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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 呂東武(Tung-Wu Lu) | |
dc.contributor.author | Hao-Ling Chen | en |
dc.contributor.author | 陳顥齡 | zh_TW |
dc.date.accessioned | 2021-06-13T06:11:47Z | - |
dc.date.available | 2007-02-24 | |
dc.date.copyright | 2006-02-24 | |
dc.date.issued | 2006 | |
dc.date.submitted | 2006-02-20 | |
dc.identifier.citation | [1] World Health Organization. Active aging. A Policy Framework 2002
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/34499 | - |
dc.description.abstract | 因跨越障礙物而絆倒是老人跌倒的主要原因之一,且其可能造成嚴重後果。一個完整的下肢運動學與力動學分析,將有助於設計預測或預防跌倒之方法。本研究利用一包括七台紅外線攝影機之動作份析系統量測跨越三種高度障礙物(10,20及30%腳長)之運動學,並利用兩塊測力板量測地面反作用力。我們先建立年輕人跨越不同高度時之下肢動力學資料,以此為基礎進一步探討健康及退化性膝關節老年人跨越不同高度障礙物時之下肢生物力學,瞭解老化對行走跨越障礙物之影響。根據結果,我們發現老人會藉由增加髖關節彎曲角度達到跨越瞬間跨越腳與障礙物之垂直距離大於年輕人的結果,基於安全考量,當前腳跨越時,老人採用將身體質量中心留在離站立腳較近且較久之策略,但其會增加站立腳膝關節伸展力矩並減少髖關節屈曲力矩。於前腳及後腳跨越時,為了控制身體質量中心內外側方向之運動,健康老人需要較大之髖、膝關節外展力矩。退化性膝關節炎老人之跨越策略會改變,站立早期時,其膝關節外展力矩會增加,在跨越瞬間及跨越後,此一力矩會藉增加骨盆傾斜角度及足偏角而降低。為了減少膝關節負荷及相關之疼痛,退化性膝關節炎老人會將骨盆前傾使膝關節伸展力矩降低,但其髖關節伸展力矩則會隨之增加以代償此一改變。因此,我們知道在跨越障礙物時,老人基於安全考量,會採用一較保守之策略,退化性膝關節炎會改變老人跨越障礙物時之正常步態,此一改變會增加跌倒發生的危險。 | zh_TW |
dc.description.abstract | Falls are a common problem leading to physical injuries among the elderly, resulting in individual costs such as pain and impairment of locomotion, as well as financial costs related to treatment and rehabilitation. From the literature review, it was suggested that investigating kinematics and kinetics of the locomotor system during obstacle crossing may help in devising strategies to predict and prevent trip-related falls in the elderly. In the present study, young, older and knee osteoarthritic subjects were recruited to investigate the influence of aging and aging-related disease on the biomechanics of obstacle crossing using motion analysis techniques. Compared to the baseline data in the young group, a higher leading toe clearance was adopted in the older group achieved by a swing hip flexion strategy. During the crossing of the leading limb, the older group kept the COM more posterior and longer on the trailing stance limb with increased knee extensor and decreased hip flexor crossing moments. For both leading and trailing stance limbs, bigger abductor moments of the hip and knee were needed in controlling the medial-lateral COM motion. Knee OA seemed to increase peak knee abductor moments for both limbs in the early stance. The corresponding moments were reduced around and after crossing the obstacle through pelvis list and toe-out gait. For reducing knee joint loading and associated pain, bigger hip extensor moments were needed to compensate by anterior tilt of the pelvis. It was suggested that the older group used a more conservative strategy for obstacle-crossing due to the safety considerations. Knee OA altered normal gait pattern during obstacle crossing, which may increase the risk of trip-related falls in the elderly. | en |
