藉由長者專用健康鞋刺激平衡力以預防跌倒之研究

Stimulate Balance to Prevent Falling by Elderly Only Health Shoes

沈佳臻(Chia-Chen Shen)

指導教授 ： 江行全

元智大學/工程學院/工業工程與管理學系/碩士(2013年)

https://doi.org/10.6838/YZU.2013.00316

摘要

臺灣已於1993年邁入高齡化社會，隨著人口的老化，人們開始注重生活的品質，跌倒的預防更是值得關注的重點，跌倒是老年族群最常見也最致命的發生事故。足弓結構在站立與行走中扮演重要的地位，提供人體維持平衡的作用，為了減少跌倒意外的發生，本研究欲透過長者專用健康鞋的刺激，來提升老年人的平衡能力。本研究針對24名65歲以上女性進行平衡力量測，透過長者專用健康鞋進行為期兩個月的刺激，每隔兩周進行一次量測，針對穿鞋與裸足兩種狀況下進行壓力中心點(COP)訊號的量測，利用傳統分析方法、多尺度熵(MSE)方法與多元多尺度熵(MMSE)方法進行訊號的分析，期望能找出實驗前後平衡能力的差異；並對步態功能性測試、足壓與主觀問卷進行分析。
研究結果顯示，24位受測者，在步態功能性測試中，平均行走秒數由20.63秒降至18.77秒，且實驗前後具有顯著差異(P-Value=0.035)，受測者的步態趨於穩定，在足壓的分析中，明顯看出受測者足部長繭與雞眼情形明顯改善，各區域之足底壓力也有明顯降低，在COP傳統指標分析中，總偏移量、前後方向總偏移量、平均速度與前後方向平均速度實驗前後具有顯著差異(P-Value依序為0.0159、0.0026、0.0189與0.0030)。在MSE的分析中，穿鞋AP之實驗前後具有顯著差異(P-Value=0.0562)，在MMSE的分析中，穿鞋之實驗前後具有顯著差異(P-Value=0.0980)，表示受測者適應外在環境的能力提高，進而提升控制平衡的能力，而主觀分析結果，受測者普遍認為實驗後皆會繼續使用長者專用健康鞋。

關鍵字

壓力中心點 ； 經驗模態分解法 ； 本質模態函數 ； 希伯特黃轉換 ； 多尺度熵分析 ； 多元多尺度熵分析 ； 複雜度

並列摘要

Taiwan has become an aging society in 1993. People began to pay attention to the quality of life. Prevention of falling is a very important issue. Fallings is the major cause of accident among the elderly. Arch structure is very important for our standing and walking. The arch structure can maintain balance of body. In order to reduce the chance of falling, this study aims to enhance the balance ability for elderly by the elderly only health shoes.
There are twenty-four subjects (aged over 65, female) participated in this study. Two conditions for each subject were involved: wear shoes and barefeet, the center of pressure (COP) signals were collected twice for each condition. It measured once every two weeks, lasting for two months.This study uses COP traditional indicator, Multi-scale entropy (MSE) and Multivariate Multi-scale Entropy Analysis (MMSE) to analyze the COP signals. And the time up and go test, the plantar pressure and questionnaire data are also collected.
The results showed that among the twenty-four subjects tested, the average walking time is from 20.63 seconds down to 18.77 seconds in the timed up and go test, and experiment four is significant lower than experiment one (P-Value: 0.035). Gait of subjects become more steady. In plantar pressure analysis, callus of foot become well, and the plantar pressure of each area is significantly reduced. In COP traditional indicator analysis, total excursion, Total excursion in AP direction, mean velocity and mean velocity in AP direction of experiment four are significantly lower than experiment one (P-Value: 0.0159、0.0026、0.0189 and 0.0030). In Multi-scale entropy (MSE) analysis, wear shoes in AP direction of experiment four is significantly higher than experiment one (P-Value: 0.0562). In Multivariate Multi-scale Entropy Analysis (MMSE) analysis, wear shoes of experiment four is significant higher than experiment one (P-Value: 0.0980). Complexity Index getting higher means that the ability of adapt to the external environment become well and can increase the balance ability. The results of questionnaire showed that subjects are willing to wear the elderly only health shoes after the experiment.

並列關鍵字

Center of pressure ； Empirical mode decomposition ； Intrinsic mode functions ； Hilbert Huang transform ； Multi-scale entropy ； Multivariate Multi-scale Entropy Analysis ； Complexity Index

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