針對步態訓練的三維列印動態足踝輔具- 設計與臨床試驗

Dynamic 3D printing AFO for gait training- Design clinical trial

許智超(Chih-Chao Hsu)

指導教授 ： 趙福杉

共同指導教授 ： 陳適卿(Shih-Ching Chen)

國立臺灣大學/工學院/醫學工程學研究所/博士(2022年)

https://doi.org/10.6342/NTU202200503

摘要

背景：我們設計了一種新型足踝輔具 (Ankle Foot Orthosis, AFO)，即理想訓練 AFO (IT-AFO)，通過對偏癱下肢的運動反饋來改善中風相關偏癱患者的行走能力。因此，我們試圖比較有和沒有動態控制的 IT-AFO 與傳統前型 AFO 或無 AFO 之間的步態運動學參數。方法：使用 RehaWatch® 系統測量 7 名偏癱患者（平均 51.14 年）的步態參數。這些參數在四種情況下進行了比較：無 AFO、傳統前部 AFO、無動態控制的 IT-AFO 和具有動態控制的 IT-AFO，每種情況進行 3 次 10 米步行測試。結果：佩戴IT-AFO後，擺動期背屈角增大，動態控制後背屈角變大。這些數據可以確認落腳的改善；然而，在擺動階段，有和沒有 AFO 控制條件的參數之間的差異並不顯著。與傳統 AFO 或無 AFO 相比，有或沒有動態控制的 IT-AFO 在更大程度上增強了偏癱和未受影響下肢之間的負荷響應。與使用傳統 AFO 相比，使用 IT-AFO 和不使用動態控制時，偏癱下肢站立階段的持續時間也更長，從而改善了不對稱性。與其他條件相比，IT-AFO 的用戶舒適度和滿意度更高。結論：具有動態控制的 IT-AFO 改善了步態模式和重心轉移到偏癱下肢，減少了步態不對稱。有無動態控制IT-AFO的差異無統計學意義，受樣本量限制。然而，這項研究顯示了 IT-AFO 在步態訓練中應用正運動反饋的潛力

關鍵字

足踝輔具 ； 偏癱 ； 中風 ； 步態訓練 ； 三維列印

並列摘要

BACKGROUND: We designed a novel ankle foot orthosis (AFO), namely, ideal training AFO (IT-AFO), with motion feedback on the hemiparetic lower limb to improve ambulation in individuals with stroke-related hemiplegia. We, therefore sought to compare the kinematic parameters of gait between IT-AFO with and without dynamic control and conventional anterior-type AFO or no AFO. METHODS: Gait parameters were measured using the RehaWatch® system in seven individuals with hemiplegia (mean 51.14 years). The parameters were compared across four conditions: no AFO, conventional anterior AFO, IT-AFO without dynamic control, and IT-AFO with dynamic control, with three trials of a 10-m walk test for each. RESULTS: The dorsiflexion angle increased during the swing phase when the IT-AFO was worn, and it was larger with dynamic control. These data can confirm drop foot improvement; however, the difference between the parameters with- and without-AFO control conditions was not significant in the swing phase. The IT-AFO with or without dynamic control enhanced the loading response to a greater extent between the hemiparetic and unaffected lower limbs than conventional AFO or no AFO. The duration of the stance phase on the hemiparetic lower limb was also longer when using IT-AFO with and without dynamic control than that when using conventional AFO, which improved asymmetry. User comfort and satisfaction was greater with IT-AFO than with the other conditions. CONCLUSIONS: The IT-AFO with dynamic control improved gait pattern and weight shifting to the hemiparetic lower limb, reducing gait asymmetry. The difference with and without dynamic control of IT-AFO is not statistically significant, and it is limited by sample size. However, this study shows the potential of IT-AFO in applying positive motion feedback with gait training.

並列關鍵字

Ankle foot orthosis ； Hemiplegia ； Stroke ； Gait training ； 3D printing

參考文獻

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