肢體障礙者穿著3D列印踝足支架之個別化設計發展與功能表現

肢體障礙者通常因為生理障礙，在就學、就業和就養各方面都受到限制，因此需要使用輔具裝具來改善。本研究主要目的在於建立3D列印技術製作踝足支架之個別化設計與發展，並探討肢體障礙者穿著3D列印踝足支架之功能表現。研究採用單一受試法之交替處理設計，以一名肢體障礙者成人為對象，探討「肢體障礙者」穿著「3D列印踝足支架」的「下肢功能表現」，以及探討3D列印技術是否可個別化製作踝足支架並建立其流程。回顧文獻得知，多數肢體障礙者之粗大動作表現低落，以行走速度下滑和平衡能力不佳為主，踝足支架則能有效增加並改善下肢功能。3D列印技術近年興起應用於醫療產業，本研究主要透過3D掃描器和桌上型3D列印機製作踝足支架；研究對象接受一週二至三次，共計九週的評量。評量項目包含「5公尺行走速度」和「柏格式平衡量表」，所得數據將以視覺分析和C統計方法進行分析，並以「受試者訪談問卷」進行訪談以了解其感受和滿意度。本研究「柏格式平衡量表」之觀察者一致性信度為90.47%(範圍85.71%~100%)，研究結論如下：一、 3D列印技術能應用於個別化設計與發展踝足支架，以提供輔具製作的新途徑。二、肢體障礙者穿著3D列印踝足支架可以提升部分行走速度，協助改變習慣性代償姿勢以改善步態。三、肢體障礙者穿著3D列印踝足支架可以提升平衡能力，具有良好的立即與維持效果。四、研究對象對於3D列印踝足支架持正向態度，願意再度使用3D列印踝足支架或相關輔具。本研究除了對研究結果進行詳細討論外，也在製作和評量項目上，提供其他專業研究人員未來於相關主題上的建議，可以發展更多跨領域合作之運用。

關鍵字

肢體障礙； 3D列印；踝足支架；功能表現；單一受試

並列摘要

Assistive technology was applied to improve the limitation of education, employment and homecare in physical disabilities. This study established individualized design and development of ankle-foot orthosis (AFO) by 3D printing technology (3DPT) then investigated the functional performances of physical disabilities. Based on alternating treatment design of single-subject research, the subject is an adult with physical disabilities. The study explored the functional performances of the lower extremities worn 3D printing AFO, and discussed 3DPT can be individualized AFO and set up AFO-making procedure or not. In literatures review, the major problem of gross motor for many physical disabilities is lower gait speed and impaired balance ability. AFO can signicantly increase and improve function of lower extremity. Implantation of 3DPT in medical industry is rising in recent years, so this study uses 3D scanner and 3D printer to produce AFO. By using “Gait Speed Test (GST)” and “Berg Balance Scale (BBS)” as assessments, subject is evaluated two or three times a week, a total of nine weeks. Data analysis was conducted with visual analysis and C stastics, as well as using questionnaire interview to understand subject’s feelings and satisfaction. Inter-observer reliability data of the “Berg Balance Scale (BBS)” is 90.47% (85.71%~100%). As follows the conclusion is: 1. 3D printing technology can be applied to individualized design and set up procedure of making AFO and provide a new approach for producing assistive devices. 2. 3D printing AFO can increase walking speed and change habitual compensatory posture, then improve gait pattern of physical disabilities. 3. 3D printing AFO can signicantly improve balance ability of physical disabilities with immediate and maintainable effects. 4. The research subject had a positive attitude to use 3D printing AFO and would consider to use 3D printing AFO and related equipment in the future. Besides the research discussion and result, this study also provides suggestions in production and assessment for other professional researchers on relevant topics. Therefore, further research is able to develop cross-domain collaboration of assistive technology.