簡易檢索 / 詳目顯示

回結果列表
研究生： 林秀青
Lin, Hsiu-Ching
論文名稱： 發展與評估氣囊監測系統應用於自發性脊柱側彎背架之研究
Development and Evaluation of the Air Bag Monitoring System used in the Braces for Idiopathic Scoliosis
指導教授： 張志涵
Chang, Chih-Han
林瑞模
Lin, Ruey- Mo
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： 2003
畢業學年度： 91
語文別： 英文
論文頁數： 75
中文關鍵詞： 青少年自發性脊柱側彎 、背架 (裝具) 、氣囊壓力監測系統 、介面壓力 、氣囊介面支撐
外文關鍵詞： interface pressure, air bag interface, brace (orthosis), adolescent idiopathic scoliosis, the air bag pressure monitoring system
相關次數： 點閱：147  下載：7 
分享至:
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報

    • 當脊椎被檢查出有中度不正常的脊椎曲線時（Cobb angle介於25度到40度），醫療上常常使用脊椎背架提供機械性的脊椎矯正及支持。臨床上脊椎背架已經被驗證為有效的改變青少年自發性脊柱側彎，其矯正範圍介於72 %到89 %之間。從生物力學的觀點，背架所提供的矯正力應該考慮病患需長時間穿戴、動態使用情形及維持矯正力在有效的範圍內，以促進裝具矯正的功能。傳統的背架內襯只能提供靜態的矯正力，因此本研究的目標為前瞻性的探討可調式的氣囊提供脊柱側彎擬動態(quasi-dynamic)矯正力之療效。為了量化氣囊提供的矯正壓力以及背架與身體的介面壓力，因此本研究發展出由氣囊提供矯正力的壓力監測系統，同時也評估這套系統的可行性。
    為了發展出氣囊壓力監測系統，我們評估了四種不同的感應器（BP-2KRS pressure sensor, FSR, PS-02與 PS-01），其中包含力量與壓力感應器，同時也設計感應器所對應的資料擷取系統，用來檢驗攜帶型監測系統架構的可行性。最後所發展出的氣囊壓力監測系統，更進一步的被應用於一位正常受試者與兩位青少年自發性脊柱側彎的患者身上，用來評估該系統在受試者做日常生活不同動作時偵測背架與身體介面壓力（力量）改變的能力。
    從感應器的評估結果得知FSR與PS-02的量測解析度不足，無法用來感應壓力。由於BP-2KRS壓力感應器較重而且價位較高，所以採用PS-01來發展氣囊壓力監測系統。由後續的研究結果指出BP-2KRS壓力感應器量測到的氣囊介面壓力與PS-01薄膜式（力量）感應器量測到的氣囊介面力量，對所有的受試者而言兩個感應器之間有著高度的相關性（相關係數=0.985~0.734, p<0.05）。因此，本研究所設計的攜帶式氣囊壓力監測系統可用於臨床上來量測背架與身體界面壓力(力量)變化的能力。至於不同姿勢的效用，軀幹前彎對矯正力產生的影響比軀幹後彎產生的影響大。造成的原因可能是關節活動度以及背架與軀幹間產生的縫隙所影響。同時本研究也觀察到當受試者朝氣囊同側做軀幹側彎時，並不會因為軀幹過度擠壓氣囊因而增加其界面壓力。
    由這些研究發現指出姿勢的確會影響背架的矯正力大小，因此設計壓力監測系統來即時量化矯正力的改變情形是必要的。本研究的目標是在背架內部安置發展出氣囊壓力監測系統進而評估其可行性，而未來的研究目標則是精確的改良壓力監測系統使能適用於臨床上背架的使用。同時未來也應探討矯正脊椎側彎所使用的氣囊壓力監測系統與整合電刺激的研究。

