臺灣博碩士論文加值系統

人體結構中，膝關節是承受身體重量的重要關節之一，對下肢所進行的活動是不可缺少;其中，前後十字韌帶、內外側副韌帶與膝關節中之肌腱主要用於穩定膝關節的擺動。膝關節常見的損傷，為瞬間外力改變而造成前十字韌帶受損，大部分前十字韌帶受損較嚴重病患會選擇手術治療，若症狀較不顯著之病患，可能認為只是肌腱或肌肉發炎而延遲了治療的時間，導致其他併發症產生。於臨床理學檢測上，尚難以量化數據的方式來診斷前十字韌帶受損之嚴重性。
本研究目的為檢測膝關節前十字韌帶受損狀況並以量化呈現，提供患者是否需進行膝關節韌帶重建手術之參考。本系統以非侵入式作檢測，採用網路攝影機進行標記點物件追蹤，並結合自製之模組固定於大腿正上方，受測者以軸移測試檢測方式進行檢查，以追蹤脛骨結節上標記點座標移動變化，進而計算脛骨水平位移量，藉此位移量評估前十字韌帶受損之狀態，有助於提供醫生作為診斷參考。因醫學研究上之位移量皆以毫米為單位，本系統經由驗證量測之誤差值可小於1 mm，故可量測出有效數據供醫生參考。

The knee-joint is an important joint to support the body weight in human structure and is indispensable in lower limb moving. The anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament, and lateral collateral ligament can keep knee swinging stable. The knee injuries are commonly caused by the external forces variation in ACL. Most patients of the serious ACL injure choose operation. If the symptom is slight, patient may consider the inflammation of tendon or muscle. Hence, delay the treatment time to cause other diseases. In clinical examination, doctor can not quantify the level of ACL injure for further diagnosis.
This study aimed to assess the situation of ACL injuries, and present the quantitative results. This research provided the basis for the patients to make a decision whether to do ACL reconstruction surgery. Apply a webcam to track marked objects., The webcam is combined with the homemade module and fixed above the femur to measure the shift. Subjects are thus examined by pivot shift test to tracking the changes of markers coordinates on the tibial tuberosity point for computing tibia horizontal displacement. The results could be for doctors as a diagnostic reference. In medical research, the amount of displacement is often measured in millimeters. Our system was verified by measurements and confirmed that the error value is less than 1 mm, it thus could effectively measure the data for reference by doctors.

中文摘要 i
英文摘要 ii
誌 謝 iv
目錄 v
圖目錄 viii
表目錄 xi
第一章 緒論 1
1.1 研究動機 2
1.2 研究目的 4
1.3 論文架構 5
第二章 文獻探討 6
2.1 膝關節結構 6
2.1.1 膝關節相關病理探討 7
2.1.2 膝關節韌帶損傷與不穩定 9
2.2 影像追蹤偵測技術 10
2.2.1 物件顏色追蹤 10
2.2.2 物件邊緣追蹤 12
2.2.3 即時臉部追蹤 13
2.3 其他文獻檢測方式 15
2.3.1 韌帶術前檢測方式 15
2.3.2 PST相關量化技術 17
第三章 實驗材料與方法 21
3.1 感測訊號模組 22
3.1.1 影像偵測設備 22
3.1.2 微控制器 24
3.1.3 慣性感測模組 25
3.1.4 感測器固定方法與位置 26
3.2 影像訊號處理與分析 27
3.2.1 慣性感測訊號分析 30
3.2.2 顏色辨識與物件追蹤 32
3.2.3 影像初始校正 37
3.3 主要量測動作 39
第四章 實驗與討論 41
4.1 模擬驗證設計 41
4.1.1 模擬驗證比較基準 43
4.1.2 靜態模擬驗證 44
4.1.3 動態驗證波形分析 45
4.1.4 動態模擬驗證 46
4.1.5 動態脛骨位移推算 51
4.2 人體膝關節量測設計 53
4.2.1 實驗量測對象 53
4.2.2 量測方法設計 54
4.2.3 實驗量測參數表 56
4.3 人體膝關節量測結果分析 57
4.3.1 量測結果分析 57
4.3.2 量測結果差異性分析 59
第五章 結論與未來研究方向 63
5.1 結論 63
5.2 未來研究方向 64
參考文獻 65
附錄 70
A 參數對照表 70
B 中英文專有名詞對照表 72
C 操作介面簡介 74
D 作者簡歷 76

[1]康翠籃，“前十字韌帶重整手術後的復健”，大專體育，vol. 35，pp. 127-133，1998。
[2]B. Yu and W. E. Garrett, “Mechanisms of non-contact ACL injuries,” British journal of sports medicine, vol. 41, no. 1, pp 47-51, Aug., 2007.
