隨著脊椎受傷的病患及老年化的人口增加，需要藉由使用智慧型行動載具來增加其活動功能的需求日與俱增。載具的發明可幫助行動不便或是長期臥床之下肢癱瘓者，增加使用者的獨立生活，亦能減輕照顧者的生理及心理負擔；然而智慧型載具的使用上，從坐姿轉為站姿的過程中，必需考慮病患本身的身體狀況，才能夠避免使用者因姿勢改變而引起的傷害。有鑑於此，本研究希望建立一套生理參數監測系統，搭配簡易操作的使用者介面，來監測智慧型載具使用者生理狀況；其中監測的生理參數包含心電圖、呼吸率、血壓、血氧濃度及體溫。利用ZigBee無線傳輸技術所開發的監控平台，可以進行長時間的即時監測藉此實現遠端照護的目的。系統架構可分為兩個部份：第一部份為生理訊號之擷取，利用微控制器DISPIC33F單晶片做訊號處理，並透過ZigBee將數值變化傳送到電腦端的監控平台上。第二部份為監控平台的訊號顯示、即時分析及儲存功能，並在生理訊號異常時即時回傳警示訊號，例如使用者從站姿轉為坐姿時，當偵測到異常生理訊號，系統會與控制載具的FPGA溝通，讓載具停止或回復坐姿避免因姿勢轉變的所造成的傷害，例如姿勢性的低血壓。實驗結果顯示，本系統可以成功量測正常人與下肢癱瘓病患的生理參數，且經由單晶片實現即時分析功能，藉此實施相關的患者保護措施。本研究也已經著手量測病患與正常人的生理參數並予以分析，未來除了量測更多病患的資訊之餘，並可使用於如病史追蹤、復健療程及更多的應用。

With growing aging population and patients with spinal cord injury, the demand of mobility through the use of intelligent vehicle increases. The invention of smart carrier could help those who are the bed-ridden paralysis of lower limbs, reduce the caregiver burden physically and psychologically. However, when patients apply the smart carrier with standing function, the thoughtfulness must be given to avoid possible injury caused by posture changing between standing and sitting. The purpose of this study is to develop a physiological status monitoring system on smart carrier. Physiological parameters included ECG (Electrocardiogram), respiratory rate, temperature, SpO2 (Oxyhemoglobin saturation) and BP (blood pressure). By integrating ZigBee technology into computerized monitoring platform, real-time remote healthcare and early warning could be fulfilled. The system architecture could be divided into two parts: one is the acquisition of physiological signals and another one is signal processing. Signals would be acquired and pre-processed by micro-controller (DSPIC33F), then transmitted to the monitoring system via ZigBee. The monitoring system can analyze, display and save those acquired signals. Additionally, when any unusual physiological signals are detected, the system would send a warning signal to user. For example, when detecting abnormal physiological signal in using standing function, the system would communicated FPGA (Field Programmable Gate Array) which mounted on smart carrier and stop or transfer its posture back to sitting to prevent some hurt like orthostatic hypotension and so on. Finally, there are still many further applications as disease history tracing or rehabilitation treatment.

[1] “http://medicinembbs.blogspot.com/2011/04/anatomy-of-spinal-cord.html”
[2] A. Curt, B. Nitsche, B. Rodic, B. Schurch, V. Dietz, “Assessment of autonomic dysreflexia in patients with spinal cord injury,” Neurol Neurosurg Psychiatry, Vol. 62, No. 5, pp. 473–477, 1997.
[3]B. Nitsche, H. Perschak, A. Curt, V. Dietz, “Loss of circadian blood pressure variability in complete tetraplegia,” Vol. 10, No. 5, pp. 311-317, 1996.
[4] S, Cohenis, “Autonomic hyperreflexia with spinal cord injury,” Topics in Spinal Cord Injury, Vol. 3, No. 1, pp. 71-81, 1997.
[5] R, Johnson, A, Gerhart, J, McCray, J, Menconi, G, Whiteneck, “Secondary conditions following spinal cord injury in a population-based sample,” Spinal Cord, Vol. 35, pp. 641-646, 1998.
[6] J, Vapnek, “Autonomic dysreflexia,” Topics in Spinal Cord Injury Rehabilitation, Vol. 2, No. 4, pp. 54-69, 1997.
[7]L. Weaver, A. Cassam, A. Krassioukova, I. Llewellyn-Smith, “Changes in immunoreactivity for growth associated protein-43 suggest reorganization of synapses on spinal sympathetic neurons after cord transection,” Neuroscience, Vol. 81, No. 2, pp. 535-551, 1997.
[8] R. Braddom, J. Rocco, “Autonomic dysreflexia. A survey of current treatment.,” American Journal of Physical Medicine and Rehabilitation, Vol. 70, No. 5, pp. 234-241, 1991.
[9] R. Braddom, J. Rocco, “Autonomic dysreflexia. A survey of current treatment.,” American Journal of Physical Medicine and Rehabilitation, Vol. 70, No. 5, pp. 234-241, 1991.
[10] W. Phillips, B, Kiratli, M, Sarkarati, G, Weraarchakul, J. Myers, B. Franklin, I. Parkash, V. Froelicher, “Effect of spinal cord injury on the heart and cardiovascular fitness,” Current Problems in Cardiology, Vol. 23, No. 11, pp. 649-716, 1998.
[11] C. McCagg, “Postoperative management and acute rehabilitation of patients with spinal cord injuries,” Orthopedic Clinics of North America, Vol. 17, No. 1, pp. 171-182, 1986.
