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研究生：	蔡忠穎 Tsai, Chung-Ying
論文名稱：	輪椅後輪傾角對上肢生物力學的影響 The Effects of Camber on Biomechanics of Upper Extremity in Wheelchair Propulsion
指導教授：	蘇芳慶 Su, Fong-Chin
學位類別：	碩士 Master
系所名稱：	工學院 - 醫學工程研究所 Institute of Biomedical Engineering
論文出版年：	2007
畢業學年度：	95
語文別：	英文
論文頁數：	112
中文關鍵詞：	上肢、輪椅、推動、輪椅後輪傾角、生物力學
外文關鍵詞：	propulsion, wheelchairs, upper extremity, biomechanics, camber
相關次數：	點閱：125 下載：10
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輪椅是目前台灣最常見的醫療儀器之ㄧ，且在很多報告中都顯示，輪椅市場的廣大且呈穩定的成長，輪椅使用者的人數也漸漸增多，但輪椅卻是一個低效率的行動輔具，長期使用下來常常會造成使用者的受傷。輪椅後輪傾角是輪椅機構設計的一部份，而它在很多輪椅運動中都扮演著非常重要的角色，但有報告指出，大部分輪椅運動員都有一處以上的受傷，輪椅機構的設計不良可能是造成受傷的原因之ㄧ，所以有很多研究針對輪椅的設計和推動輪椅時的生理學參數，尤其是能量消耗，加以探討，但在輪椅後輪傾角對生物力學方面的影響卻仍然是乏人問津，所以本研究就針對不同的輪椅後輪傾角對上肢推動輪椅時的運動學和動力學變化加以分析比較，並藉由這些改變來探討輪椅後輪傾角對上肢的影響。

　　共有12個正常年輕人參與此實驗，使用三維動作分析系統(Motion Analysis Corporation Santa Rosa, CA, USA)來收取使用者推動輪椅過程的運動學資料，而在動力學方面，本研究使用可分析三維動力學資料的輪椅系統來收取推動輪椅時的力學資料，此輪椅系統的輪子上裝有一個三軸的力感測器，並加上訊號轉換系統和藍芽無線系統傳出數據，以獲得動力學資料。本實驗所用的後輪傾角分別為0°、9°、15°，輪椅速度控制在1 m/s和2 m/s，收取受測者四公尺距離的輪椅推動情形，最後再結合運動學和動力學資料來算出想要得的參數。實驗結果使用多項重複測驗分析(Repeated Measures Analysis)來進行統計分析。

　　本實驗結果顯示，在不同傾角的情況下，無論是時間、運動學與動力學參數上都有很顯著的差異，顯示出輪椅後輪傾角的確會對上肢生物力學產生非常大的影響，隨著輪椅後輪傾角的變大，尤其是增加到15°時，會使推動輪椅的模式改變，上肢各關節的動作會變大，手握把處的推動力變大且方向改變，向前的分力比率增加，而向下的分力比率減少，使得手把處推動力更有效率，但上肢各關節的關節力矩變大，卻加重了各個關節的負擔，所以要使用大後輪傾角時，必須考慮到使用者本身的體能狀況，才不至於導致使用者容易受傷。這些結果相信可以提供輪椅使用者和設計者在選用輪椅時, 必須要詳細考慮的一項因素。

Wheelchairs are the most common medical devices in Taiwan. Many reports have showed that the market of wheelchair is large and increases stably. There are more and more wheelchair users in the world. However, the wheelchair is one kind of assistant device with low efficiency, and it will cause the users to get injury easily for long term using. The camber is one component of wheelchair design. It plays an important role in many handicapped activities. Some studies mentioned that most wheelchair athletes have one injury at least. One of the reasons that the athletes get injury easily is the mal-designed wheelchair. There are many researches concerning about the design of wheelchairs and the parameters of physiology during propulsion, especially energy consumption. But the effects of camber on biomechanics still lack for probing into. Therefore, the study compared the change of kinematics and kinetics of upper extremity in different cambers. And then, the effects of camber on biomechanics of upper extremity would be discussed further more.

　　There were twelve normal subjects participating in the study. An eight-camera Expert VisionTM motion capture system (Motion Analysis Corp, CA, USA) was used to collect the three-dimensional trajectory data of wheelchair propulsion. A standard type manual wheelchair with an instrumented wheel which consists of a six-component load cell, a data logger, and a Bluetooth system was used to collect the kinetics data. Three cambers, 0°, 9°, 15°, were chosen in the study, and the velocity of the wheelchair would be controlled at 1 m/s and 2 m/s. The subjects used a standard manual wheelchair to perform the propulsion activity for four meters. Then, the parameters were calculated by combining the kinematics data with kinetics data. At last, repeated measures analysis was used for statistical analysis.

