張璞曾臺灣大學:生醫電子與資訊學研究所徐銘聰Hsu, Ming-TsungMing-TsungHsu2010-05-262018-07-052010-05-262018-07-052009U0001-1608200923475100http://ntur.lib.ntu.edu.tw//handle/246246/184203This research is aimed to design a new assessment and training system of human standing balance. In addition to hardware design and production, we have also made the assessment software which could be used together with the hardware. In terms of system features, the hardware offers the individual the chance to actively control and interact with the platform. As for the assessment software, we have designed numerous assessment items and parameters on the basis of tilt.n order to examine the discriminating power of the newly developed system, we have looked at two groups whose balance control had been known different, stroke patients (n=3) and normal young adults (n=3); then compared the assessment result in system parameters (n=36) of these two groups. It was found that most parameters showed a statistically significant difference (p<0.000). Meanwhile, the stroke patients have also done the Berg’s Functional Balance Test (total score) and one-foot standing experiment (second), which were analyzed by Pearson correlation tests together with system parameters. The result showed that 3 (3/36) system parameters was significantly related to Berg’s Functional Balance Test, while 4 (4/36) system parameters were significantly related to the one-foot standing experiment result. After the correlation result was analyzed, we found that the further backward the stroke patients could move their body weight on the system, the better they were at balance control.ith the construction of the parameter norms and the completion of studying balance training advantages, this system is expected to become a new aid for the clinical assessment and training of standing.eywords: balance system, balance performance, standing balanceContents文摘要...................................................ibstract.........................................................................................................iiontents........................................................................................................ivist of Figures..............................................................................................ixist of Tables...............................................................................................xiihapter 1 Introduction................................................................................1-1 Research background................................................................................................1-2 Research motivation..................................................................................................2-3 Research purpose.......................................................................................................6hapter 2 Literature Review.......................................................................8-1 The concept of balance and postural control.............................................................8-2 The reaction of balance and postural control..........................................................12-3 The component factors of balance and postural control..........................................14-3.1 Sensory systems and strategies-Input.................................................................15-3.2 High-level neural system and cognitive ability- Decision Making....................21-3.3 Neuromuscular system-Output...........................................................................28-4 Review of balance assessment approaches.............................................................29-4.1 Evaluation of electronic systems........................................................................30-4.2 Assessment scale and simple tool for clinical assessment.................................39-5 Review of balance training methods.......................................................................39-5.1 Balance training of the sensory system..............................................................41-5.2 Postural symmetry training................................................................................42-5.3 Steadiness training..............................................................................................43-5.4 Dynamic stability training..................................................................................44-5.5 Training effectiveness of visual feedbacks.........................................................45-5.6 Clinical treating props training...........................................................................46-6 Testing cases - movement performances of stroke patients....................................47-6.1 Relevant anatomical structures...........................................................................47-6.2 Balance-related movement problems.................................................................48-6.3 Clinical training treatment practices..................................................................51-7 System design considerations..................................................................................52-7.1 A challenging platform.......................................................................................52-7.2 Interference stimuli of tilting..............................................................................53-7.3 Other functions considered.................................................................................55hapter 3 System Architecture and Implementation................................57-1 System structure......................................................................................................57-2 Hardware design and considerations.......................................................................58-2.1 Load cells...........................................................................................................59-2.2 Accelerometer.....................................................................................................59-2.3 Main mechanic platform....................................................................................60-2.4 Handrails............................................................................................................62-2.5 Personal computers............................................................................................63-2.6 Signal amplifiers................................................................................................64-2.7 Data acquisition card..........................................................................................65-3 Balance assessment software design.......................................................................66-3.1 Program structure...............................................................................................66-3.2 Assessment items and parameter design............................................................71-4 Clinical testing.........................................................................................................79-4.1 Test subjects.......................................................................................................80-4.2 Experimental procedure.....................................................................................81-5 Data processing and statistic analysis.....................................................................82hapter 4 Results......................................................................................86-1 Hardware functions.................................................................................................86-2 Parameter analysis...................................................................................................86-2.1 Assessing ability of the parameters....................................................................86-2.2 Parameter validation examination results..........................................................97hapter 5 Discussion and conclusion.....................................................104-1 System hardware characteristics...........................................................................104-2 System software discussion...................................................................................105-2.1 Assessment methods and parameter analysis...................................................105-2.2 Assessment software characteristics.................................................................107-3 Research limitations..............................................................................................108-3.1 Hardware restrictions.......................................................................................108-3.2 Software restrictions.........................................................................................109-4 Conclusion.............................................................................................................110hapter 6 Future Research Directions....................................................111-1 Exploration of the possibility of balance training.................................................111-1.1 Dual task training..............................................................................................111-1.2 Training for stroke patients...............................................................................111-1.3 Training for other groups..................................................................................113-2 Balance assessment...............................................................................................113-3 External interfering stimuli