dc.description.provenance | Made available in DSpace on 2021-06-13T06:11:47Z (GMT). No. of bitstreams: 1 ntu-95-F90548045-1.pdf: 1617619 bytes, checksum: 273ef1ec85f500ff94f4b981e28c7e04 (MD5) Previous issue date: 2006 | en |
dc.description.tableofcontents | CHAPTER 1 INTRODUCTION 1
1.1. Aging and Falls 1 1.2. Approaches to Study Obstacle Crossing 3 1.2.1. Forward Dynamics Approach 4 1.2.2. Inverse Dynamic Approach 5 1.2.3. Terminology of Obstacle Crossing 5 1.3. Strategies of Obstacle Crossing in Young Adults 9 1.3.1. Height Effects on the End-Point Variables 10 1.3.2. Height Effects on the Joint Kinematics 12 1.3.3. Height Effects on the Center of Mass (COM) Motion 14 1.3.4. Height Effects on the Kinetics 15 1.3.5. Comparisons between the Functions of the Leading and Trailing Limbs 18 1.3.6. Limitations of Previous Studies 19 1.4. Strategies of Obstacle Crossing in Older Adults 20 1.4.1. Age-Related Degeneration 21 1.4.2. Age-Related Factors Affecting Obstacle Crossing 22 1.4.3. Effects of Obstacle Height on the Kinematics and Kinetics of Obstacle Crossing in Elderly 25 1.4.4. Limitations of the Previous Studies 27 1.5. Strategies of Obstacle Crossing in Patients 27 1.6. Aims of This Dissertation 31 CHAPTER 2 EXPERIMENTAL PROTOCOL AND BIOMECHANICAL ANALYSIS METHODS FOR STUDYING OBSTACLE CROSSING 33 2.1. Subjects 33 2.1.1. Young Subjects 33 2.1.2. Older Subjects 33 2.1.3. Older Subjects with Knee OA 34 2.2. Instruments 35 2.3. Experiments 36 2.4. Biomechanical Analysis Models 39 2.4.1. Coordinate Systems 39 2.4.2. Anthropometric Parameters 44 2.4.3. Inverse Dynamics Analysis 44 2.4.4. Body COM Model 51 2.5. Data Analysis 52 2.5.1. Definition of the Crossing Cycles 52 2.5.2. End-Point Variables and Crossing Speed 53 2.5.3. Joint Kinematics 54 2.5.4. Joint Kinetics and GRF 55 2.5.5. COM Variables 56 2.5.6. Statistical Analysis 57 CHAPTER 3 THREE-DIMENSIONAL KINEMATIC ANALYSIS OF STEPPING OVER OBSTACLES IN YOUNG SUBJECTS1 58 3.1. Subjects 59 3.2. Data Analysis 59 3.3. Results 59 3.4. Discussion 70 3.4.1. Heel, Toe and Minimum Clearances 70 3.4.2. Crossing and Peak Joint Angles 71 3.5. Conclusion 72 CHAPTER 4 COMPARISONS OF THE JOINT MOMENTS BETWEEN LEADING AND TRAILING LIMB IN YOUNG ADULTS WHEN STEPPING OVER OBSTACLES 73 4.1. Subjects 74 4.2. Data Analysis 74 4.3. Results 75 4.4. Discussion 87 4.4.1. Height Effect on the Trailing Peak Moments 87 4.4.2. Height Effect on the Leading Peak Moments 88 4.4.3. Height Effect on the Trailing Crossing Moments 88 4.4.4. Height Effect on the Leading Crossing Moments 89 4.4.5. Peak Moments vs. Crossing Moments 90 4.4.6. Inter-Limb Comparison of the Peak Moments 91 4.4.7. Inter-Limb Comparison of the Crossing Moments 91 4.5. Conclusion 92 CHAPTER 5 COMPARISONS OF THE LOWER LIMB KINEMATICS BETWEEN YOUNG AND OLDER ADULTS WHEN CROSSING OBSTACLES OF DIFFERENT HEIGHTS 94 5.1. Subjects 95 5.2. Data Analysis 96 5.3. Results 96 5.4. Discussion 106 5.4.1. End-Point Variables 106 5.4.2. Joint Kinematics When the Leading Toe Was above the Obstacle 108 5.4.3. Joint Kinematics When the Trailing Toe Was above the Obstacle 