臺灣博碩士論文加值系統

士兵經常在戰場上擔任搬運炮彈、重武器操作等荷重任務，而高重複性的蹲站、搬運，具有高度肌肉骨骼傷害的風險，而為了提高士兵的持久作戰能力並減少肌肉骨骼傷害，許多國家以發展外骨骼輔具來輔助並減少肌肉負荷已然成為趨勢。然而，外骨骼提供動力輔助的時機，應視人員動作過程中肌肉的相對負荷(最大能力百分比)而定，但肌肉的最大施力能力會同時受到肌肉長度與收縮速度的影響，且在多肌群合力作用下變得更加複雜。
本研究採用BTE Primus RS測功機，測量6 名男性及6名女性受試者膝關節與髖關節於等長和等速狀況下的最大伸展力矩，建立下肢最大關節力矩與關節角度、速度之函數，以探討下肢在關節角度、速度影響下的最大施力能力。實驗結果顯示男性及女性在同關節下最大力矩的變化趨勢大致相同，但女性的最大力矩約為男性的70-80% (p<0.01)。等長施力的情況下膝、髖關節有最大的力矩輸出，但隨關節角度遞減少及角速度的增加，所能產生的關節力矩會明顯降低(p<0.01)。
本研究實驗資料所建立最大力矩函數，可提供實際動作下的關節角度、角速度的最大參考力矩，結合動作分析系統所推算的關節力矩、角度與角速度，可以推算特定動作下關節的相對負荷，以作為外骨骼提供輔助力矩大小與時機之參考。

Soldiers often undertake heavy-duty tasks such as carrying artillery shells and operating heavy weapons on the battlefield, which contain high repetitive squatting, and carrying and have a high risk of musculoskeletal injury. In order to improve the long-term combat capability of soldiers and reduce musculoskeletal injuries, it has become a trend in many countries to develop exoskeletons to assist and reduce musculoskeletal load. However, the timing of the power assistance provided by the exoskeleton should depend on the muscles' relative load (percentage of maximum capacity) during the person's movement. Nevertheless, the maximum force applied by the muscle is affected by both muscle length and contraction speed and becomes more complicated by the combined action of multiple muscle groups.
In this study, the BTE Primus RS dynamometer was used to measure the maximum extension torque of the knee and hip joints in six male and six female subjects. Data collected under isometric and isokinetic conditions were used to establish the maximum joint torque function of the lower limb joint angle and speed. The experimental results showed that the changing trend of maximal torque of the same joint was roughly the same for men and women, but the maximal torque of women was about 70-80% of that of men (p<0.01). Under the condition of isometric exertion, the knee and hip joints have the greatest torque output, but with the decrease of the joint angle and the increase of the angular velocity, the joint torque that can be generated will decrease significantly (p<0.01).
The maximum torque function established by the experimental data in this study can provide the maximum reference torque of the joint angle and angular velocity under the actual movement. Combined with the joint torque, angle, and angular velocity calculated by the movement analysis system, the relative load of the joint under a specific movement can be calculated to provide the exoskeleton a reference for the magnitude and timing of the auxiliary torque.

摘要 i
ABSTRACT iii
致謝 v
目錄 vi
表目錄 viii
圖目錄 ix
1 第一章 緒論 1
1.1 研究背景 1
1.2 研究動機與目的 1
1.3 研究架構 2
2 第二章 文獻探討 3
2.1 外骨骼發展應用 3
2.2 荷重對肌肉骨骼影響 4
2.3 最大自主肌力量測 5
2.4 肌力量測應用 6
3 第三章 研究方法 8
3.1 研究對象 8
3.2 儀器設備 8
3.3 實驗方法 10
3.3.1 等長運動 11
3.3.2 等速運動 13
3.4 實驗步驟 15
3.5 資料處理 15
3.5.1 最大等長收縮曲線建立 16
3.5.2 最大等速收縮曲線建立 19
4 第四章 實驗結果 20
4.1 等長運動結果 20
4.1.1 膝關節 20
4.1.2 髖關節 21
4.2 等速運動結果 23
4.2.1 膝關節 23
4.2.2 髖關節 25
4.3 肌力函數 27
4.3.1 膝關節 28
4.3.2 髖關節 29
5 第五章 討論與結論 31
5.1 關節角度影響 31
5.2 關節施力差異 32
5.3 男女性差異 33
5.4 研究限制 34
5.5 結論 34
參考文獻 35
附錄 40

1.Sankai, Yoshiyuki, HAL: Hybrid assistive limb based on cybernics, in Robotics research. 2010, Springer. p. 25-34.
