkula, P., Lehto, J., &; Brander, P.(2010). requency of upper airway symptoms before and during continuous positive airway pressure treatment in patients with obstructive sleep apnea syndrome. Respiration, 80(6), 488-494.
[11] Wang, Y., Gao, W., Sun, M., &; Chen, B. (2012). Adherence to CPAP in patients with obstructive sleep apnea in a Chinese population. Respiratory Care, 57(2), 238-243.
[12] Lequeux, T., Chantrain, G., Bonnand, M., Chelle, A. J., &; Thill, M. P. (2005). Physiotherapy in obstructive sleep apnea syndrome: Preliminary results. European Archives of Oto-Rhino-Laryngology, 262(6), 501-503.
[13] Guimaraes, K. C., Drager, L. F., Genta, P. R.,Marcondes, B. F., &; Lorenzi-Filho, G. (2009).Effects of oropharyngeal exercises on patients with moderate obstructive sleep apnea syndrome. American Journal of Respiratory and Critical Care Medicine, 179(10), 962-966.
[14] Robbins, J., Kays, S. A., Gangnon, R. E., Hind, J. A., Hewitt, A. L., Gentry, L. R., &; Taylor, A. J. (2007). The effects of lingual exercise in stroke patients with dysphagia. Archives of Physical Medicine and Rehabilitation, 88(2), 150-158.
[15] Randerath, W. J., Galetke, W., Domanski, U., Weitkunat, R., &; Ruhle, K. H. (2004). Tongue-muscle training by intraoral electrical
[16] Valbuza, J. S., de Oliveira, M. M., Conti, C. F., Prado, L. B. F., de Carvalho, L. B. C., &; do Prado, C. F. (2010). Methods for increasing upper airway muscle tonus in treating obstructive sleep apnea: Systematic review. Sleep and Breathing, 14(4), 299-305.
[17] Smeltzer, S. C.,&; Bare, B. G. ,Brunner &; Suddarth's textbook of medical-surgical nursing,(9th ed.), Philadelphia,Lippincott,2000
[18] Black, J. M., &; Matassarin-Jacobs, E.. Medical-surgical nursing:Clinical management for continuity of care,(5th ed.), Philadelphia,Saunders,1997.
[19] Dehuijzen, P. N., Van-Herwaarden, C. L.,&; Folgering, H. T. Exercise training during pulmonary rehabilitation in chronic obstructive pulmonary disease, Lung, 168, 481-488,1990.
[20] Gallagher, C. G.Exercise limitation and clinical exercise testing in chronic obstructive pulmonary disease,Clinics in Chest Medicine, 15(2),305-323,1994.
[21] E. H. Chester, , M. J. Belman, R. C. Bahler, Multidisciplinary treatment of chronic pulmonary insufficient:Ⅲ The effect of physical on cardiopulmonary disease performance in patients with chronic obstruction, Chest, 72, 695-702, 1977.
[22] D. A. Holden, K. D. Stelmach, P. S., G. J. Beck, J. K. Stoller, The impact of a rehabilitation program on functional status of patients with chronic lung disease., Respiratory Care, 35(4), 332-341, 1990.
[23] P. Weiner, Y. Azgad, R. Ganam, Inspiratory muscle training combined with general exercise reconditioning in patients with COPD, Chest, 102, 1351-1356, 1992.
[24] J. Reardon, E. Awad, E. Normandin, F. Vale, B. Clark, R. L. ZuWallack, The effect of comprehensive outpatient pulmonary rehabilitation on dyspnea., Chest, 105, 1046-1052, 1994.
[25] P. J. Wijkstra, R. Van Altena, J. Kraan, V. Otten, D. S. Postma, G. H. Koeter, Quality of life in patients with chronic obstructive pulmonary disease improves after rehabilitation at home, European Respiratory Journal, 7, 269-273, 1994.
[26] M. J. Berry, W. J. Rejeski, N. E. Adair, D. Zaccaro, Exercise rehabilitation and chronic obstructive pulmonary disease stage, American Journal of Respiratory Critical Care Medicine, 160, 1248-1253, 1999.