　　According to the results of different cambers, there was significant difference in the parameters of temporal-spatial characteristics, kinematics, and kinetics. The results meant that the effects of camber on biomechanics of upper extremity were significant. When camber became larger, such as 15。, the propulsion pattern would be changed, the joint movement of upper extremity would become larger, and the hand-rim contact force also became larger. Otherwise, the direction of hand-rim contact force would be changed. It became more forward, but less downward. The change of direction would make the hand-rim contact force more efficient. But the increase of camber also increased the loading of each joint. Therefore, if the users want to use the large camber, it is necessary to consider the users’ physical condition. These results could provide both wheelchair users and the designers of wheelchairs some useful information. The camber is one of the important components for then to consider.

中文摘要　　　　　　　　　　                           I
Abstract　　　　　　　　　　                           III
誌謝　　　　　　　　　　　　                           V
Contents　　　　　　　　　　                           VI
List of Tables                                         IX
List of Figures                                        XI
Chapter 1                                              1
Introduction                                           1
1	Background                                    1
2 Clinical problems                                  1
3 Wheelchair propulsion                              3
4 Kinematics                                         5
5 Kinetics                                           7
6 Camber                                             10
7 Motivation and purpose                             11
Chapter 2	                                              13
Materials and methods                                  13
1 Subjects                                           13
2 Experimental Equipment                             13
2.1 Hardware                                         14
2.2 Software                                         17
3 Experimental Procedures                            17
4 Parameters Calculation                             20
4.1 Marker set                                       20
4.2 Definition of the Coordinate System              21
4.3 Kinematical Model of the Upper Extremity	25
4.4 Kinetic Model of the Upper Extremity             28
5 Statistics                                         29
Chapter 3	                                              30
Results                                                30
1 Temporal-spatial characteristics in slow velocity    (1 m/s)                                                30
2 Kinematics of wheelchair propulsion in slow velocity (1 m/s)                                                32
2.1 Movement pattern                                 32
2.2 Range of motion and peak angle                   35
2.3 Propulsion pattern                               42
3 Kinetics of wheelchair propulsion in slow velocity    (1 m/s)                                                43
3.1 Hand-rim contact force                           43
3.2 Axial moment                                     47
3.3 Fraction of effective force and force ratio square	                                              47
3.4 Horizontal force and vertical force              49
3.5 Effective axial moment                           52
3.6 Vertical and horizontal force ratio square	53
3.7 Joint moment                                     54
4 Temporal-spatial characteristics in high velocity    (2 m/s)                                                61
5 Kinematics of wheelchair propulsion in high velocity (2 m/s)                                                62
5.1 Range of motion and peak angle in high velocity	62
5.2 Propulsion pattern                               67
6 Kinetics of wheelchair propulsion in high velocity   (2 m/s)                                                68
6.1 Hand-rim contact force in high velocity          68
6.2 Axial moment in high velocity                    69
6.3 Fraction of effective force and force ratio square in high velocity                                       70
6.4 Horizontal force and vertical force in high velocity                                               71
6.5 Effective axial moment in high velocity          72
6.6 Vertical and horizontal force ratio square in high velocity                                               73
6.7 Joint moment                                     73
Chapter 4                                              77
Discussion                                             77
1 Temporal-spatial characteristics in slow velocity    (1 m/s)                                                77
2 Kinematics of wheelchair propulsion in slow velocity (1 m/s)                                                78
2.1 Propulsion pattern                               78
2.2 Range of motion and peak angle                   79
3 Kinetics of wheelchair propulsion in slow velocity   (1 m/s)                                                84
3.1 Hand-rim contact force and axial moment          84
3.2 Fraction of effective force and force ratio square                                                 87
3.3 Horizontal force, vertical force, and effective axial moment                                           88
3.4 Vertical and horizontal force ratio square	91
3.5 Joint moment                                     92
4 The maximal coefficient of static friction and coefficient of kinetic friction in the three camber conditions                                             95
5 The different results between slow velocity (1 m/s) and high velocity (2 m/s)                              97
5.1 Difference in temporal-spatial characteristics	97
5.2 Difference in range of motion of each joint	98
5.3 Difference in peak angle of each joint           101
5.4 Difference in joint moment                       102
6 Limitations                                        105
Chapter 5                                              106
Conclusion                                             106
Reference                                              109
                                    

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校內：2008-08-27公開
校外：2009-08-27公開

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