大部分的中風患者在發病後會遭受到神經生理方面的損傷，因而造成身體半側癱瘓或肌肉痙攣，這些症狀會導致相當多日常生活上的不方便。多數的中風偏癱患者選擇以傳統手動輪椅為其主要的移行輔具。然而，傳統手動輪椅主要設計對象為雙側上肢健全的患者，對於偏癱患者而言，操作傳統手動輪椅不但會因為不對稱的施力方式造成輪椅偏向，耗費更多力氣，因而妨礙他們在日常生活的獨立性！
　　本研究經由對10位針中風偏癱患者進行觀察研究，測試者觀察患者操作傳統手動輪椅的過程及分析其操作特性，並依此獲得他們對移行輔具的需求。由中風偏癱患者的需求，本研究開發出一款功能性電刺激輔助下肢驅動輪椅。患者可利用健側腳及功能性電刺激輔助患側腳來驅動此款輪椅。當無功能性電刺激輔助時，此款輪椅便成為單純下肢驅動輪椅。
　　接著，本研究利用三個實地測試（操作輪椅在沿橢圓軌道行進200公尺）來評估功能性電刺激輔助下肢驅動輪椅，下肢驅動輪椅及傳統手動輪椅的操控性，耗能成本及對下肢肌肉張力的影響。在操控性測試方面，20位中風偏癱患者參與評估輪椅的測試完成時間、偏軌次數及偏移百分比。結果顯示相較於傳統手動輪椅，功能性電刺激輔助下肢驅動輪椅耗費較少40％的完成時間、減少23％的偏移次數與減少36％偏移百分比。
　　在耗能成本測試方面，16位中風偏癱患者參與評估輪椅的心肺反應，包含心跳、耗氧量、二氧化碳生成量、分鐘呼吸量及、呼吸交換率；以及耗能成本包含生理耗能指數及耗氧指數。結果顯示下肢驅動輪椅（有／無功能性電刺激輔助）比傳統手動輪椅有顯著高的心肺反應；此外，兩款下肢驅動輪椅比傳統手動輪椅有顯著低的生理耗能指數與耗氧指數。然而，有／無功能性電刺激輔助在心肺反應及耗能成本方面並無顯著差異。
　　在下肢肌肉張力測試方面，17位中風偏癱患者參與評估操作輪椅前後對肌肉張力的影響，包含踝關節的埃許瓦斯量表修改版及H反射之H/M比率；及膝關節鐘擺運動的放鬆指數。另外，本研究利用埃許瓦斯量表修改版、H/M比率及放鬆指數在操作輪椅前後前後的改變量來比較下肢驅動輪椅有／無功能性電刺激輔助時的差異性。結果顯示操作兩款下肢驅動輪椅後，踝關節的埃許瓦斯量表修改版及H/M比率呈顯著下降；放鬆指數則顯著上升。但比較肌肉張力測試參數改變量發現，對肌肉張力高的患者，功能性電刺激輔助下肢驅動輪椅提供更多降低張力的效果。
　　對中風偏癱患者而言，操作功能性電刺激輔助下肢驅動輪椅及下肢驅動輪椅能提供較傳統手動輪椅更佳的操控性，較高的心肺反應及較低的耗能成本。在使用下肢驅動輪椅後，可減少患者的肌肉張力。下肢驅動輪椅加上功能性電刺激並無法改善其操控性或降低耗能成本，但對肌肉張力高的患者，有顯著降低張力的效果。

　Most stroke survivors suffered from residual neurological deficits, and remains awkward motions such as hemiplegia and hypertonia after recovery from disease. Manual wheelchair is the most popular tools stroke survivors choose as their mobility device. A manual wheelchair was designed for patients with both healthy upper limbs; however, its asymmetrical propel pattern would force the wheelchair deviate toward the affected side and causing strait for stroke patients. Existent motor function impairments not only reduce exercise ability, consume much more energy, but also constipate the independent of daily life.
　10 stroke patients with hemiplegia were recruited to participate in observation survey. The tester observed the patients operating manual wheelchairs and analyzed their propulsion characteristics to obtain their requirements of mobility devices. From the hemiplegic patients’ requirements, we developed a functional electrical stimulation-assisted leg-cycling wheelchair (FES-LW). Subjects can propel the FES-LW by unaffected leg and affected leg with the assistance of FES. Subjects can also propel the LW without FES.
　Three field tests (i.e. propels wheelchair along an oval pathway for 200 m) were conducted to evaluate the controllability, energy cost and effects of leg muscle tone of the FES-LW, LW comparing to the manual wheelchair (MW). In the controllability test, 20 stroke patients were recruited to evaluate the finish time, deviation frequencies, and deviation percentage of each wheelchair. The results showed subjects can propel the FES-LW and LW with 40% less finish time; 23% lower deviation frequencies and 36% lower deviation percentage than the MW.
　In the energy cost evaluation, 16 stroke patients were recruited to evaluate the cardiopulmonary responses including, heart rate (HR), oxygen consumption (VO2), carbon dioxide production (VCO2), minute ventilation (VE,), respiratory exchange ratio (RER); and energy cost including physiological cost index (PCI) and oxygen index (OI), of each wheelchair. The results showed the HR, VO2, VCO2, VE and RER were significantly higher in the FES-LW and LW than the MW. The PCI and OI recorded from applying FES-LW and LW were significantly lower than those from MW. Yet; no dramatic difference was found in cardiopulmonary responses and energy cost between FES-LW and LW.
　In the leg muscle tone evaluation, 17 stroke patients were recruited to evaluate the modified Ashworth Scale (MAS), H/M ratio and relaxation index (RI) of each wheelchair between pre- and post test. Changes of MAS (MASc), changes of H/M (H/Mc) and changes of RI (RIc) were then compared between FES-LW and LW. The results showed MAS and H/M ratio decreased a lot and RI increased huge immediately after the FES-LW and LW usage. For subjects with higher muscle tone, significant lower of MASc, H/Mc and higher of RIc were found by using FES-LW compared to the LW.
　For stroke patients, FES-LW and LW showed better controllability than MW. In addition, higher cardiopulmonary responses and lower energy cost was found in the LWs with or without FES compared to the MW. The situation of leg spasticity is reduced after propulsion of the FES-LW and the LW. The application of FES doesn’t help improve controllability and reducing energy cost but reduce subjects’ spasticity with higher muscle tone.

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