[27] Maria Teresa Elı´as Herna´ndez, MD; Teddoro Montemayor Rubio, MD; Results of a Home-Based Training Program for Patients With COPD , Pneumology Department, Virgen del Rocı´o University Hospital,Seville,Spain.CHEST ,118 , 1 , JULY, 2000.
[28] Oh,The effects of home-based pulmonary rehabilitation in patients with chronic lung disease,CHEST,2003.
[29] Emtner M, Porszasz J, Burns M, et al. Benefits of supplemental oxygen in exercise training in non-hypoxemic COPD patients. Am J Respir Crit Care Med 2003;168:1034-1042.
[30] American College of Sports Medicine. (2009). ACSM’s Resource Manual for Guidelines for Exercise Testing and Prescription. Philadelphia: Wolters Kluwer Health/ Lippincott Williams &; Wilkins.
[31] Fahey, T. D., Insel, P. M., &; Roth, W. T. (2010). Fit &; Well: Core Concepts and Labs in Physical Fitness and Wellness. New York: McGraw-Hill.
[32] 行政院衛生署統計室(2007-2012),國人主要死因統計結果
[33] 李薇萱,老年人的運動處方,社區醫學-基層醫學第二十四卷第一期
[34] 羅昌仁,生理回饋閉迴路運動強度恆定控制之跑步復健設備開發與臨床應用研究,長庚大學醫療機電工程研究所,2007。
[35] 張華洋,氧氣濃度補償與運動強度控制步行訓練系統開發,長庚大學醫療機電工程研究所,2012。
[36] 劉家駒,漸進式氣道阻力吸氣訓練系統開發與呼吸肌肌動圖及呼吸生理表現評估測試,大學醫療機電工程研究所,2013。
[37] Carrieri-Kohlman, V., Douglas, M. K., Gormley, J. M., &; Stulbarg,M. S.. Desensitization and guided mastery, Treatment approaches for the management of dyspnea, Heart &; Lung,22, 226–234,1993.
[38] 慢性阻塞性肺病(慢阻肺)2012診治指引。
[39] Omachi, T. A., Claman, D. M., Blanc, P. D., &; Eisner, M. D. (2009). Obstructive sleep apnea: A risk factor for work disability. Sleep, 32(6), 791-798.
[40] Fogel, R. B., Malhotra, A., &; White, D. P. (2004).Sleep. 2: Pathophysiology of obstructive sleepapnoea/hypopnoea syndrome. Thorax, 59(2),159-163.
[41] Wang, Y., Gao, W., Sun, M., &; Chen, B. (2012).Adherence to CPAP in patients with obstructive sleep apnea in a Chinese population.Respiratory Care, 57(2), 238-243.
[42] J. Reardon, E. Awad, E. Normandin, F. Vale, B. Clark, R. L. ZuWallack, The effect of comprehensive outpatient pulmonary rehabilitation on dyspnea., Chest, 105, 1046-1052, 1994.
[43] P. J. Wijkstra, R. Van Altena, J. Kraan, V. Otten, D. S. Postma, G. H. Koeter, Quality of life in patients with chronic obstructive pulmonary disease improves after rehabilitation at home, European Respiratory Journal, 7, 269-273, 1994.
[44] M. J. Berry, W. J. Rejeski, N. E. Adair, D. Zaccaro, Exercise rehabilitation and chronic obstructive pulmonary disease stage, American Journal of Respiratory Critical Care Medicine, 160, 1248-1253, 1999.
[45] Maria Teresa Elı´as Herna´ndez, MD; Teddoro Montemayor Rubio, MD; Results of a Home-Based Training Program for Patients With COPD , Pneumology Department, Virgen del Rocı´o University Hospital,Seville,Spain.CHEST ,118 , 1 , JULY, 2000.
[46] Oh,The effects of home-based pulmonary rehabilitation in patients with chronic lung disease,CHEST,2003.

連結至畢業學校之論文網頁點我開啟連結
註: 此連結為研究生畢業學校所提供,不一定有電子全文可供下載,若連結有誤,請點選上方之〝勘誤回報〞功能,我們會盡快修正,謝謝!
QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top