[3]F. Yan, F. Xie, X. Gong, F. Wang, and L. Yang, “Effect of anterior cruciate ligament rupture on secondary damage to menisci and articular cartilage,” The Knee, vol. 23, pp. 102-105, Jul., 2015.
[4]B. L. van Meer, E. H. Oei, D. E. Meuffels, and E. R. van Arkel, “Degenerative changes in the knee 2 years after anterior cruciate ligament rupture and related risk factors a prospective observational follow-up study,” The American Journal of Sports Medicine, vol. 44, no. 6, pp. 1524-1533, Mar., 2016.
[5]F. Han, A. Banerjee, L. Shen, and L. Krishna, “Increased compliance with supervised rehabilitation improves functional outcome and return to sport after anterior cruciate ligament reconstruction in recreational athletes,” Orthopaedic journal of sports medicine, vol. 3, no. 12, Dec., 2015.
[6]Brown, H. Charles, and E. W. Carson, “Revision anterior cruciate ligament surgery,” Clinics in sports medicine, vol. 18, no. 1, pp. 109-171, Jan., 1999.
[7]K. C. Miyasaka, D. M. Daniel, M. L. Stone, and P. Hirshman, “The incidence of knee ligament injuries in the general population,” The American journal of knee surgery, vol. 4, no. 1, pp. 3-8, 1991.
[8]張慈映、蔡孟男，“2015醫療器材產業年鑑”，經濟部技術處產業技術知識服務計畫，2015。
[9]戴遐齡、陳奕良，“運動城市調查”，http://goo.gl/KTPWWJ，2015。
[10]K. E. Wilk, M. M. Reinold, and T. R. Hooks, “Recent advaces in the rehabilitation of isolated and combined anterior cruciate ligament injuries,” Orthopaedic Clinics of North America, vol. 34, no. 1, pp. 107-137, Jan., 2003.
[11]D. M. Boni and G. E. Herriott, “Hamstring tendon graft for anterior cruciate ligament reconstruction,” AORN Journal, vol. 76, no. 4, pp. 612-624, Oct., 2002.
[12]G. Spahn, H. M. Klinger, and G. O. Hofmann, “How valid is the arthroscopic diagnosis of cartilage lesions? Results of an opinion survey among highly experienced arthroscopic surgeons,” Archives of orthopaedic and trauma surgery, vol. 129, no. 8, pp. 1117-1121, Aug., 2009.
[13]M. A. Bohensky, C. Kondogiannis, V. Sundararajan, and N. Andrianopoulos, “Adverse outcomes associated with elective knee arthroscopy: a population-based cohort study,” Arthroscopy: The Journal of Arthroscopic & Related Surgery, vol. 29, no. 4, pp. 716-725, Apr., 2013.
[14]I. A. Harris, N. S. Madan, J. M. Naylor, S. Chong, and R. Mittal, “Trends in knee arthroscopy and subsequent arthroplasty in an Australian population: a retrospective cohort study,” BMC musculoskeletal disorders, vol. 14, no. 1, Apr., 2013.
[15]G. Garra, A. J. Singer, B. R. Taira, and J. Chohan, “Validation of the Wong-Baker FACES pain rating scale in pediatric emergency department patients,” Academic Emergency Medicine, vol. 17, no. 1, pp. 50-54, Jan., 2010.
[16]C. H. Lu, Y. T. Chiang, and C. C. Tuan, “Non-invasive detection system of ligament with sound signal,” in Proc. of the 8th international Conference on Advanced information Technologies, Taichung, Taiwan, Apr., 2014.
