等速訓練結合影像追蹤標記與功能性電刺激應用於膝關節前十字韌帶鬆弛者之復健

Isokinetic Rehabilitation System Incorporated with Synchronous Marker Tracking Device and Functional Electrical Stimulator: An Approach for Individuals with Anterior Cruciate Ligament Insufficiency

郭易軒(Yi-Hsuan Kuo)

指導教授 ： 郭德盛 ； 賴金鑫

國立臺灣大學/電機資訊學院/生醫電子與資訊學研究所/碩士(2011年)

https://doi.org/10.6342/NTU.2011.01666

摘要

膝關節前十字韌帶扭傷或斷裂為常見的運動傷害之一，嚴重者會造成股四頭肌萎縮無力以及膝關節活動時鬆脫不穩等功能障礙。患者在進行傳統之股四頭肌等速肌力復健訓練時，常因為前十字韌帶張力不足造成脛骨前移的現象。本研究運用攝影裝置拍攝復健過程中，黏貼於脛骨與股骨之標籤位置變化，透過影像分析計算出脛骨與股骨相對位移之變化，開發出一套脛骨前移量測系統以提供客觀脛骨前移量測數據，此系統並結合功能性電刺激器刺激腿後肌收縮以補償因前十字韌帶張力不足所造成之脛骨前移現象。透過本研究開發之脛骨前移量測系統可針對兩種不同防止脛骨前移方式進行臨床試驗，初步結果顯示傳統制式防止脛骨前移裝置對於防止脛骨前移具有顯著之功效，但因為其機械結構而降低在肌力訓練上之表現。因此，本研究希望藉由功能性電刺激器搭配脛骨前移量測裝置，與等速訓練結合，開發出一套完整復健系統，以幫助運動員在受到類似傷害後能以最有效的復健方式提早回復到受傷前的最佳狀態。

關鍵字

前十字韌帶 ； 脛骨前移 ； 等速肌力訓練 ； 功能性電刺激 ； 臨床試驗

並列摘要

Sprain or rupture of anterior cruciate ligament (ACL) in knee is a common sports injury which may cause knee instability and disuse atrophy of quadriceps. In order to prevent anterior translation of the tibia during traditional isokinetic training exercises of quadriceps, this study looks at feasible means of detecting and restricting anterior tibial translation (ATT) in isokinetic exercises. By using a camera that tracks markers placed on bony prominences of the distal femur and proximal tibia, the ATT can be measured by image processing procedures. The preliminary results demonstrate reduction of ATT despite restricted training effects with the use of a conventional anti-shearing device, suggesting that an alternative device for replacing the conventional anti-shearing device is probably necessary. Accordingly, a new functional electrical stimulation feedback system that incorporates marker tracking is demonstrated to promote functional recovery of quadriceps in athletes who suffer from ACL insufficiency by facilitating more efficient rehabilitation exercises of their quadriceps muscles during isokinetic training exercises.

並列關鍵字

anterior cruciate ligament ； anterior tibial translation ； isokinetic training ； functional electrical stimulation ； clinical trial

參考文獻

[10] 陳昭瑩, 詹美華, 柴惠敏, and 賴金鑫, "前十字韌帶重建術後膝部等速肌力之物理治療效果," 中華民國物理治療學會雜誌, vol. 19, pp. 46-52, 1994.

[16] 陳建名, 江清泉, and 詹美華, "以 K T-1000 量測台灣健康成人脛骨前移鬆弛度," 臺灣醫學, vol. 8, pp. 622-629, 2004.

[2] D. M. Hooper, M. C. Morrissey, W. Drechsler, D. Morrissey, and J. King, "Open and closed kinetic chain exercises in the early period after anterior cruciate ligament reconstruction," The American Journal of Sports Medicine, vol. 29, p. 167, 2001.

[3] E. Witvrouw, R. Lysens, J. Bellemans, K. Peers, and G. Vanderstraeten, "Open versus closed kinetic chain exercises for patellofemoral pain," The American Journal of Sports Medicine, vol. 28, p. 687, 2000.

[5] S. King, D. J. Butterwick, and J. P. Cuerrier, "The anterior cruciate ligament: a review of recent concepts," Journal of Orthopaedic & Sports Physical Therapy, vol. 8, pp. 110-122, 1986.