兼具下肢復健功能的行動輔具之創新設計

Abstract

行動輔具，是在生活中最常見的一種輔助工具。所謂的行動輔具，顧名思義就是輔助移動的裝置，當下肢弱化或失能時可藉由行動輔具的協助來移動。綜觀今日的行動輔具，大致上可以分為支架式、輪式以及兩種複合式。對於行動輔具之設計，本研究是採用複合式的設計方式，在使用上是將患者固定在輔具的支架上，而輔具本身具有輪子，因此患者可以不用雙手支撐，便可站立及行走。另外為提供復健功能，在支架上加上了軌跡導引機構，透過該機構可以牽引患者的腳來行走出指定的軌跡，藉以達到復健的效果。 在本研究中，主要是針對中風造成的重度及中度失能患者，設計及規劃一套具有復健功能的行動輔具設計流程。首先探討中風的復健方式，對於重度及中度失能的患者，在復健治療的方式有所不同。在重度失能的情況，普遍是使用雙側動作訓練，透過交互式或是鏡射的動作，來刺激患側的腦神經，使其產生新的連結，達到修補的功能。另外在中度失能的患者，雖然也可以使用雙側動作訓練的方法來治療，不過在本研究中參考了手部的復健方式，將侷限誘發動作治療及動作技巧學習等概念導入下肢復建，希望透過視覺化的回饋來使患者主動練習腳步的移動軌跡，恢復行動能力。 本研究透過參考一般人走路的動作作為範例，並將移動軌跡簡化為二維運動，再透過OpenSim的模擬來檢驗其效果是否與一般走路相當，並設計出導引機構初步雛型，成為一套設計的流程，讓後人可以針對不同年齡及體態的使用者，去找尋與使用者條件相似的一般人作為範本，利用其行走動作來做依據，按照本研究所設計的流程執行，便可設計出適用於該體態之中風患者所適合的行動輔具。

Mobility assistive device is one of the most commonly used accessibility tool for supporting the people with lower limbs disability in the daily life. This study proposes an innovative design of the mobility assistive device which is added on a rehabilitation function for the patient on the vehicle. In this study, we focus on the rehabilitation of lower limbs disability due to the stroke. The rehabilitation therapies for patients with severe or moderate disability are in different ways. For the case of severe disability, bilateral training is mostly suggested. Since that, through the interactive or mirror actions stimulating, the nerve can possibly come to a new linking. For the case of moderate disability, the methods of constraint-induced movement therapy or movement skill learning are usually suggested to the case of lower limbs rehabilitation. In this research, several critical steps for designing the rehabilitative device are introduced and implemented. First of all, typical walking gait contour is measured and modeled in OpenSim system for investigating the effectiveness of the braining for some typical muscles of lower limbs. In order to quantify the effectiveness in OpenSim by using active index, some simulation projects are implementing and executed. Based on the simulated data afforded in the previous research processes, mechanism and function driver system are proposed and generated some examples are illustrated for demonstrating the functions of the designed assistive device system.