[12] T. McGuire, V. Kumar, “Autonomic dysreflexia in the spinal cord-injured. What the physician should know about this medical emergency,” Postgraduate Medicine, Vol. 80, No. 2, pp. 81-89, 1986.
[13] F. Naso, “Cardiovascular problems in patients with spinal cord injury,” Physical Medicine and Rehabilitation Clinics in North America, Vol. 3, No. 4, pp. 741-749, 1992.
[14] K. Andrei, C. Victoria, “The clinical problems in cardiovascular control following spinal cord injury: an overview,” Autonomic Dysfunction after Spinal Cord Injury, Vol. 152, pp. 223-229, 2006.
[15] A. Burt, “Philadelphia: W.B. Saunders,” Textbook of Neuroanatomy, 1993.
[16] A. Nobunaga, “Orthostatic hypotension in spinal cord injury,” Topics in Spinal Cord Injury Rehabilitation, Vol. 4, No. 1, pp. 73-80, 1998.
[17] K. Lehmann, J. Lane, J. Piepmeier M, W. Batsford, “Cardiovascular abnormalities accompanying acute spinal cord injury in humans: incidence, time course and severity,” Journal of the American College of Cardiology, Vol. 10, No. 1, pp. 46-52, 1987.
[18] G. Davis, “Exercise capacity of individuals with paraplegia,” Medical Science in Sports and Exercise, Vol. 25, No. 4, pp. 423-432, 1993.
[19] S. Figoni, “Exercise responses and quadriplegia,” Medical Science in Sports and Exercise, Vol. 25, No. 4, pp. 433-441, 1993.
[20] M. Hopman, B. Oeseburg, R. Binkhorst, “Cardiovascular responses in paraplegic subjects during arm exercise,” European Journal of Applied Physiology, Vol. 65, No. 1, pp. 73-78, 1992.
[21] M. King, S. Lichtman, J. Pellicone, R. Close, P. Lisanti, “Exertional hypotension in spinal cord injury,” Chest, Vol. 106, No. 4, pp. 1166-1171, 1994.
[22] M. Nash, “Exercise reconditioning of the heart and peripheral circulation after spinal cord injury,” Topics in Spinal Cord Injury Rehabilitation, Vol. 3, pp. 1-15, 1998.
[23] A. Berić, M. Dimitrijević, J. Light, “A clinical syndrome of rostral and caudal spinal injury: neurological, neurophysiological and urodynamic evidence for occult sacral lesion,” Journal of Neurology, Neurosurgery, and Psychiatry, Vol. 50, pp. 600-606, 1987.
[24] J. Myers, M. Lee, J. Kiratli, “Cardiovascular disease in spinal cord injury: an overview of prevalence, risk, evaluation, and management,” American Journal of Physical Medicine and Rehabilitation, Vol. 86, No. 2, pp. 142-152, 2007.
[25] M. DeVivo, K. Black, S. Stover, “Causes of death during the first 12 years after spinal cord injury,” Achieves of Physical Medicine and Rehabilitation, Vol. 74, No. 3, pp. 248-254, 1993.
[26] M. DeVivo, P. Kartus, S. Stover, R. Rutt, P.Fine, “Cause of death for patients with spinal cord injuries,” Achieves of Physical Medicine and Rehabilitation, Vol. 149, No. 8, pp. 1761-1766, 1989.
[27] W. Amy, J. Robert, Y. Gary, T. Rose, “Cough in spinal cord injured patients: the relationship between motor level and peak expiratory flow,” Spinal Cord, Vol. 35, No. 5, pp. 299-302, 1989.
[28] H. Alamaki, R. Sliz, H. Sorvoja, E. Alasaarela, “Measurement of ECG, Respiratory rate, tilt and temperature of a patient and wireless ZigBee data transmission,” The 2nd International Symposium on Medical Information and Communication Technology, 2007.
[29] D. Han, J. Kim, J. Hong, E. Cha, T.Lee, “Performance evaluation of biosignal measurement at the wheelchair system,” 30th Annual International IEEE Conference of the Engineering in Medicine and Biology Society, 2008., pp. 1451-1454, 2008.
[30] O. Postolache, S. Girao, J. Mendes, E. Pinheiro, G. Postolache, "Physiological Parameters Measurement Based on Wheelchair Embedded Sensors and Advanced Signal Processing," IEEE Transactions on Instrumentation and Measurement, , Vol. 59, No. 10, pp. 2564-2574, 2010.
[31] N. Alan, L. Ramer, A. Jessica, Inskip, G. Saeidi, M. Ramer, I. Laher, A. Krassioukov, “Recurrent autonomic dysreflexia exacerbates vascular dysfunction after spinal cord injury,” The Spine Journal, Vol. 10, pp. 1108-1117, 2010.
[32] J. Anmin, Y. Bin, G. Morren, H. Duric, R.M. Aarts, "Performance evaluation of a tri-axial accelerometry-based respiration monitoring for ambient assisted living," 31st Annual International Conference of the IEEE EMBS Minneapolis, Minnesota, USA, September 2-6, , pp. 5677-5680. 2009
[33]”http://www.itwm.fraunhofer.de/en/departments/system-analysis-prognosis-and-contro
l/decision-support-in-the-medical-sciences-and-in-technology/detection-of-atrial-fibrillation-based-on-the-heart-rhythm-in-rest.html”
[34] J. Webster, J. Clark, "Medical instrumentation: application and design," 4 ed: John Wiley, Inc. , pp. 317-328, 2010.
[35] J. Moraes, M. Cerulli, P. Ng, "A strategy for determination of systolic, mean and diastolic blood pressures from oscillometric pulse profiles," Computers in Cardiology proceeding, pp. 211-214, 2000.