臺灣博碩士論文加值系統

由於工作模式的轉變，辦公室的久坐辦公已經是現代社會的趨勢。隨著這種變化，源自久坐及坐姿不良的腰痛和退行性疾病也成為醫學和醫學工程領域的關注問題。
眾所皆知，久坐姿勢會導致身體上的疼痛和其他肌肉骨骼症狀。到目前為止有許多不同類型的座椅且具有腰背支撐效果的產品在市面上販售，並且這些產品的設計是可以改變的。雖然所聲稱的結構和功能不同，但最終目標是為辦公室工作人員提供舒適和保護脊椎。人體脊椎曲率和椅背接觸區域與椅子的設計密切相關。如果坐在椅子上，座椅設計不良，可能無法保持脊柱的曲率，最終會導致椎間盤脫水和脊椎提早退化。
基於人體腰椎的生物力學特性，採用可調式椅子，X光影像和接觸面積來評估人體腰椎前凸的角度，骨盆解剖參數的關係，椎骨曲率和椅背的曲率之間的相關性以及人體與椅背接觸面積在不同坐姿下的分佈。可調式座椅的效果同時採用主觀問卷進行評估。
研究方法是使用X光影像和MASFOOT(感測墊)圖像進行客觀評估。評估的另一部分是使用主觀問卷，進行主觀數據量測;客觀數據量測來自X射線和MASFOOT圖像。進行數據分析和統計學分析，以說明不同姿勢之間的差異。
根據本研究結果，有腰背部支撐的座椅有助於減輕下背痛，減少腰背部壓力集中，保持腰椎前凸和腰椎節段角度。

Owing to the radid change of the working patterns, sedentary working at the office has been the majority in the modern society. With this change, lower back pain and degenerative diseases derived from sedentary postures have also become the subject of concern in the fields of medicine and medical engineering.
It is well accepted that sedentary postures would result in pain and other musculoskeletal symptoms among the workers. So far, many products with different seat supports are available in the market, and the designs of these are variable. Although the structures and functions claimed are different,the goal is to provide office workers with comfort and maintenance of the spine alignments. The curvature of the human spine and the back-seat contact area are strongly related to the designs of the chairs. If one sits on a chair with poor design, which may fail to maintain curvature of the spine and eventually end up with dehydration of the intervertebral discs and early degeneration of the spine.
Based on the biomechanical properties of the human lumbar spine, an adjustable chair, X-ray images, and distributions of the body-seat were utilized to evaluate the angles of human lumbar lordosis,the relationships of pelvic anatomical parameters, the correlations between participants' vertebra curvatures and chair's back curvatures, and the distributions of the body-seat contact areas at standing and different sitting postures. The effect of adjustable seats were also evaluated with subjective questionnaires.
The method of the study was to use X-rays and MASFOOT (sensory pad)images for objective evaluation. Another part of the assessment was to use subjective questionnaires, Subjective data measurement came from the questionnaires; objective data measurement came from X-ray and MASFOOT images. Data analysis and statistical difference were done to elucidate the differences between different postures.
According to the result of this study, a chair with back support is helpful to reduce the lower back pain, decrease body-seat pressure concentration, and maintain lumbar lordosis and lumbar segmental angles.

摘要
Abstract
致謝
目錄
圖目錄
表目錄
第一章 緒論
1.1 研究背景
1.2 研究動機與目的
1.3 正常與退化脊椎介紹
1.3.1 脊椎解剖構造介紹
1.3.2 椎骨解剖構造介紹
1.3.3 脊神經介紹
1.3.4 肌肉與韌帶介紹
1.3.5 椎間盤介紹
1.3.6 骨盆矢狀面解剖參數與代償機制介紹
1.3.7 椎間盤退化治療評估介紹
1.3.8 下背痛危險因子介紹
1.4 論文架構
第二章 文獻回顧
2.1 人因工程介紹
2.1.1 人因工程主要受傷類型
2.2 坐姿與腰椎退化之關聯性
2.3 腰墊與背墊支撐功能影響探討
2.4 腰椎二維影像量測
2.5 脊柱骨盆矢狀面平衡的研究進展
2.6 久坐與整體疾病發生率
第三章 材料與方法
3.1 實驗流程與評估項目
3.1.1 實驗流程規劃
3.1.2 主觀量表(問卷)設計與方法
3.1.3 臨床實驗規劃
3.1.4 實驗受測者規劃
3.2 實驗儀器設備
3.2.1 可調式座椅
3.2.2 Ｘ光機儀器
3.2.3 接觸面積影像系統
3.3 實驗數據統計分析
第四章 結果與討論
4.1 受測者基本資料與分析
4.2 問卷題目之信度分析
4.3 臨床實驗量測結果
4.3.1 主觀問卷量測結果分析
4.3.2 脊椎解剖參數角度分析
4.3.3 脊椎曲度與可調式座椅椅背曲度貼合分析
4.3.4 椅背接觸面積分佈分析
第五章 結論與未來展望
5.1 結論
5.2 未來展望
第六章 參考文獻
附錄
附錄A 敏盛綜合醫院人體試驗委員會研究計畫同意函
附件B 實驗問卷

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