    Clinically, an orthosis may be used to support and correct the spine mechanically when moderate abnormal curvature of the spine is detected (Cobb angle: 25° ~ 40°). The conventional spinal orthoses have been confirmed to be effective in altering the natural history of adolescent idiopathic scoliosis (AIS) and their effectiveness varies from 72% to 89% of the cases being treated. In view of the biomechanics, to improve the correcting ability, the correction force provided by the orthosis should be maintained within the effective range considering its dynamic use condition during the long period of wearing. The conventional orthotic pad only can provide static and constant corrective force. The aim of this study was to investigate the treatment effect prospectively by applying a quasi-dynamic correction force on the scoliosis with the adjustable air bag. To quantify the correction pressure applied by the air bag and the interface pressure between the orthosis and body, a pressure monitoring system to detect the correction fore supplied by the air bag was developed and the feasibility was also evaluated.
    To develop this air bag pressure monitoring system, four sensors (BP-2KRS pressure sensor, FSR, PS-02 and PS-01) including force and pressure sensors, were evaluated and corresponding data loggers were established to examine the possibility of setting up a portable system. The developed pressure monitoring system was further evaluated on one normal subject and two AIS patients to assess its ability in detecting the pressure (force) changes during different postures of daily activities.
    The evaluation results indicated that the resolution of FSR and PS-02 sensors were too low to sense the pressure. The PS-01 force sensor was determined for the air bag pressure monitoring system, because the BP-2KRS sensor is too heavy and expensive. The follow-up results indicated that high correlation existed between the interface pressure of air bag measured by the BP-2KRS pressure sensor and the interface force of air bag measured by the PS-01 for all subjects (correlation coefficient = 0.985~0.734, p<0.05). Therefore, the design of a portable air bag monitoring system has the capability to measure the interface pressure change between the orthosis and body for clinical use. As for the postural effect, trunk flexion had larger influence on the correction force than trunk extension. The reasons might be the range of motion and a gap developed between the orthosis and the trunk. In the mean while, when the subject performed trunk side bending toward the ipsilateral side of the air bag did not increase the correction force by over-pressed on it.
    The research findings indicated that postures indeed affected the corrective force of the orthosis; hence, a pressure monitoring system to quantify the alteration of correction force in real-time is necessary. The objectives of this study were to develop an air bag pressure monitoring system installed within the spine orthosis system and to evaluate its feasibility. In the future, further refinement of this system is required for clinical use. The investigation of using air bag pressure monitoring system integrated with electrical stimulation for spinal curve correction is suggested for future work.