110 5.5. Conclusion 111 CHAPTER 6 AGE EFFECTS ON CENTER OF MASS MOTION AND LOWER LIMB KINETICS DURING OBSTACLE CROSSING: RISK FACTORS FOR FALLING IN THE ELDERLY 113 6.1. Subjects 114 6.2. Data Analysis 114 6.3. Results 115 6.4. Discussion 125 6.4.1. The ROM of the COM 126 6.4.2. A/P Motion of the COM 126 6.4.3. The COM Motion When the Leading Toe Was above the Obstacle 127 6.4.4. Interactions between the COM Motion and the Joint Kinetics When the Leading Toe Was above the Obstacle 128 6.4.5. Interactions between the COM Motion and the Joint Kinetics When the Trailing Toe Was above the Obstacle 129 6.5. Conclusion 131 CHAPTER 7 MEDIAL KNEE OSTEOARTHRITIS ALTERS GAIT PATTERNS IN OLDER ADULTS WHEN CROSSING OBSTACLES OF DIFFERENT HEIGHTS WITH THE LEADING LIMB 133 7.1. Subjects 134 7.2. Data Analysis 135 7.3. Results 136 7.4. Discussion 151 7.4.1. Temporal-Distance Variables 151 7.4.2. Clearance and Related Joint Kinematics 152 7.4.3. Joint Moments in the Frontal Plane 153 7.4.4. Joint Moments in the Sagittal Plane 156 7.5. Conclusion 157 CHAPTER 8 EFFECTS OF KNEE OSTEOARTHRITIS ON THE JOINT MECHANICS WHEN CROSSING OBSTACLES OF DIFFERENT HEIGHTS WITH THE TRAILING LIMB 158 8.1. Subjects 159 8.2. Data Analysis 159 8.3. Results 160 8.4. Discussion 173 8.4.1. Trailing Toe Clearance 173 8.4.2. Crossing Joint Angles of Both Limbs 174 8.4.3. Crossing Joint Moments 175 8.4.4. Peak Joint Moments 176 8.5. Conclusion 177 CHAPTER 9 CONCLUSIONS AND SUGGESTIONS 178 9.1. Conclusions 179 9.1.1. Height Effects on the Kinematics in Young Adults 179 9.1.2. Joint Moments between Leading and Trailing limb in Young Adults 179 9.1.3. Lower Limbs Kinematics between Older and Young Adults 180 9.1.4. Age Effects on Center of Mass Motion and Lower Limb Kinetics 181 9.1.5. Effects of Knee OA on the Joint Mechanics in the Crossing of the Leading Limb 182 9.1.6. Effects of Knee OA on the Joint Mechanics in the Crossing of the Trailing Limb 182 9.2. Suggestions for Further Studies 183 9.2.1. Effects of Contextual Constraints 183 9.2.2. Risk Factors during Obstacle Crossing in the Elderly 184 9.2.3. Control of Obstacle Crossing 184 9.2.4. Clinical Applications 185 APPENDIX A PUBLICATIONS 186 REFERENCES 190 | |
dc.language.iso | en | |
dc.title | 正常人與退化性膝關節患者於行走跨越障礙物時之生物力學分析 | zh_TW |
dc.title | Biomechanical Analysis of Obstacle Crossing in Normal Adults and Patients with Knee Osteoarthritis | en |
dc.type | Thesis | |
dc.date.schoolyear | 94-1 | |
dc.description.degree | 博士 | |
dc.contributor.oralexamcommittee | 謝清麟(Ching-Lin Hsieh),林光華(Kwan-Hwa Lin),陳文斌(Wen-Pin Chen),吳菁宜(Ching-Yi Wu),李淑貞(Shwn-Jen Lee) | |
dc.subject.keyword | 跨越障礙物,運動學,力動學,下肢,老化,退化性關節炎, | zh_TW |
dc.subject.keyword | obstructed gait,kinematics,kinetics,lower limb,aging,osteoarthritis, | en |
dc.relation.page | 201 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2006-02-20 | |
dc.contributor.author-college | 工學院 | zh_TW |
dc.contributor.author-dept | 醫學工程學研究所 | zh_TW |
顯示於系所單位: | 醫學工程學研究所 |
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