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研究生： 林昀萱
Lin, Yun-Hsuan
論文名稱： 預防久坐型高齡者下肢深部靜脈栓塞之運動輔助裝置設計
Design Exercise Assistance Device for Elderly with Sedentary Lifestyle to Prevent from Lower Extremity Deep Vein Thrombosis
指導教授： 陳建旭
Chen, Chien-Hsu
學位類別： 碩士
Master
系所名稱： 規劃與設計學院 - 工業設計學系
Department of Industrial Design
論文出版年： 2020
畢業學年度： 108
語文別： 英文
論文頁數： 121
中文關鍵詞： 高齡者 、深部靜脈栓塞 、久坐生活型態 、肌電訊號 、運動輔助裝置
外文關鍵詞： the elderly, deep vein thrombosis, sedentary lifestyle, electromyogram, exercise assistance device
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    • 國內照護者在長期照護人員嚴重人力短缺的情況下，需要同時照顧多位高齡者，而這使得他們無法在短時間內掌握到所有高齡者的詳細身體狀況。再加上，由於深靜脈血栓形成的早期症狀不易被發現，以及久坐型高齡者屬於其病症的高風險群，因此協助照護者及高齡者提早預防該疾病是迫切需要的。
    本研究以預防深部靜脈栓塞為目標，從高齡者日常生活中的下肢行為切入，設計符合久坐生活型態高齡者的新型運動輔助裝置。然而，由於多篇研究指出提升小腿的收縮次數可以增加下肢血液回流，因此，新型運動輔助裝置應用肌電訊號的技術收集高齡者小腿的收縮狀況，同時也轉換其數據成提供高齡者的運動指引與回饋。另一方面，透過使用者訪談及焦點團體發現，高齡者與照護者共會依據四個指標評估高齡者的運動輔助裝置，包括熟悉感、易用性、舒適度，以及輔助性，而這些項目同時也是本研究設計裝置時的依據及後續評估裝置成效的指標。
    本研究分成兩項實驗：評估裝置之效用及高齡者於長時間穿戴之感受，皆招募5位久坐型高齡者及2位照護者。透過實驗結果發現，受測者皆能依據裝置給予的運動指引提升足背動脈的血流速及血流量，同時視覺類比量表及五類別口述疼痛表評估結果指出受測者於穿戴裝置時皆無感到嚴重不適。然而，由於受測者皆對此裝置的操作不熟悉，因此裝置易用性之平均分數落在「可以」的程度。另一方面，照護者也表示可以透過裝置提供的數據更了解高齡者的下肢狀況。整體來說，新型運動輔助裝置不但使高齡者更有效的運動下肢，久坐提醒也減少高齡者久坐的時間，也協助照護者快速了解其下肢運動狀況，是一個具有預防深部靜脈栓塞之可能性及未來發展性之下肢健康促進裝置。

    In Taiwan, the severe shortage of long-term care manpower makes one caregiver need to take care of multiple elderlies at the same time, which makes them not able to care for every detailed condition of the elderly. Furthermore, since the early symptoms of deep vein thrombosis are not easy to discover and the sedentary elderly are the high-risk group of it, it is urgent and essential to help both the elderly and caregivers prevent the disease earlier.
    To prevent the disease, the behaviors of the lower extremities of the sedentary elderly was researched, and based on the results of that, a new type of exercise assistance device was designed. Since many studies point out that increasing the number of calf contractions can increase the blood return of the lower extremities, the electromyogram is applied to collect muscle contractions of the calves of the elderly, and is converted to the exercise guidance and feedback for the elderly in the device. Besides, it is known from the user interview and focus group that the elderly and caregivers evaluate the elderly exercise devices for elderlies based on four indicators, including familiarity, usability, comfort, and assistance, which are also the considering basis during design and the indicators for its effectiveness evaluation.
    On the other hand, there are two experiments in this research: the effectiveness evaluation of the device and the user experience of the elderly during long-time use. Totally 5 sedentary elderly people and 2 caregivers were recruited. In the results, the subjects were found to increase the blood flow of the dorsal foot artery after exercising with the guide given by the device, while not having severe discomfort during use. However, because the subjects were not familiar with the operation method, the average score of usability fell to the level of "OK", but as for the assistance evaluation, caregivers still expressed that they can better understand the condition of the lower extremities of the elderly with the output data of the device. To conclude, the device shows the possibility of prevention deep vein thrombosis and future development because it not only enables the elderly to exercise more effectively and helps them reduce the sedentary behaviors but also helps caregivers quickly monitor the status of their lower extremities.