    Table of Contents ABSTRACT……………...…………………..…………….….I ACKNOWLEDGMENT……………………………………..V CONTENT…………………………………………….……..VI LIST OF FIGURES………………………………..……...…IX LIST OF TABLES……………………………………….….XII 1. INTRODUCTION 1.1 Scoliosis…………………………………………………………1 1.2 Radiography Evaluation…………………………………………4 1.2.1 Cobb Angle for Curve Measurement………………………4 1.2.2 Risser Sign for Skeletal Maturity…………………………..5 1.3 Spinal Orthoses…………………………………………………..7 1.3.1 Boston Thoraco-Lumbo-Sacral Orthosis (TLSO)………….8 1.3.2 Milwaukee Cervico-Thoraco-Lumbo-Sacral Orthosis……..9 1.3.3 Osaka Medical College Brace (OMC Brace)……………...10 1.4 Motivation and Purposes………………………………………..11 2. MATERIALS AND METHODS 2.1 Sensor Selection………………………………………………... 14 2.1.1 Pressure Sensor…………………………………………….14 2.1.2 Force Sensing Resistors (FSR)……………………………..17 2.1.3 FlexiForce Pressure Sensor………………………………...21 2.1.4 PS-02 of FlexiForce Pressure Sensor………………………21 2.1.5 PS-01 of FlexiForce Pressure Sensor………………………24 2.1.6 Instrumentation Design--the Air Bag Monitoring Pressure System……………………………………………………..26 2.2 In vivo Evaluation……………………………………………….31 2.2.1 Evaluation of the Air Bag Pressure Monitoring System and Pressure Change with Various Postures………………….. 31 2.3 Data Analysis…………………………..………..……………… 36 3. RESULTS 3.1 Functional Performance of Pressure and Force Sensors………...38 3.1.1 BP-2KRS Pressure Sensor…………………………………38 3.1.2 FSR ………………………………………………………...39 3.1.3 PS-02 of FlexiForce Pressure Sensor………………………41 3.1.4 PS-01 of FlexiForce Pressure Sensor………………………43 3.2 The Air Bag Monitoring System--in vivo Evaluation……………44 3.2.1 Normal Subject……………………………………………..44 3.2.2 AIS Subjects………………………………………………..47 3.3 Air Bag Location and Postural Effect on Pressure Changes…….49 3.3.1 Statistical Results…………………………………………..49 4. DISCUSSION 4.1 Sensor Selection--in vitro………………………………………..53 4.1.1 Feasibility of the BP-2KRS BP-2KRS Pressure Sensor…...53 4.1.2 Feasibility of the FSR………………………………………54 4.1.3 Feasibility of PS-02 of the FlexiForce Pressure Sensor…....54 4.1.4 Feasibility of PS-01 of the FlexiForce Pressure Sensor…....54 4.2 The Air Bag Pressure Monitoring System……………………….55 4.3 Air Bag and Postural Effect Location on Pressure Changes…….56 4.3.1 Air Bag Location on Pressure Changes…………………….56 4.3.2 Postural Effect on Pressure Changes……………………….58 4.3.3 The Interaction between the Air Bag Locations and postures on Pressure Changes………………………………………58 4.4 Limitations………………….……………………………………60 5. CONCLUSION AND FUTURE WORK…………...……61 REFERENCES………………………………………………63 APPENDIX…………………………………………….……..67 Appendix 1: Properties of FlexiForce Pressure Sensor……….….….67 Appendix 2: Raw data of the BP-2KRS……………….…….….…...68 Appendix 3:The calibration of FSR raw data from 0 kg to 2 kg with an increasing 100-gram interval……………….………….69 Appendix 4: The calibration of PS-02 raw data from 0 kg to 6 kg with an increasing 1-kg interval……………….....................70 Appendix 5: The calibration of PS-01 raw data from 0 g to 200 g with an increasing 50-gram interval.......................................71 Appendix 6: Raw data for different air bag locations of middle and posterior axillary lines and different postures on the normal subject……………………………………….…72 Appendix 7: Raw data for the air bag locations at left and right corresponding apex prominent areas and different postures on the two AIS subjects……………………....82

    1. Bowker, P., Condie, D. N., Bader, D. L. and Pratt, D. J. (1993). “The biomechanics of orthoses.” Biomechanics basis of orthotic management: p27-37. Butterworth-Heinemann Ltd.

    2. Bowker, P., Condie, D. N., Bader, D. L. and Pratt, D. J. (1993). “The patient-orthosis interface.” Biomechanics basis of orthotic management: p58-68. Butterworth-Heinemann Ltd.

    3. Bowker, P., Condie, D. N., Bader, D. L. and Pratt, D. J. (1993). “Spinal orthoses.” Biomechanics basis of orthotic management: p234-252. Butterworth-Heinemann Ltd.

    4. Bunch, W. H. and Patwardhan, A. G. (1989). “Thinking about scoliosis.” Scoliosis: making clinical decisions.p3-14. Baltimore, The C. V. Mosby Company.

    5. Bunch, W. H. and Patwardhan, A. G. (1989). “Models and Patterns.” Scoliosis: making clinical decisions.p15-41. Baltimore, The C. V. Mosby Company.

    6. Bunch, W. H. and Patwardhan, A. G. (1989). “Biomechanics of orthoses.” Scoliosis: making clinical decisions.p204-215. Baltimore, The C. V. Mosby Company.

    7. Bunch, W. H. and Patwardhan, A. G. (1989). “Fitting and fabrication of orthoses.” Scoliosis: making clinical decisions.p216-236. Baltimore, The C. V. Mosby Company.

    8. Cote, B., Dansereau, J., Labelle, H. and Reinecke, S. (1992). “A method for the measurement of the Boston brace biomechanical action on scolioitc deformities.” In: Proceedings International Symposium on 3-D Scoliotic Deformities, Montreal, 27-30 June, p81-88.