effect.........................................................................114-4 Balance training.....................................................................................................115eferences.................................................................................................116ist of Figuresigure 2-1-1 Different types of LOS borders....................................................................9igure 2-2-1 Four balance strategies...............................................................................13igure 2-3-1 Illustration of the postural control system theory.......................................15igure 2-3-2 Clinical Test of Sensory Interaction and Balance, CTSIB.........................20igure 2-3-3 Sensory Organization Test, SOT.................................................................20igure 2-3-4 Body swaying scale of Young adults and the elderly in the six contexts...21 Figure 2-3-5 Difference of demand for attention and reaction time between elders andoung people..............................................................................................25igure 2-3-6 Reaction time of elders and young people under different contexts..........27igure 2-3-7 Body swaying scale of three ethnic groups under six situations................27igure 2-4-1 Graph of the force plate..............................................................................30igure 2-4-2 Track of body mass center and pressure center..........................................32igure 2-4-3 50% LOS assessment model......................................................................33igure 2-4-4 75% LOS assessment model......................................................................33igure 2-4-5 Motion Analysis System (Vicon 370).........................................................35igure 2-4-6 Functional Reach Test Equipment..............................................................36igure 2-4-7 Balance Equipment Available in Market: Equitest.....................................38igure 2-4-8 Balance Equipment Available in Market: Smart Equitest..........................38igure 2-4-9 Providing displacement or tilting disturbance (Source: NeuroCom).........38igure 2-5-1 Changes of Brain Cortex of Monkeys........................................................40igure 2-5-2 Balance Performance Monitor System.......................................................42igure 2-5-3 Postural Symmetry Training.......................................................................43igure 2-5-4 Steadiness Training.....................................................................................44igure 2-5-5 Dynamic Stability Training........................................................................45igure 2-7-1 Righting Reactions Assessment..................................................................54igure 2-7-2 Equilibrium Reaction Assessment..............................................................55igure 3-1-1 Experiment flow chart................................................................................58igure 3-2-1 Load Cell....................................................................................................59igure 3-2-2 Accelerometer.............................................................................................60igure 3-2-3 A foot column.............................................................................................61igure 3-2-4 Single foot platform....................................................................................61igure 3-2-5 The main mechanic platform......................................................................62igure 3-2-6 Handrails.....................................................................................................63igure 3-2-7 The main mechanic platform and handrails...............................................63igure 3-2-8 Signal Amplifier and the base.....................................................................65igure 3-2-9 USB-6218 Data Acquisition Card..............................................................66igure 3-3-1 Configuration options area.........................................................................67igure 3-3-2 Display area of mass center track...............................................................67igure 3-3-3 Display area of mass center offset..............................................................68igure 3-3-4 Display area of three-axis acceleration.......................................................69igure 3-3-5 Diagram of the visual feedback “point”.....................................................71igure 3-3-6 Diagram for individual directions assessment items..................................75igure 3-3-7 Individual directions assessment result analysis 1.....................................78igure 3-3-8 Individual directional assessment result analysis 2....................................79ist of Tablesable 2-4-1 Functional Reach Test and the risk for falls.................................................36able 3-4-1 Participant data.............................................................................................80able 3-5-1 Events and statistic analysis.........................................................................83able 4-2-1 Different result of “A, B” of normal young adults and stroke patients........88able 4-2-2(1) Different result of “C, D, E, F (forward)” of normal young adults andtroke patients..................................................................................................................89able 4-2-2(2) Different result of “C, D, E, F (right forward)” of normal young adultsnd stroke patients...........................................................................................................90able 4-2-2(3) Different result of “C, D, E, F (right)” of normal young adults and strokeatients.............................................................................................................................91able 4-2-2(4) Different result of “C, D, E, F (right backward)” of normal young adultsnd stroke patients...........................................................................................................92able 4-2-2(5) Different result of “C, D, E, F (backward)” of normal young adults andtroke patients..................................................................................................................93able 4-2-2(6) Different result of “C, D, E, F (left backward)” of normal young adultsnd stroke patients...........................................................................................................94able 4-2-2(7) Different result of “C, D, E, F (left)” of normal young adults and strokeatients.............................................................................................................................95able 4-2-2(8) Different result of “C, D, E, F (left forward)” of normal young adults andtroke patients..................................................................................................................96able 4-2-3 Different result between the eyes-open and eyes-closed stroke patients inasymmetries”.................................................................................................................97able 4-2-4 Different results between the eyes-open and eyes-closed normal youngdults in “asymmetries”...................................................................................................97able 4-2-5 Correlation between the Berg functional balance scale result and the one legtand test result of stroke patients....................................................................................99able 4-2-6 Correlation between the “asymmetries” score, the Berg functional balancecale result, and the one leg stand test result of stroke patients.......................................99able 4-2-7(1) Correlation between “C, D, E, F (forward)”score, Berg functionalalance scale result, and one leg stand test result of stroke patients.............................100able 4-2-7(2) Correlation between “C, D, E, F (right forward)”score, Berg functional balance scale result, and one leg stand test result of stroke patients.............................100able 4-2-7(3) Correlation between “C, D, E, F (right)”score, Berg functional balance scale result, and one leg stand test result of stroke patients..........................................101able 4-2-7(4) Correlation between “C, D, E, F (right backward)”score, Berg functional balance scale result, and one leg stand test result of stroke patients.............................101able 4-2-7(5) Correlation between “C, D, E, F (backward)”score, Berg functional balance scale result, and one leg stand test result of stroke patients.............................102able 4-2-7(6) Correlation between “C, D, E, F (left backward)”score, Berg functional balance scale result, and one leg stand test result of stroke patients.............................102able 4-2-7(7) Correlation between “C, D, E, F (left)”score, Berg functional balance scale result, and one leg stand test result of stroke patients..........................................103able 4-2-7(8) Correlation between “C, D, E, F (left forward)”score, Berg functional balance scale result, and one leg stand test result of stroke patients.............................103able 5-2-1 System parameter numbers significantly relevant (Pearson) to the Berg’s Functional Balance Scale and the one-foot standing experiment..................................107application/pdf1895721 bytesapplication/pdfen-US平衡系統平衡表現站立平衡balance systembalance performancestanding balancethesishttp://ntur.lib.ntu.edu.tw/bitstream/246246/184203/1/ntu-98-R96945026-1.pdf