| Summary: | 碩士 === 國立成功大學 === 醫學工程研究所 === 86 === AbstractThe prevalence of stroke, which is caused from
hemorrhage or infarction in the brain, has been substantial in
Taiwan. The prognosis of stroke is different due to the injured
areas of the brain. Brunnstrom developed the assessment of
sequential recovery stages in hemiplegia commonly used by
physical therapists. This assessment describes qualitatively
two major characteristics of synergy and spasticity. Synergy is
defined by simultaneous co-contraction of agonist and antagonist
as well as synergist, which lead to changes of angular motion of
several joints. Due to lack of quantitative investigation, the
objective of this research was to characterize the synergy
patterns for lower limbs movement in stroke patients by using
kinematics data analysis. More specifically, a 3space trace
system was used to record the kinematics data, then the
relationships for synergy patterns between hip, knee, and ankle
joint trajectory during the time sequence of movement were
quantitatively analyzed and characterized. The experiment of
lower limb movements include flexion in supine position and
extension in sidelying. The study is to test the hypothesis
that synergy characteristics could be quantified from the
trajectory of joint movements.Experiment group included seven
stroke patients recruited from the National Cheng-Kung
University Hospital. Control group consisted of seven able-
bodied subjects in order to establish able-bodied patterns for
comparative evaluation. The movement testing was required for
pre-training until consistency and reproducible to increase
intra-reliability. Neuromuscular control is velocity-dependent,
environmental factors and bio-feedback are highly likely to
influence in synergy movement. High speed movement would like
to minimize these interference; therefore, subjects in both
groups were requested to perform the tested movement with their
fastest speed. Subjects were repeated thirty times in every
trial for averaging out variations and increasing reliability in
this dynamic nature. Kinematics data was collected with 3space
fastrak system and four receivers with overall sampling rate at
120 Hz. The receivers, which were placed on pelvis, thigh,
shank and foot, had recorded angular movement data of hip, knee,
and ankle joints including flexion, extension, abduction,
adduction, internal and external rotation. Ten landmarks were
need for Euler angle transformation including both anterior and
posterior iliac spine, epicondyles, malleolus, 1st, and 5th
metatarsal head.The results show that different patterns could
be happened in normal subjects. Hip rotation is different
between CVA and normal subjects. Brunnstrom clinic evaluation
of CVA can be characterized by this quantitative assessment.
The synergy association between the paired joint angles could be
identified by regression analysis. Statistical analysis were
sufficient in further systematic study including regression
analysis for correlation and association, least-square error
method, linear or nonlinear best-fit, determining correlation
coefficients, statistical significance, and piecewised
linearlization for time sequence activity. 3SPACE is needed to
be reconsidered in this kinematics study.(Keywords: cerebral
vascular accident, CVA, stroke, hemiplegia, synergy)
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