    摘要 ii SUMMARY iii ACKNOWLEDGEMENTS iv TABLE OF CONTENTS vi LIST OF TABLES ix LIST OF FIGURES x LIST OF SYMBOLS AND ABBREVIATIONS xii CHAPTER 1 INTRODUCTION 1 1.1 Background and Motivation 1 1.2 Purpose 5 1.3 Problem Formulation 6 1.4 Importance 7 1.5 Scope and Limitations 7 1.5.1 Scope 7 1.5.2 Limitations 8 1.6 Process 9 1.7 Conceptual Definition 10 CHAPTER 2 Literature Review 13 2.1 The Relationship between Sedentary Behavior and DVT 13 2.2 Current Prevention Methods for DVT 14 2.2.1 Active Exercise 15 2.2.2 Passive Exercise 17 2.2.3 Viewpoints on the Current Products Used in the Lives of the Elderly 19 2.3 Evaluation Methods for Preventing DVT 19 CHAPTER 3 Methodology 21 3.1 Field Observation 22 3.2 Expert Interview 23 3.3 User Observation 23 3.4 User Interview 25 3.4.1 The Lower Extremity Exercise Habits and Health Awareness of the Elderly 27 3.4.2 The Subjective Feelings of Current Prevention Products 27 3.5 Focus Group 28 3.5.1 The Discussions on the Use of Current Preventive Products 29 3.5.2 The Suggestions for Improvement of Each Device 30 3.5.3 Summary 31 3.6 Integrated Design Requirements 31 CHAPTER 4 Design and Implementation 33 4.1 Interactive System Design 33 4.1.1 Conversion of the Design Requirements and Device Functions 34 4.1.2 Structure of the Function in the Device 37 4.1.3 The Relationship of the User-device Interaction 39 4.1.4 The ARI and PRI in Functions of the Device 39 4.1.5 The Conversion from the ARI and PRI to the Program Flowchart 43 4.2 Integrated Design of the Device 44 4.2.1 Development of Design and Prototypes 44 4.2.2 Working Prototype and the Presentation of NEAD 47 4.2.3 The Operation Process of NEAD 50 4.2.4 The Output Data of NEAD and the Interpretations 51 CHAPTER 5 Experiment and Evaluation 52 5.1 Experiment Design 52 5.1.1 Experiment Field 53 5.1.2 Subjects 53 5.1.3 The Process and Evaluation Method of Experiment 1 55 5.1.4 The Process and Evaluation Method of Experiment 2 58 5.2 Experiment results 60 5.2.1 Results of Experiment 1 60 5.2.2 Results of Experiment 2 66 CHAPTER 6 Discussion and Conclusion 74 6.1 Discussion 74 6.1.1 Awareness of the Sedentary Elderly on the Lower Extremity Behaviors 74 6.1.2 Effectiveness and Subjective Feelings of NEAD 76 6.1.3 Design Suggestions for Future Related Design 80 6.2 Conclusion 84 REFERENCES 85 Appendix B Questionnaires of the User Interview 93 A.1 Questionnaire of the Lower Exercise Habits and Health Awareness of the Elderly 93 A.2 Questionnaire of the Subjective Feelings of Current Prevention Products 96 Appendix C Design Kit of Interaction Design in Device 98 Appendix D The Diagram of the ARI and the PRI, the Table of the Factors in the ARI and the PRI, and the Program Flowchart 103 Appendix E Mini-mental State Examination 107 Appendix F Rapid Assessment Disuse Index 108 Appendix G The Comfort Scales 109 Appendix H System Usability Scale 110 Appendix I Questionnaires of the Subject Feelings 111 Appendix J Questionnaire of Awareness of the Lower Extremity Behaviors of the Elderly 112 Appendix K Questionnaire of User Experience of the Elderly after Using for 1.5 hours 113 Appendix L Questionnaire of Care Feedback of the Caregiver to the elderly's lower extremities 114 Appendix M Questionnaire of Feedbacks of the Caregiver to the Elderly after Using for 1.5 hours 115 Appendix N The EMG Signals of Subjects during Experiment 2 116 Appendix O The Ideal APP Presentation of the Device in the Future 119

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