符合人體工學之「坐到站」及「站至走」之年長者輔助系統

Abstract

由於近十年來出生率下降及平均壽命之延長，高齡少子化社會已成為全球必然的趨勢且在台灣尤其顯著，因此未來高齡者的照護需求將逐年增加。對高齡者而言，由於其腿部肌肉骨骼以及神經反應隨著年齡嚴重退化，在執行起身行走 (Sit to Stand and Walk, STSW) 之動作時相當困難，因而需他人攙扶或是使用輔具，進而降低其活動意願，導致長期處於坐或臥之姿勢，反而加快其肌力之衰退，且新陳代謝隨之下降進而使得其免疫系統之功能也跟著下降等多項嚴重後果。目前市面上已有許多STSW之輔助器材，但目前的輔具都有起身姿勢輔助不符合自然姿勢、無適當的起身及行走力量輔助這兩項問題。 本研究提出創新的姿勢輔助設計，使STSW的輔具能符合人體自然起身及行走姿勢進行輔助，並讓使用者於起身同時進行復健運動。於研究中進行起身動作之運動學測試找出詳細之自然起身之姿勢曲線，並經由力量與尺寸計算及力學模擬過程，設計出居家照護使用的符合人體工學之「坐到站」及「站至走」之年長者輔助系統之完整架構，並針對輔助系統之動力模組、傳動模組、移動及煞車模組、感測與控制模組等，進行各項材料及組件之詳盡評估與選擇，經過共九代之工程原型設計、測試改良以及控制程式之撰寫，最終製作出符合人體工學之「坐到站」及「站至走」之年長者輔助系統，並對此輔助系統之使用者起身姿勢軌跡、使用者運動強度等進行驗證，證實居家照護使用的符合人體工學之「坐到站」及「站至走」之年長者輔助系統符合設計目標，可輔助居家使用者以自然姿勢起身，並同時進行一定量之復健運動。期望此開發之新式居家照護使用的符合人體工學之「坐到站」及「站至走」之年長者輔助系統能增進年長者起身活動之能力與意願，並協助其維持肌力與協調性，降低年長者因腿部肌力退化所帶來的生活不便，達到居家照護之功能。

Recently, the aging trend has become obvious in the world’s population, and it is especially severe in Taiwan due to low fertility. Hence, the health care of the elderly has become an essential topic. With aging, the degeneration of physiological functions, such as muscle force, muscle endurance, and balance ability, makes the elderly hard to perform sit-to-stand and walk (STSW), which is frequent in daily lives. The elderly need support from others or lifts to be capable of standing up and walking. Hence, the elderly will decrease activity and tend to lie in bed or sit on a wheelchair for longer time. With decreasing activity, their metabolic rates decline and the elderly are more vulnerable to cardiovascular diseases. Additionally, the quality of life will decline. There is an increasing number of lifts developed to help the elderly standing and walking. However, there are drawbacks in the existing lifts that should be improved. One is their lack of ability to lift the elderly people with a good posture to stand up normally and the second is their lack of an appropriate support during the standing and walking process. Therefore, the aim of this research is to develop a home-care smart STSW lift system, which can support the elderly to stand in a normal movement and provide them with partially body weight support during the standing and walking process. Making it easier for the elderly to stand up, the designing system can motivate them to do active rehabilitation exercise every time they stand up and walk. In this study, we executed a kinematic experiment to find out the precise position of each body segment during a normal sit-to-stand movement and got the curve of standing. We also carefully designed the basic structure of STSW lift, and calculated numerically the needed supporting force, the stress and the safety factors with its 3D model. Calculation of the data of these standing-curves and results from simulations provide detail information to finish the design and define the precise dimension of STSW lift. During the design process, we built the working prototypes to test each design ideas at the same time. After the evolution of nine generations of designs and prototypes, we finally built the home-care smart STSW lift system. The system was finished after a series of well evaluation and selection of materials and components of the mechanism, power module, power transmit module, move and brake module and the sensor and control module of the home-care smart STSW lift system. At the last, we executed some experiments of kinematic, exercise intensity, electromyography (EMG) and supporting force to verify the standing-curves and intensity of active rehabilitation exercise when a user standing with the home-care smart STSW lift system. After all, the researcher finally designed and built a home-care smart STSW lift system which can not only support the elderly to stand in a normal sit-to-stand movement but also let them do active rehabilitation exercise at the same time. We expect this innovated home care smart STSW lift system can encourage the elders to stand up and move around. By doing so, the elderly can postpone the degeneration of the muscle force, and thus they can have longer life span and better life qualities.