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Simulation and Analysis of Biomechanical effects for Trendelenburg's Gait
|關鍵字:||Gait analysis;步態分析;Trendelenburg's sign;Abductors muscles;LifeMOD;臀中肌無力症;LifeMOD;外展肌群||出版社:||生物產業機電工程學系所||引用:|| S. Affatato and A. Toni, "Leg length measurement: a new method to assure the correct leg length in total hip arthroplasty," Med Eng Phys, vol. 22, pp. 435-9, Jul 2000.  B. Gurney, C. Mermier, R. Robergs, A. Gibson, and D. Rivero, "Effects of limb-length discrepancy on gait economy and lower-extremity muscle activity in older adults," J Bone Joint Surg Am, vol. 83-A, pp. 907-15, Jun 2001.  R. H. Gross, "Leg length discrepancy: how much is too much?," Orthopedics, vol. 1, pp. 307-10, Jul-Aug 1978.  M. Ipavec, R. A. Brand, D. R. Pedersen, B. Mavcic, V. Kralj-Iglic, and A. Iglic, "Mathematical modelling of stress in the hip during gait," J Biomech, vol. 32, pp. 1229-35, Nov 1999.  J. Perry, Gait analysis : normal and pathological function. Thorofare, N.J.: SLACK, 1992.  P. K. Levangie and C. C. Norkin, Joint Structure and Function, Third ed. Philadelphia PA: F. A. Davis, 2001.  J. Perry, "Kinesiology of lower extremity bracing," Clin Orthop Relat Res, pp. 18-31, Jul-Aug 1974.  P. K. Levangie, C. C. Norkin, C. C. J. s. Norkin, Joint structure and function : a comprehensive analysis, 3rd ed / Pamela K. Levangie, Cynthia C. Norkin. ed. Philadelphia: F.A. Davis, 2001.  K. R. Kaufman, L. S. Miller, and D. H. Sutherland, "Gait asymmetry in patients with limb-length inequality," J Pediatr Orthop, vol. 16, pp. 144-50, Mar-Apr 1996.  M. E. Brunet, S. D. Cook, M. R. Brinker, and J. A. Dickinson, "A survey of running injuries in 1505 competitive and recreational runners," J Sports Med Phys Fitness, vol. 30, pp. 307-15, Sep 1990.  A. Bhave, D. Paley, and J. E. Herzenberg, "Improvement in gait parameters after lengthening for the treatment of limb-length discrepancy," J Bone Joint Surg Am, vol. 81, pp. 529-34, Apr 1999.  H. J. Woltring, "A FORTRAN package for generalized, crossvalidatory spline smoothing and differentiation. Advances in Engineering Software," vol. Vol. 8, pp. 104-113, 1986.  J. C. Goh, S. E. Solomonidis, W. D. Spence, and J. P. Paul, "Biomechanical evaluation of SACH and uniaxial feet," Prosthet Orthot Int, vol. 8, pp. 147-54, Dec 1984.  M. Nordin and V. H. Frankel, Basic Biomechanics of the Musculoskeletal System, Third ed. Baltimore, Maryland: Lippincott Wolters & Kluwer, 2001.  M. Walsh, P. Connolly, A. Jenkinson, and T. O''Brien, "Leg length discrepancy--an experimental study of compensatory changes in three dimensions using gait analysis," Gait Posture, vol. 12, pp. 156-61, Oct 2000.  T. Ryu and H. Choi, "A comparision of gait characterisitics between Korean and Western people for establishing Korean normal gait data," in The fourth International Cyberspace Conference on Ergonomics Johannesburg International Ergonomics Association, 2005.  K. C. Moisio, D. R. Sumner, S. Shott, and D. E. Hurwitz, "Normalization of joint moments during gait: a comparison of two techniques," J Biomech, vol. 36, pp. 599-603, Apr 2003.||摘要:||
身體的關節與肌肉作用受力情形很難以直接的方式進行量測，利用步態分析(Gait analysis)為工具，並配合電腦軟體建立可靠的人體模型，以模擬的方式來分析臀中肌無力症(Trendelenburg’s sign)患者在步行時的生物力學效應。
本研究利用Vicon MX System、Workstation 5.0軟體及AMTI測力板擷取患者及正常個體(subject)之步態資料，以模擬軟體ADAMS及其人體模組LifeMod，建立人體模型並模擬分析兩者步態的差異。
當人體模型關節參數設定為Stiffness：105 Damping：104，運動代理器(Motion Agent)設定為Stiffness：600 Damping：60，正向動力學模擬控制參數設定為P. Gain：105 D. Gain：103時，可得到最佳模擬結果。
由實驗發現病患的步態有不對稱(asymmetric)的現象；患者在測力板上數據顯示出各方向反作用力(GRF)健側都比患側大；髖關節力矩在單腳站立期(Single leg stance)短腿側於矢狀面(Sagittal)上比長腿側多出0.55N-m/kg，於冠狀面(Frontal)多出0.12 N-m/kg。擺動期健側膝關節彎曲角度比患側多出7度，冠狀面上之髖關節內收角度比患側多出3度；兩側臀中肌作用力患側明顯較小，致使骨盆下垂角度較大，身體重心向患側偏移。而正常個體其步態較對稱，其下肢各關節之活動度與力矩差異較小，兩側外展肌群的作用力也較為平均。
It was difficult for researchers to measure effects between joints and muscles directly. As a result, to use the gait analysis and computer software program to set up a reliable model and then to analyze biomechanics effects on patients of Trendelenburg's sign.
The research adopted the Vicon MX System, Workstation 5.0 software program, and AMTI OR6-6 force plate to gather gait data from normal subjects and patients. The study also used the stimulate software program ADAMS and LifeMod to establish the model to analyze the gait differences between normal subjects and patients.
When we set up the joint parameter Stiffness: 105 Damping: 104, the Motion Agent Stiffness: 600 Damping: 60, forward dynamics servocontrol parameter P. Gain: 105 D. Gain: 103, will got the best stimulate results.
The results revealed that patients had asymmetric gaits. The healthy limb has more large Ground Reaction Force then the other. At single leg stance, the patients' hip joint moment of unhealthy limbs in sagittal plane was 0.55N-m/kg higher than healthy limbs. In addition, the hip joint moment of unhealthy limbs in frontal plane was 0.12 N-m/kg higher than healthy limbs. At swing phase, knee joint flexion was 7 degrees higher than the unhealthy side and 3 degrees adduction in frontal plane. Compared the patients' gaits with normal subjects' gaits, we found that all joints of the lower limbs had lower functions and moment discrepancy. Also, the effect of abductors muscles was on the average.
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