腦性麻痺患者的障礙多樣而複雜，其中肢體動作功能障礙是主要的問題，而肌肉張力異常為肢體障礙癥結所在。一旦肌肉張力問題獲得改善，靜態姿勢的維持、動作功能性的表現、獨立之日常生活的表現都可獲得實質上的進步。學者Fay、Knott、Voss、Bobath以及Ayres使用震動、旋轉的運動治療方式作為實驗的療程，結果顯示此種治療的方式有降低高肌肉張力現象、正常化身體坐姿擺位以及增加動態功能性動作穩定度的效果。但此種身體刺激缺乏量化的輸入，以致於其沒有經過系統性的評估而不能達到最大的療效。本研究目的為設計可在三維(前後、上下與左右)提供振幅、頻率皆為可調震動方式的平臺，以提供腦性麻痺兒童量化的運動刺激，並建立鐘擺測試(Pendulum Test)系統以量化並評估運動刺激對於腦性麻痺兒童肌肉張力的影響。

震動平臺採用機電系統設計架構，其包含X與Z軸震動系統、訊號傳輸介面系統與GUI人機操作介面系統。X與Z軸震動系統採用相同的設計架構，可提供擬正弦波的震動波形。其中單軸的震動系統由連桿機構組(linkage)、滾珠螺桿(ball screw)、傳動皮帶、圓盤、交流馬達(A.C. motor) 與變頻器(inverter)、伺服馬達(servo motor) 與伺服器(A.C. servo)、編碼器(encoder)所組成。訊號傳輸介面主體為ADLINK 8164運動卡與ADLINK 9112卡。人機操作介面系統採用工業電腦以達穩定的操作環境，作業系統則採用Windows 2000，GUI 操作介面為以Borland C++ Builder 5.0所撰寫。平臺的校正包含9112卡迴授波形訊號、波形震幅與波形頻率。鐘擺測試與肌電量測評估系統用以評估震動治療的效果，其由可調式座椅、膝關節角度量測系統、肌電訊號量測系統、訊號處理與紀錄設備所組成，系統採用5位正常受測者以Intraclass Correlation Coefficient(I.C.C.)評估系統的信賴度(Reliability)。

經過校正與測試後本震動平臺在X軸的最大振動頻率1.08 Hz，振幅範圍為2 ~ 8 cm，最大加速度為0.33。Z軸最大振動頻率為1.85 Hz，振幅範圍亦為2 ~ 8 cm，最大加速度為0.82。X與Z軸在震動震幅愈大時則與正弦波的差異愈大，其中X軸在震幅最小為20mm時，mean square error為89.8 mm2，在震幅最大80 mm時，mean square error為786.2 mm2。Z軸在震幅最小為20mm時，mean square error為66.84 mm2，在震幅最大80 mm時，mean square error為865.34 mm2。分別以空載、100 kg、150 kg與200 kg所進行的載重測試中顯示載重對於平臺的輸出平率亦有影響。在正常人鐘擺測試與肌電量測評估系統信賴度測試中，其結果顯示膝關節黏彈系統的阻尼係數(damping coefficient)具有較高的穩定與重複性。

本震動平臺可提供神經肌肉病變族群(如腦性麻痺患者)在震動控制感覺刺激輸入上的療效研究。未來本平臺震動波形的設計可採取建立震動波形函數配合電腦模擬的方式決定連桿機構的尺寸，以獲得正確的正弦波形輸出。鐘擺評估測試系統則可增加機械式腿部釋放機構以減少人為操作誤差，並配合臨床醫療人員使用本震動平臺與評估系統對腦性麻痺患者進行系統性的療程實驗。

The cerebral palsied have multiple function disabilities, particularly motor function problems resulted from abnormal muscle tone and reflex. Literatures showed that reducing high muscle tone is leading to improve the patients’ alignment of position and motor function performance as well as independence of their daily activities. Fay, Knott, Voss, Bobath, and Ayres applied whole body motion such as vibration and rotation therapeutic interventions as their clinical treatment. The results of motion and/or vibration treatment showed significant changes toward normalized muscle tone, better body positioning, and dynamic stability of motor function. Quantitative investigation of body motion stimulation may lead to better understanding of the effects of such whole body motion.This research was aimed to develop a vibration platform with adjustable frequency and amplitude in the orthogonal coordinate directions to provide 3-D controlled motion stimulation for therapeutic intervention. A pendulum test system and an electromyography were set up to evaluate the effects of treatment on muscle tone for the cerebral palsied.

The vibration platform is through mechtronic design and consists of X and Z axis vibration systems, signal transmitting interface, and GUI operation interface. X and Z vibration systems are designed by the same components to provide quasi-sine wave vibration with adjustable amplitude and frequency using a linkage, a set of ball screw, a conveying belt, a disk, an A.C. motor, an inverter, a servo motor, an A.C. servo, and an encoder. Signal transmitting interface consists of an ADLINK 8164 motion card and an ADLINK 9112 A/D signal acquisition card interfaced to an industrial personal computer. The GUI interface is written in Borland C++ Builder 5.0. The performance of X and Z vibration systems is calibrated for the vibration amplitude and frequency. The consistency of pendulum testing system and electromyography has been conducted by 5 normal subjects using intraclass correlation coefficient (I.C.C.) analysis.

The vibration platform has a maximum working frequency up to 1.08 Hz for the X axis and 1.85 Hz for the Z axis. The range of adjustable amplitude range is between 2 and 8cm for both X and Z axes. The maximal acceleration is 0.33in X axis and 0.82 in Z axis. As the amplitude of X and Z axis is increasing, the bias between the output vibration wave and the theoretical sine wave also increases. With unloading, 100 kg, 150 kg, and 200 kg loading test, frequency variations are found for the system characteristics under different loading conditions. The consistency test of pendulum test shows elastic coefficient is very stable and reproduciable (I.C.C. = 0.823).

The vibration platform can provide controllable vibration stimulation with specified frequency, amplitude, and acceleration parameters to systematically investigate therapeutic effects of vibration stimulation on the cerebral palsied. The future work is suggested to develop a mathematical modeling and computer simulation in the determination of adequate link dimensions and accurate sine vibration wave output. Auto-mechanical releasing mechanism could be designed to avoid pendulum test operation error. Working together with clinical therapists, experimental protocols are suggested to be developed for investigating the effects of whole body vibration on clinical efficacy.

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