||Biomechanical Characteristics of Lower Extremity during Elliptical Training with Body Weight Suspension System
||Department of BioMedical Engineering
weight suspension system
復健運動橢圓機安全背帶系統（The intelligently controlled assistive rehabilitation elliptical trainer with suspension system）被使用來鍛鍊下肢肌力缺乏的患者其行走能力。然而，在使用不同的懸吊強度下之生物力學反應卻未曾被仔細地來觀察並研究。因此本論文的主要目的為探究在使用復健運動橢圓機安全背帶系統時對於下肢生物力學特性之影響。本研究共分析14名健康男性受試者（平均身高：172.5±4.5公分，平均體重：65.0±10.5公斤）。在實驗的過程中，我們會請受試者分別在不同的懸吊強度之下（0%、10%、20%、30%、40%、50% 體重），以每分鐘60轉來踩踏此儀器，並且在不同的懸吊強度之下給予兩種實驗設計：馬達帶動以及馬達不帶動受試者自己踩踏。在實驗驗過程中，我們使用八台攝影機（Eagle Digital RealTime System）來擷取空間中受試者關節骨突點的反光球位置，以及在兩個腳踏板底下裝置六維的力/力矩傳感器系統（Mini85-E Transducer, ATI Industrial Automation）來量測兩個踏板的反作用力。我們利用重複測量單因子變異數分析來比較不同的懸吊強度之下的結果，以及相依樣本的t檢定來比較機器有無帶動以及左右腳的差異。髖關節的關節角度變化量在懸吊0%體重時為49.0±4.2度，而懸吊50%體重時為37±4.7度。慣用腳的關節受力以及部分力矩 (髖關節屈曲力矩、膝關節屈曲力矩、踝關節蹠曲力矩) 會較非慣用腳來得大。髖關節屈曲力矩在0%的時候最大值為33.8±5.8牛頓米/體重*腿長，而在50%時為27.3±3.9牛頓米/體重*腿長。膝關節屈曲力矩在0%的時候最大值為19.1±7.9牛頓米/體重*腿長，而在50%時為16.7±7.8牛頓米/體重*腿長。踝關節蹠曲力矩在0%的時候最大值為5.7±2.9牛頓米/體重*腿長，而在50%時為0.7±1.3牛頓米/體重*腿長。根據此研究我們發覺，當懸吊的強度越高，髖關節屈曲力矩、膝關節屈曲力矩以及踝關節蹠曲力矩的最大值會越小。尤其當懸吊30%體重以上時，機器帶動時的關節受力及力矩會明顯比受試者自主踩踏時來得小。我們期望此篇研究的內容能予與臨床人員在給予病患運動處方時多一點的參考依據。
The intelligently controlled assistive rehabilitation elliptical trainer (ICARE) with suspension system (SportsArt, Inc) has been used to help to improve the walking capacity. However, the movement characteristics and joint loadings under the various suspended force were unclear. Therefore, the purpose of this study was to investigate the effects of body weight support on the biomechanical characteristics during stepping the ICARE. Fourteen healthy male volunteers (mean height: 172.5±4.5 cm, mean weight: 65.0±10.5 kg) were recruited. They were asked to step the ICARE at the speed of 60 RPM under suspended forces of 0%, 10%, 20%, 30%, 40%, and 50% body weight support with active and passive movement patterns respectively. The motion capture system with 8 cameras (Eagle Digital RealTime System) and load cells embedded in bilateral pedals (Mini85-E Transducer, ATI Industrial Automation) were used to collect data. Repeated one-way ANOVA was used to compare the differences among 6 suspended levels and paired-t test was used to exam the differences between two movement patterns and both feet. The movement ranges of the hip joint were 49.0±4.2° at 0% body weight support (BWS), and 37±4.7° at 50% BWS. The joint forces and the joint moments (maximum hip flexion moments, maximum knee flexion moments, maximum ankle dorsiflexion moments) of the dominant legs are greater than the non-dominant legs. The maximum hip flexion moments were 33.8±5.8 N-m/BW*LL at 0% BWS, and 27.3±3.9 N-m/BW*LL at 50% BWS. The maximum knee flexion moments were 19.1±7.9 N-m/BW*LL at 0% BWS, and 16.7±7.8 N-m/BW*LL at 50% BWS, respectively. The maximum ankle plantar flexion moments were 5.7±2.9 N-m/BW*LL at 0% BWS, and 0.7±1.3 N-m/BW*LL at 50% BWS, respectively. According to our study, the maximum moments of hip flexion, knee flexion, and ankle plantar flexion would decrease when hanging higher partial body weight. Especially, the joint forces and moments would be smaller in passive modes as suspended 30% to 50% BWS. According to the different needs of patients, the therapists could make the appropriate setting of elliptical trainer with suspension system.
List of Tables VIII
List of Figures XI
Chapter 1 Introduction 1
1.1 Background 1
1.1.1 Rehabilitation of elliptical training and suspension system 1
1.1.2 Improvement of elliptical trainer 2
1.2 Biomechanics of elliptical training 6
1.3 Clinical needs 6
1.4 Motivation 7
1.5 Purpose 8
1.6 Hypothesis 8
Chapter 2 Materials and Methods 9
2.1 Participants 9
2.2 Instruments 10
2.2.1 ICARE 10
2.2.2 Suspension system 10
2.2.3 Motion Capture System 13
2.2.4 Load cell 14
2.3 Procedures 16
2.3.1 Pre-experimental preparation 16
2.3.2 The placement of markers 18
2.4 Data Collection and Parameters Calculation 20
2.4.1 The Coordinate System 20
2.4.2 Kinematics 22
2.4.3 Kinetics 23
2.5 Parameters analysis 24
2.6 Statistical Analysis 25
Chapter 3 Results 26
3.1 Pedal reaction force during elliptical training 26
3.1.1 Pedal reaction force (vertical direction) 27
3.1.2 Pedal reaction force (anterior/posterior) 34
3.1.3 Pedal reaction force (medial/lateral) 41
3.2 Joint angles during elliptical training 48
3.3 Joint forces during elliptical training 58
3.4 Joint moments during elliptical training 68
3.5 Relationship between body weight support and biomechanical data 88
3.5.1 The variation of pedal reaction forces 88
3.5.2 The variation of joint forces 89
3.5.3 The variation of joint moments 91
Chapter 4 Discussion 93
4.1 Characteristics of motion 93
4.2 Pedal reaction force 93
4.3 Active vs passive modes 94
4.3.1 Joint angles 94
4.3.2 Joint forces 95
4.3.3 Joint moments 95
4.4 Dominance 96
4.4.1 Joint angles 96
4.4.2 Joint forces 96
4.4.3 Joint moments 96
4.5 BWS effects 97
4.5.1 Joint angles 97
4.5.2 Joint forces 97
4.5.3 Joint moments 98
4.6 Summary 99
4.7 Limitations 99
Chapter 5 Conclusions 101
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