    9. Dansereau, J., Labelle, H., Bellefleur, C. and Poitras, B. (1992). “Boston brace treatment: 3-D immediate effect on the thoracic scolioitc spine.” In: Proceedings International Symposium on 3-D Scoliotic Deformities, Montreal, 27-30 June, p312-316.

    10. Eilert RE (2001). Scoliosis. In WW Hay, Jr. et al., eds., Current Pediatric Diagnosis and Treatment, 15th ed., pp. 704–705. New York: Lange Medical Books/McGraw-Hill.

    11. Fidler, M. W. and Plasmans, M. T. (1983). “The effect of four types of support on the segmental mobility of the lumbosacral spine.” Journal of Bone and Joint Surgery 65: 943-947.

    12. Greene WB, et al. (2001). Scoliosis. In Essentials of Musculoskeletal Care, 2nd ed., pp. 696–699. Rosemont, IL: American Academy of Orthopaedic Surgeons and American Academy of Pediatrics.

    13. Hu SS, et al. (2000). Scoliosis. In HB Skinner, ed., Current Diagnosis and Treatment in Orthopedics, 2nd ed., pp. 176–216. New York: Lange Medical Books/McGraw-Hill.

    14. Jiang, H., Raso, V. J., Hill, D. L., Durdle, N. G. and Moreau, M. J. (1992). “Interface pressures in the Boston brace treatment for scoliosis.” In: Proceedings International Symposium on 3-D Scoliotic Deformities, Montreal, 27-30 June, p395-399.

    15. Kehl, D. K. and Morrissy, R. T. (1988). “Brace treatment in adolescent idiopathic scoliosis: an update on concept and technique.” Clinical Orthopaedics and Related Research 229: 34-43.

    16. Lin HW, Chang GL, Lo CW, Lin RM: Osaka Medical College brace in scolioitc adolescent. J Orthop Surg ROC 14: 49-54, 1997.

    17. Lou, E., Raso, J. V., Hill, D. L., Durdle, N. G., Mahood, J. K. and Moreau, M. J. (2002). “The daily force pattern of spinal orthoses in subjects with adolescent idiopathic scoliosis.” Prosthetics and Orthotics International 26: 58-63.

    18. Magee, D. J. (2002). “Lumbar spine.” Orthopedic Physical Assessment 4th Edition. p467-566. Saunders.

    19. Nachemson, A. L. and Peterson, L. (1995). “Effectiveness of treatment with a brace in girls who had adolescent idiopathic scoliosis: a prospective controlled study based on data from the brace study of the scoliosis research society.” Journal of Bone and Joint Surgery 77A: 815-821.

    20. Wong, M. S. and Evans, J. H. (1998). “Biomechanical evaluation of the Milwaukee brace.” Prosthetics and Orthotics International 22: 54-67.

    21. Wong, M. S., Mak, A. F. T., Luk, K. D. K. and Brown, B. (2001). “Effectiveness of audio-biofeedback in postural training for adolescent idiopathic scoliosis patients.” Prosthetics and Orthotics International 25: 60-70.

    22. Wong, M. S., Mak, A. F. T., Luk, K. D. K. and Brown, B. (2000). “Effectiveness and biomechanics of spinal orthoses in the treatment of adolescent idiopathic scoliosis (AIS).” Prosthetics and Orthotics International 24: 148-162.

    23. Salter RB (1998). Scoliosis. In Textbook of Disorders and Injuries of the Musculoskeletal System, 3rd ed., pp. 365–372. Baltimore: Williams and Wilkins.

    24. Smet, A. A. D. (1985). Radiology of spinal curvature. The C. V. Mosby Company.

    25. Weinstein SL (1999). Natural history. Spine, 24(24): 2592–2600.

    26. A to Z 醫學圖書館 - 國際厚生健康園區 - 24Drs.com: http://www.24drs.com/Health_Guide/

    27. Scoliosis Research Society: http://www.srs.org/index.htm

    下載圖示 校內：立即公開
    校外：2003-08-21公開
    QR CODE