2.Sanz-Merodio, Daniel, Manuel Cestari, Juan Carlos Arevalo, Xavier Alberto Carrillo,Elena Garcia, Generation and control of adaptive gaits in lower-limb exoskeletons for motion assistance. Advanced Robotics, 2014. 28(5): p. 329-338.
3.Chiri, Azzurra, Nicola Vitiello, Francesco Giovacchini, Stefano Roccella, Fabrizio Vecchi,Maria Chiara Carrozza, Mechatronic design and characterization of the index finger module of a hand exoskeleton for post-stroke rehabilitation. IEEE/ASmE Transactions on mechatronics, 2011. 17(5): p. 884-894.
4.Mao, Ying,Sunil Kumar Agrawal, Design of a cable-driven arm exoskeleton (CAREX) for neural rehabilitation. IEEE Transactions on Robotics, 2012. 28(4): p. 922-931.
5.Colombo, Gery, Matthias Joerg, Reinhard Schreier,Volker Dietz, Treadmill training of paraplegic patients using a robotic orthosis. Journal of rehabilitation research and development, 2000. 37(6): p. 693-700.
6.Jamwal, Prashant K, Sheng Q Xie, Shahid Hussain,John G Parsons, An adaptive wearable parallel robot for the treatment of ankle injuries. IEEE/ASME Transactions on mechatronics, 2012. 19(1): p. 64-75.
7.Kazerooni, Hami, J-L Racine, Lihua Huang,Ryan Steger. On the control of the berkeley lower extremity exoskeleton (BLEEX). in Proceedings of the 2005 IEEE international conference on robotics and automation. 2005. IEEE.
8.Marcheschi, S., F. Salsedo, M. Fontana,M. Bergamasco. Body Extender: Whole body exoskeleton for human power augmentation. in 2011 IEEE International Conference on Robotics and Automation. 2011.
9.Roy, Tanja C, Joseph J Knapik, Bradley M Ritland, Nicole Murphy,Marilyn A Sharp, Risk factors for musculoskeletal injuries for soldiers deployed to Afghanistan. Aviation, space, and environmental medicine, 2012. 83(11): p. 1060-1066.
10.Straker, Leon, Evidence to support using squat, semi-squat and stoop techniques to lift low-lying objects. International Journal of Industrial Ergonomics, 2003. 31(3): p. 149-160.
11.Roldán-Jiménez, Cristina, Paul Bennett,Antonio I Cuesta-Vargas, Muscular activity and fatigue in lower-limb and trunk muscles during different sit-to-stand tests. PloS one, 2015. 10(10): p. e0141675.
12.Dreischarf, Marcel, Aboulfazl Shirazi-Adl, Navid Arjmand, Antonius Rohlmann,Hendrik Schmidt, Estimation of loads on human lumbar spine: a review of in vivo and computational model studies. Journal of biomechanics, 2016. 49(6): p. 833-845.
13.Cho, Kang Hee, Jae Won Beom, Tae Sung Lee, Jun Ho Lim, Tae Heon Lee,Ji Hyun Yuk, Trunk muscles strength as a risk factor for nonspecific low back pain: a pilot study. Annals of rehabilitation medicine, 2014. 38(2): p. 234.
14.Takarada, Yudai,Daichi Nozaki, Shouting strengthens maximal voluntary force and is associated with augmented pupillary dilation. Scientific Reports, 2021. 11(1): p. 1-11.
15.Chaffin, Don B, Ergonomics guide for the assessment of human static strength. American Industrial Hygiene Association Journal, 1975. 36(7): p. 505-511.
16.Melendez-Calderon, Alejandro, E Rodrigues, K Thielbar,James L Patton. Movement therapy without moving—First results on isometric movement training for post-stroke rehabilitation of arm function. in 2017 International Conference on Rehabilitation Robotics (ICORR). 2017. IEEE.
17.Marginson, Vicky,Roger Eston, The relationship between torque and joint angle during knee extension in boys and men. Journal of sports sciences, 2001. 19(11): p. 875-880.
18.Krishnan, Chandramouli,Glenn N Williams, Effect of knee joint angle on side-to-side strength ratios. The Journal of Strength & Conditioning Research, 2014. 28(10): p. 2981-2987.
