可輔助上下樓梯之輕便輔具開發與評估

Abstract

台灣已成為一個高齡化社會，並且平均壽命也逐年提升，進而開始更重視了退休後的生活品質，因此，讓老年人能獨立自主完成居家環境中的基本動作已成為重要課題。其中，樓梯是居家環境中常見的設施。上下樓梯更是日常生活中較為吃力且最危險的動作之一，此外，根據相關輔具查詢發現許多上下樓梯輔具皆為單臂、雙臂操作步行輔具或輪椅改造，無法確保其能否穩固地支撐，或者體積較為大型不適於高齡者在一般居家環境使用。 故本研究目的為開發可輔助上下樓梯之輕便輔具並評估其輔助效益。根據本研究的設計方法，設計了附於扶手上且可隨人體於樓梯間移動之滑動式握把機構，尺寸為0.17x0.11x0.15立方公尺，並且利用有限元素分析(Finite element analysis)使輔具更為輕量化，重量可降低至1.25kg。接著以自行建構之樓梯實驗平台紀錄地面反作用力與時間關係圖中的相關參數、表面肌電訊號以及肌肉共同活化情形之參數，評估輔具對於兩側腿部的輔助效果。 結果顯示不論上樓梯或下樓梯，使用輔具於下樓梯接觸地面時兩側皆能減少身體的負擔，垂直地面反作用力(vertical ground reaction force, vertical GRF)降低體重的36%，尤其降低了股外側肌(Vastus lateralis)與外側腓腸肌(Gastrocnemius lateral)的活化情形；至於輔助上樓梯則是靠近輔具的腿較能獲得輔助。此外，本研究也提供了一個輔具開發的設計流程，效益的評估方法是利用地面反作用力規劃出不同的時期，藉由觀察各時期不同的參數，包括肌群的活化情況與受力情況等等，綜合相關參數以評估輔助效果。

The society in Taiwan is aged, and the life expectancy increases year by year. So, a better life has become an important issue after retirement. The elderly should be able to carry out the activity of daily life independently, especially in the home-environment. However, stairs are common in the home-environment. Stair ascending/descending is one of the most hazardous and demanding activities. In addition, according to a search of related devices, many assistive devices were operated by one-arm, two-arm or modified from wheelchair. However, while utilizing in home-environment, those devices were fail to provide steady assistance or convenience due to size. The objective of the study is to develop and evaluate a lightweight device for assisting stair ascending/descending. Therefore, we have designed a mobile grip-device that attach to the handrail. The size of the device is 0.17m x0.11m x0.15m, and the weight have been reduced to 1.25kg after using the finite element analysis and weight reduction. Moreover, we have used an experimental platform to measure and to record some parameters in ground reaction force versus time patterns and surface electromyography (surface EMG) signals simultaneously. Finally, we evaluated the efficacy of both legs when using the device. The results showed using the device could reduce the vertical GRF by a weight of 36% and muscle activities on both sides during stair descending, especially on Vastus lateralis and Gastrocnemius lateral. Equally, the device also help users to reduce the load during stair ascending, and the side close to the device is provided with better assistance. In this study, we integrated and developed a procedure to design assistive devices. In addition, the evaluation of efficacy was determined by parameters, such as muscle activations and supporting force, in different phases divided by GRF patterns.