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研究生：	王立夫 Wang, Li-Fu
論文名稱：	在推輪椅時的肘關節肌肉力學分析 Elbow Muscle Force Analysis during 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：	2009
畢業學年度：	97
語文別：	英文
論文頁數：	59
中文關鍵詞：	肘關節、輪椅驅動、肌肉力學模型、肌肉力量、動作分析
外文關鍵詞：	Elbow, Wheelchair propulsion, Muscle mechanics model, Muscle force, Motion analysis
相關次數：	點閱：73 下載：4
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手推輪椅是下身麻痺患者日常生活中常使用的一種工具。輪椅使用者在獨自行動時高度依賴他們的上肢，導致上肢常常會有疼痛或損傷的現象發生。在過去的文獻中，大多數學者研究推輪椅時上肢各關節之接觸力和力矩，並集中注意在肩關節肌肉力量的分析。然而，肘關節肌肉力量則鮮為人知。因此本研究之目的為發展一套肘關節肌肉力學模型做為推輪椅時的肌肉力學分析。
本研究參與受試者為十一位無病痛之正常人。一台裝有訂製量測工具輪的市售輪椅以及擁有八台攝影機的動作擷取系統，用來收集運動學及動力學量測資料。本肘關節肌肉力學模型包含九條肌肉，結合逆向動力學演算法和牛頓法計算平衡方程式，並用最佳化求解，目標函數為使肌肉應力平方合最小。此外，兩種不同限制用於此研究，分別為：(1) 設定X、Y、Z三方向關節作用力矩為零 (2) 只設定Y軸向(屈曲/伸展)之肘關節作用力矩為零。
結果顯示在輪椅推進期中，肱肌、肱三頭肌外側頭和肱三頭肌內側頭有較大於其他肘關節肌肉之力量。在輪椅回復期中，肱肌有較大的力量。此外，肌肉力量的最大值在不同限制中有統計上的顯著差異。總結而言，本研究之模型可用於分析、並調整任意肌肉之參數以及限制來探討各肌肉之交互影響，做為臨床上的應用。

Handrim wheelchair is one of the most common instruments used by paraplegic patients for their daily mobility. The users of manual wheelchair rely heavily on their upper limbs for independent mobility so that upper extremity pain and impairment have often occurred. In the literature, most researchers have investigated joint contact forces and moments and focused on shoulder muscle forces during wheelchair propulsion. However, the forces of elbow muscle have not been known. The purpose of this study was to develop a muscle mechanics model of elbow joint for analyzing muscle forces during wheelchair propulsion.
Eleven normal subjects participated in this study. A Quikie GP ultralight wheelchair with custom instrumental wheels and an 8-camera motion capture system were used to collect the kinetic and kinematic measurements. An elbow muscle model including nine muscle lines was combined the inverse dynamic solution and Newtonian formulation to calculate the equilibrium equation. Muscle forces were solved by the optimization method and the objective function was to minimize the sum of squared muscle stress. Otherwise, two different equilibrium conditions were used in this study: (1) setting entire joint constraint moment to zero; (2) only setting joint constraint moment of y-axis (flexion/extension) to zero.
Results of this study showed that in propulsion phase, brachialis, triceps lateral head, and triceps medial head have larger predicted muscle forces than the other elbow muscles. In recovery phase, brachialis has larger predicted muscle force. Besides, the magnitudes of peak muscle force have statistically significant differences between two conditions. To conclude, the present model can be used to analyze and adjusted the parameter of each muscle or constraint to investigate the interactive of every muscle for clinical applications.

Abstract..................................................I
中文摘要.................................................II
致謝....................................................III
Contents.................................................IV
List of Figures.........................................VII
List of Tables...........................................IX
Chapter 1 Introduction....................................1
1.1 Background............................................1
1.2 Muscle Force Analysis during Wheelchair Propulsion....2
1.3 Musculoskeletal Model.................................3
1.4 Musculoskeletal Model of Elbow........................5
1.5 Summary and Purpose...................................6
Chapter 2 Materials and Methods...........................9
2.1 Experimental model validation.........................9
2.1.1 Participants........................................9
2.1.2 Experimental Equipments............................10
2.2 Development of Elbow Joint Model.....................10
2.2.1 Elbow Anatomy......................................10
2.2.2 Marker Attachments and Definition of Segmental Local Coordinate System........................................11
2.2.3 Muscular Model of the Elbow Joint..................12
2.3 Muscular Force Analysis in Elbow Model...............15
2.3.1 Kinematic Analysis.................................15
2.3.2 Kinetic Analysis...................................15
2.3.3 Muscle Force Analysis..............................16
2.4 Statistical Analysis.................................19
Chapter 3 Results........................................23
3.1 Kinematic and Kinetic Analysis in Wheelchair Propulsion...............................................23
3.2 Muscle Activation in Wheelchair Propulsion...............................................24
3.3 Muscle Force Analysis in Different Equilibrium Conditions...............................................26
3.4 Shoulder Muscle Force Analysis in Different Models...26
Chapter 4 Discussion.....................................38
Chapter 5 Conclusion.....................................45
5.1 Summary..............................................45
5.2 Limitations of the Present Study.....................45
5.3 Future Research......................................46
Reference................................................47
Appendix A Definitions of local coordinate systems.......51
Appendix B...............................................53
B.1 Regression Method of Scapula Motion..................53
B.2 Y-X-Z Euler angle....................................53
B.3 Euler parameters.....................................54
Appendix C...............................................56
C.1 Muscle path hits a sphere obstacle...................56
C.2 Muscle path hits a cylinder obstacle.................57
                                    

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校內：2011-07-17公開
校外：2011-07-17公開

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