[17]N. Xue, M. Doellinger, J. Fripp, C. P. Ho, and R. K. Surowiec, “Automatic model‐based semantic registration of multimodal MRI knee data,” Journal of Magnetic Resonance Imaging, vol. 41, no. 3, pp. 633-644, Mar., 2015.
[18]K. N. Glazebrook, L. J. Brewerton, S. Leng, and R. E. Carter, “Case–control study to estimate the performance of dual-energy computed tomography for anterior cruciate ligament tears in patients with history of knee trauma,” Skeletal radiology, vol. 43, no. 3, pp. 297-305, Mar., 2014.
[19]K. A. Buckwalter, J. Rydberg, K. K. Kopecky, K. Crow, and E. L. Yang, “Musculoskeletal imaging with multislice CT,” American Journal of Roentgenology, vol. 176, no. 4, pp. 979-989, Apr., 2001.
[20]W. L. Calmbach and M. Hutchens, “Evaluation of patients presenting with knee pain: Part I. History, physical examination, radiographs, and laboratory tests,” American family physician, vol. 68, no. 5, 2003, pp. 907-912, Sep., 2003.
[21]M. V. Paterno, M. J. Rauh, L. C. Schmitt, K. R. Ford, and T. E. Hewett, “Incidence of second ACL injuries 2 years after primary ACL reconstruction and return to sport,” The American Journal of Sports Medicine, vol. 42, pp. 7, pp. 1567-1573, Jul., 2014.
[22]K. D. Shelbourne and R. W. Benner, “Isolated anterior cruciate ligament reconstruction in the chronic ACL-deficient knee with degenerative medial arthrosis,” Journal of Knee Surgery, vol. 20, no. 3, pp. 216-222, Jul., 2007.
[23]J. Insall, “Current Concepts Review: patellar pain,” The Journal of Bone & Joint Surgery, vol. 64, no. 1, pp. 147-152, Jan., 1982.
[24]王亦璁，“骨與關節損傷”，人民工生出版社，北京，2001。
[25]S. Zhao, B. Liu, Y. Ren, and J. Han, “Color tracking vision system for the autonomous robot,” in Proc. of the 9th International Conference on Electronic Measurement & Instrument, Beijing, China, pp. 182-185, Aug., 2009.
[26]H. Kwon, Y. Yoon, J. B. Park, and A. C. Kak, “Person tracking with a mobile robot using two uncalibrated independently moving cameras,” in Proc. of the 2005 IEEE International Conference on Robotics and Automation (ICRA), Barcelona, Spain, pp. 2877-2883, Apr., 2005.
[27]A. Ambardekar, M. Nicolescu, and G. Bebis, “Efficient vehicle tracking and classification for an automated traffic surveillance system,” in Proc. of the International Conference on Signal and Image Processing, Bratislava, Slovakia, Aug., 2008.
[28]W. Kubinger, F. Rinnerthaler, C. Sulzbachner, J. Langer, and M. Humenberger, “An embedded vision sensor for robot soccer,” In Proc. International Conference on Computer Aided Systems Theory, Gran Canaria, Spain, pp. 1025-1032, Feb., 2007.
[29]P. Zhao, H. Zhu, H. Li, and T. Shibata, “A directional-edge-based real-time object tracking system employing multiple candidate-location generation,” IEEE Transactions on Circuits and Systems for Video Technology, vol. 23, no. 3, pp. 503-517, Mar., 2013.
[30]M. Sabet, R. A. Zoroofi, K. S. Niiat, and M. Sabbaghian, “Automated face tracking with self correction capability,” in Proc. 2011 International Conference of Soft Computing and Pattern Recognition (SoCPaR), Dalian, China, pp. 280-284, Oct., 2011.
[31]P. Viola, M. J. Jones, “Robust real-time face detection,” International of Computer Vision, vol. 57, no. 2, pp. 137-154, May., 2004.
[32]J. S. Jang and J. H. Kim, “Fast and robust face detection using evolutionary pruning,” IEEE Transactions on Evolutionary Computing, vol. 12, no. 5, pp. 562-571, Oct., 2008.