19.Chan, Addie Yf, Flora Ll Lee, Pk Wong, Cass Ym Wong,Simon S Yeung, Effects of knee joint angles and fatigue on the neuromuscular control of vastus medialis oblique and vastus lateralis muscle in humans. European journal of applied physiology, 2001. 84(1): p. 36-41.
20.Thompson, Brennan J, Morgan Whitson, Eric J Sobolewski,Matt S Stock, The influence of age, joint angle, and muscle group on strength production characteristics at the knee joint. The Journals of Gerontology: Series A, 2018. 73(5): p. 603-607.
21.Connelly, Denise M,Anthony A Vandervoort, Effects of isokinetic strength training on concentric and eccentric torque development in the ankle dorsiflexors of older adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 2000. 55(10): p. B465-B472.
22.Colliander, Erland B,Per A Tesch, Bilateral eccentric and concentric torque of quadriceps and hamstring muscles in females and males. European journal of applied physiology and occupational physiology, 1989. 59(3): p. 227-232.
23.Gonosova, Zuzana, Petr Linduska, Lucia Bizovska,Zdenek Svoboda, Reliability of ankle–foot complex isokinetic strength assessment using the Isomed 2000 dynamometer. Medicina, 2018. 54(3): p. 43.
24.Guilhem, Gaël, Caroline Giroux, Antoine Couturier,Nicola A Maffiuletti, Validity of trunk extensor and flexor torque measurements using isokinetic dynamometry. Journal of Electromyography and Kinesiology, 2014. 24(6): p. 986-993.
25.Roth, Ralf, Lars Donath, Eduard Kurz, Lukas Zahner,Oliver Faude, Absolute and relative reliability of isokinetic and isometric trunk strength testing using the IsoMed-2000 dynamometer. Physical therapy in sport, 2017. 24: p. 26-31.
26.Habets, Bas, J Bart Staal, Marsha Tijssen,Robert Van Cingel, Intrarater reliability of the Humac NORM isokinetic dynamometer for strength measurements of the knee and shoulder muscles. BMC research notes, 2018. 11(1): p. 1-5.
27.Samuel, Dinesh,Philip J Rowe, Effect of ageing on isometric strength through joint range at knee and hip joints in three age groups of older adults. Gerontology, 2009. 55(6): p. 621-629.
28.Savelberg, Hans Hcm,Kenneth Meijer, The effect of age and joint angle on the proportionality of extensor and flexor strength at the knee joint. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 2004. 59(11): p. 1120-1128.
29.Bergamin, Marco, Stefano Gobbo, Valentina Bullo, Barbara Vendramin, Federica Duregon, Antonio Frizziero, et al., Reliability of a device for the knee and ankle isometric and isokinetic strength testing in older adults. Muscles, ligaments and tendons journal, 2017. 7(2): p. 323.
30.Tsiokanos, Athanasios, Eleftherios Kellis, Athanasios Jamurtas,Spiros Kellis, The relationship between jumping performance and isokinetic strength of hip and knee extensors and ankle plantar flexors. Isokinetics and exercise science, 2002. 10(2): p. 107-115.
31.Babault, Nicolas, Michel Pousson, Yves Ballay,Jacques Van Hoecke, Activation of human quadriceps femoris during isometric, concentric, and eccentric contractions. Journal of applied physiology, 2001. 91(6): p. 2628-2634.
32.Stotz, Andreas, Ebrahem Maghames, Joel Mason, Andreas Groll,Astrid Zech, Maximum isometric torque at individually-adjusted joint angles exceeds eccentric and concentric torque in lower extremity joint actions. BMC Sports Science, Medicine and Rehabilitation, 2022. 14(1): p. 1-8.
33.Hahn, Daniel, Walter Herzog,Ansgar Schwirtz, Interdependence of torque, joint angle, angular velocity and muscle action during human multi-joint leg extension. European journal of applied physiology, 2014. 114(8): p. 1691-1702.
34.Šarabon, Nejc, Žiga Kozinc,Mihael Perman, Establishing Reference Values for Isometric Knee Extension and Flexion Strength. Frontiers in physiology, 2021: p. 1809.
35.Miller, Andrea Elizabeth Jane, Jd Macdougall, Ma Tarnopolsky,Dg Sale, Gender differences in strength and muscle fiber characteristics. European journal of applied physiology and occupational physiology, 1993. 66(3): p. 254-262.