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研究生：	林罡生 Lin, Gang-Sheng
論文名稱：	膝下殘肢與義肢承筒在不同行走速度下之介面應力分析 Interface Pressure Analysis between Below-Knee Stump and Prosthetic Socket at Various Walking Speeds
指導教授：	許來興 Hsu, Lai-Hsing
學位類別：	碩士 Master
系所名稱：	工學院 - 機械工程學系 Department of Mechanical Engineering
論文出版年：	2005
畢業學年度：	93
語文別：	中文
論文頁數：	123
中文關鍵詞：	膝下截肢患者、介面應力、殘肢受壓區與非受壓區、義肢承筒
外文關鍵詞：	BK amputee, Prosthetic socket, Interface stress, Pressure-tolerant/Pressure-relief area
相關次數：	點閱：203 下載：6
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　　對於膝下截肢的患者，義肢承筒為義肢中與人體殘肢接觸的部分，並且是負責義肢在人體下肢負荷時的穩定支撐及力量傳遞的介面。因此，殘肢與承筒間的介面壓力就顯得非常重要，若設計不良就會導致殘肢受力不均，亦造成穿戴的併發症。輕者暫時無法穿戴義肢及生活上不便，重者會因疼痛而產生代償動作而產生殘肢病變，最後甚至需要再截肢。

　　本研究建立殘肢的三維模型，並利用田口方法配合有限元素分析軟體，找出適當的承筒形狀。再經由患者試穿和義肢師的經驗與建議修改承筒形狀，以達成患者的需求。在實驗部分，使用兩套實驗設備，分別是壓力量測裝置與三維動作分析系統，並設計三種步頻（即85，95，110 步/分）以控制速度，觀察截肢患者殘肢上壓力變化情形。壓力值較大區域為腓骨末端、脛骨峭、髕骨韌帶、腓骨頭、脛骨節結、腓腸肌。另外，隨著行走速度增加，患者會將身體重量偏重於健肢側，減少截肢側所承受的重量，以加快行走速度，導致殘肢上大部分區域的最大壓力有下降的趨勢。這些資料將可提供臨床義肢師一個客觀的參考，同時可作為不同族群的膝下截肢病患在選配義肢時的參考。

　During designing a BK (below-knee) prosthetic socket, the interface pressures between stump and socket are the important considerations. At the stance phase of the gait cycle of an amputee wearing prosthesis, the prosthetic socket is expected to support and uniformly distribute the entire weight of the amputee. If the interface pressures at sensitive areas of the stump are too large, it will induce pain, discomfort and breakdown. The objective of this study is to measure and analyze the pressurees between stump and socket at different walking speeds.

　In the study, the computer-aided software was employed to construct the CAD models of the stump, bone, and socket. Taguchi method, finite element analysis and prosthetist experience were employed to obtain fit prosthetic socket. In the study, two experimental systems, i.e. Pliance socket sensor system of Novel GmbH and a gait analysis system of MotionAnalysis, are used to measure the interface pressures. A volunteer subject was asked to walk at three different speeds (i.e. 85 steps/min, 95 steps/min, 110 steps/min). The values of the maximum pressures and pressure-time integrals were larger at fibular end, tibial crest, patella tendon, fibular head, tibial tuberosity, calf muscle than other areas. The data also reveals a significant happening that is when walking speed increases the maximum pressures at most areas decrease. The results of this study may provide an objective information for prosthetist to design and manufacture prosthetic sockets.

摘要............................................................I
Abstract.......................................................II
致謝..........................................................III
目錄...........................................................IV
表目錄........................................................VII
圖目錄.......................................................VIII
第一章  緒論....................................................1
　1.1  前言.....................................................1
　1.2  文獻回顧.................................................3
　　1.2.1  截肢(Amputation)與義肢(Prosthesis)之簡介.............3
　　1.2.2  步態分析之簡介.......................................6
　　1.2.3  膝下截肢患者之承筒與殘肢間的介面應力分析............14
　1.3  研究目的................................................25
第二章  理論基礎...............................................27
　2.1  動作分析系統理論基礎....................................27
　　2.1.1  運動分析............................................27
　　2.1.2  動力分析............................................41
　2.2  介面應力量測分析........................................46
　2.3  有限元素分析流程簡介....................................48
第三章  實驗設計...............................................50
　3.1  有限元素法於殘肢與義肢承筒的介面應力模擬................50
　　3.1.1  殘肢模型修改需求....................................50
　　3.1.2  介面應力分析步驟....................................51
　3.2  田口方法於殘肢曲面編修..................................55
　　3.2.1  田口方法簡介........................................55
　　3.2.2  田口方法於殘肢曲面編修..............................57
　　3.2.3  義肢實作過程........................................62
　3.3  實驗設備與方法..........................................76
　　3.3.1  實驗假設............................................76
　　3.3.2  實驗對象與設備......................................76
　　3.3.3  實驗步驟............................................80
　　3.3.4  實驗數據處理方式....................................90
第四章  實驗結果與討論.........................................93
　4.1  運動學與動力學結果......................................93
　4.2  義肢承筒與殘肢介面應力結果.............................105
　4.3  實驗結果討論...........................................112
第五章  結論..................................................115
　自述........................................................123
                                    

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校內：立即公開
校外：2005-07-22公開

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