[33]D. Comaniciu, V. Ramesh, and P. Meer, “Real-time tracking of non-rigid objects using mean shift,” in Proc. of the 16th International Conference on Pattern Recognition (ICPR), Barcelona, Spain, vol. 2, pp. 142-149, Jun., 2000.
[34]J. Ning, L. Zhang, D. Zhang, C. Wu, “Robust object tracking using joint color-texture histogram,” International Journal of Pattern Recognition and Artificial Intelligence, vol. 23, no. 7, pp. 1245-1263, Nov., 2009.
[35]A. Benjaminse, A. Gokeler, and C. P. van der Schans, “Clinical diagnosis of an anterior cruciate ligament rupture: a meta-analysis,” Journal of Orthopaedic & Sports Physical Therapy, vol. 36, no. 5, pp. 267-288, May., 2006.
[36]R. J. P. M. Scholten, W. Opstelten, C. G. van der Plas, and D. Bijl, “Accuracy of physical diagnostic tests for assessing ruptures of the anterior cruciate ligament: a meta-analysis,” Journal of family practice, vol. 52, no. 9, pp. 689-696, Sep., 2003.
[37]H. Dejour and M. Bonnin, “Tibial translation after anterior cruciate ligament rupture. Two radiological tests compared,” Bone & Joint Journal, vol. 76, no. 5, pp. 745-749, Sep., 1994.
[38]S. Zaffagnini, C. Signorelli., A. Grassi, H. Yue, and F. Raggi, “Assessment of the pivot shift using inertial sensors,” Current reviews in musculoskeletal medicine, vol. 9, no. 2, pp. 160-163, Jun., 2016.
[39]Y. Hoshino, P. Araujo, J. J. Irrgang, F. H. Fu, and V. Musahl, “An image analysis method to quantify the lateral pivot shift test,” Knee Surgery Sports Traumatology Arthroscopy, vol. 20, no. 4, pp. 703-707, Apr., 2012.
[40]M. Berruto, F. Uboldi, L. Gala, B. Marelli, and W. Albisetti, “Is triaxial accelerometer reliable in the evaluation and grading of knee pivot-shift phenomenon?,” Knee Surgery Sports Traumatology Arthroscopy, vol. 21, no. 4, pp. 981-985, Apr., 2013.
[41]P. H. Borgstrom, K. L. Markolf, B. Foster, F. A. Petrigliano, and D. R. McAllister, “Use of a gyroscope sensor to quantify tibial motions during a pivot shift test,” Knee Surgery Sports Traumatology Arthroscopy, vol. 22, no. 9, pp. 2064-2069, Sep., 2014.
[42]S. Kubo, H. Muratsu, S. Yoshiya, K. Mizuno, and M. Kurosaka, “Reliability and usefulness of a new in vivo measurement system of the pivot shift,” Clinical orthopaedics and related research, vol. 454, pp. 54-58, Jan., 2007.
[43]A. Bedi, V. Musahl, C. Lane, and M. Citak, “Lateral compartment translation predicts the grade of pivot shift: a cadaveric and clinical analysis,” Knee Surgery Sports Traumatology Arthroscopy, vol. 18, no. 9, pp. 1269-1276, Sep., 2010.
[44]Y. Hoshino, R. Kuroda, K. Nagamune, D. Araki, S. Kubo, M. Yamaguchi, and M. Kurosaka, “Optimal measurement of clinical rotational test for evaluating anterior cruciate ligament insufficiency,” Knee Surgery Sports Traumatology Arthroscopy, vol. 20, no. 7, pp. 1323-1330, Jul., 2012.
[45]P. H. Araujo, M. K. Junior, B. Ohashi, and Y. Hoshino, “Individualized ACL reconstruction,” Knee Surgery Sports Traumatology Arthroscopy, vol. 22, no. 9, pp. 1966-1975, Sep., 2014.
[46]P. H. Borgstrom, K. L. Markolf, Y. Wang, X. Xu, and P. R. Yang, “Use of inertial sensors to predict pivot-shift grade and diagnose an ACL injury during preoperative testing,” The American journal of sports medicine, vol. 43, no. 4, pp. 857-864, Apr., 2015.
[47]P. Read, and M. P. Meyer, “Restoration of motion picture film,” Butterworth-Heinemann, 2000.