針對五十肩病患之穩定性模型及力矩增益值動態調整方法應用於NTUH-II復健機器手臂

五十肩，或稱為冰凍肩，是一個與肩部關節功能相關的疾病。臨床上普及率約在2%至5%，好發於40至65歲族群。在眾多的治療策略當中，物理治療是最為常見且容易實行的方式，其中，在超過疼痛點的往復運動、以及最大化極限點附近的停留時間將對五十肩復健有益。本研究中設計並實作出了新一代的八自由度復健機器手臂NTUH-II，此機械手臂能提供上肢復健的各種模式需求，包含被動、主動、輔助主動模式。新一代機械手臂相較於上一代機械手臂有許多進步之處，如更大的肩關節屈伸活動角度、肩部定位雷射工具、左右互換功能、肩部牽引功能等。本研究結合了復健醫學以及電機工程上的知識背景。從肌肉伸展的張力及角度關係出發，可發現一指數形式之曲線，再根據此建構出一病患個人狀況模型，及評估病患的動作品質。本研究著重探討僵直性(Stiffness)此參數，進而提出動態僵直性模型及輔助力矩增益函數的建構方式。本研究提出的控制演算法能針對不同位五十肩病患的需求，個人化出不同的復健療程。而在本論文最後部份，呈現足以驗證本研究所提出理論之許多實驗成果。

關鍵字

復健機械手臂；五十肩；上肢復健； NTUH-II

並列摘要

Frozen shoulder is a functional disorder related to shoulder muscles. Among many treatment strategies, rehabilitation exercise is one of the most common and viable therapy. In this research, a new 8 degrees of freedom (DOFs) rehabilitation robot arm named NTUH-II has been developed for frozen shoulder rehabilitation in our laboratory. The robot arm is able to provide most of upper limb rehabilitation motions in passive, active, and assistive modes. There are many improvements for NTUH-II from the previous version NTUH-ARM, also developed in our laboratory such as larger shoulder flexion/extension range of motion, shoulder localization with laser tools, side-changing, and shoulder traction. This work combines knowledge from rehabilitation medicine to robotic engineering. From the nature of muscle stretching, the exponential torque-angle relationship curve can be found, and thus it is possible to model and evaluate the condition of the patient’s motion quality. The use of two parameters, stiffness and control authority, is proposed in this work. Based on these two parameters, an adjustment method of dynamic stiffness model and assistance torque gain is developed and implemented on NTUH-II. The control algorithm proposed in this research can customize the rehabilitation to meet the individual needs of frozen shoulder patients. Various experiments have been conducted on healthy subjects in National Taiwan University Hospital, and appealing performance has been observed, which validates the method proposed in this paper.

並列關鍵字

rehabilitation robotics ； frozen shoulder ； upper limb ； NTUH-II

參考文獻

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[28] 陳安寶, "優秀劍道選手上肢等速肌力與打擊速度相關性之研究," 北體學報, vol. 第七期, pp. 128- 145, 2000.

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[3] J. L. Yang, M. H. Jan, C. W. Chang, and J. J. Lin, "Effectiveness of the end-range mobilization and scapular mobilization approach in a subgroup of subjects with frozen shoulder syndrome: a randomized control trial," Man Ther, vol. 17, pp. 47-52, Feb 2012.

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針對五十肩病患之穩定性模型及力矩增益值動態調整方法應用於NTUH-II復健機器手臂

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