供中風患者步行訓練之膝關節控制器設計

The Design of a Knee Lock Controller for Cerebral Vascular Accident (CVA) in Locomotion Training

許鵬飛(Peng-Fei Sheu)

指導教授 ： 張恆雄 ； 陳友倫

中原大學/工學院/醫學工程研究所/碩士(2002年)

https://doi.org/10.6840/cycu200200555

摘要

本研究針對中風病患設計一套可以讓患者自行操作的膝關節控制器並且合併功能性電刺激，來改善病患膝無力以及懸垂足的情形，病患在行進間使用患側站立時，利用膝關節控制器的輔助，協助病患站立穩定，而在行走時，利用足底開關控制，解除膝關節控制器的控制，並且配合功能性電刺激同時刺激髖關節屈肌以及脛骨前肌來改善病患行走步態，並與其他復健條件：無輔助行走、功能性電刺激、膝關節控制器做復健之情況記錄病患行走時的步距（step length）、步幅（stride length）、步行速度（walking velocity）以及下肢各關節角度來做比較。
四位腦中風病患參與本實驗進行，並完成五週訓練，結果測出，其中三位使用電刺激加上膝關節控制器這一組，其左右腳步距在左右腳比較T-檢定下，並無顯著差異，而在步行速度的改進方面其中三位也有顯著進步，而關節角度也藉由電刺激的輔助有一定程度的改進，尤其是針對懸垂足改進的部分，這都表示經過這樣的訓練之後，患者可改善其行走步態，增進步態美觀，但也需更多病患來證明此法的效用，並且最終目的希望能做成可方便攜帶的輔具，希望能夠為病患縮短治療時間，以及提供病患便利的復健方式。

關鍵字

膝關節控制器 ； 步態分析 ； 偏癱 ； 腦中風 ； 功能性電刺激

並列摘要

Abstract

This study proposed a integrated system of knee lock controller and functional electrical stimulation (FES) for cerebral vascular accident (CVA) patients showed the symptoms of drop foot and kneeback during locomotion. The knee lock controller unlocked the knee electrically and allowed knee joint flexion during the swing phase of the gait. When the knee was extended by electrical stimulation of the hip flexor, the knee was automatically locked by the weight of the locking bar, and the stimulation of the hip flexor stopped.
We compared this device with the FES, knee lock controller and assistance. In each of these four trainings, we measured and recorded step length, stride length, walking velocity and various angles of lower limbs respectively.
Four patients were recruited in this study and trained for four weeks. After four weeks of training with this system, three of them have abetter improvement on the symptoms of drop foot and kneeback.
This system is advantageous because it is easy to put on and take off and has a good cosmetic appearance. In the near future, we hope to make this device into a portable type. However, we still need more patients for clinical evaluation to verify these results.

並列關鍵字

Functional Electrical Stimulation ； Cerebral Vascular Accident ； Knee Lock Controller ； Kneeback ； drop foot

參考文獻

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