| Summary: | 碩士 === 長庚大學 === 醫療機電工程研究所 === 94 === In anterior cruciate ligament (ACL) deficient or reconstructed populations, have a problem of loss of proprioception in knee, and usually it may result in ACL recurrent injury or knee arthritis. The improvement of the peripheral proprioceptive sensory input of knee to compensate the loss of proprioception with ACL-deficient or reconstructed is an important topic to discuss.
In this research, knee angle biofeedback motor control rehabilitation system (KABIS) was developed for ACL-deficient or reconstructed patients to reinforce the peripheral proprioceptive sensory input. A knee angle biofeedback motor control rehabilitation system (KABIS) was constructed, consisting of a self-made knee orthosis with an electric goniometer and a microcomputer-monitoring device attached to a lateral pocket. The electric goniometer was constructed from 2 anatomically aligned metal stabilizers with a potentiometer at the hinge. It was placed on the lateral side of the orthosis. The battery-powered microcomputer-monitoring unit was mounted on a waist belt worn by the patients.
The KABIS provides visual feedback whenever flexion and extension joint angle pass a present threshold goal. The device can be set for feedback-on mode, in which visual feedback are on, or feedback-off mode, in which the device monitor and log every motion that passes the present threshold but does not provide visual feedback. The monitoring unit also acts as an electronic recorder for the patients to range their knee at threshold or over threshold. The monitoring unit has counters that track and record each event and how long the device is worn. The recorded information can be easily downloaded into a portable computer.
The core of the KABIS is the Borland C++ interface (19.5 cm 27 cm 37.5 cm workspace size, 0.03 mm 2-D positional resolution increment, 2 active degree of free freedom, 4 evaluation module included (1) straight path module; (2) sinus-shaped wave path module; (3) square-shaped wave path module; (4) arbitrarily manual hand draw path module. A complex and movement demanding virtual environment, representing a straight path, sinus-shaped wave, square-shaped wave or arbitrarily manual hand draw path is aligned with the patient’s frontal plane. The patient can move the pointer, represented with a ball, through the straight path, sinus-shaped wave, square-shaped wave or arbitrarily manual hand draw path in two dimensions by moving the KABIS digital knee angle biofeedback motor control system. The visual information is fedback to the patient using a computer display and KABIS interface. The patient can see the ball moving in the path contact with the straight path, sinus-shaped wave, square-shaped wave arbitrarily manual hand draw path’s walls and can corrected the direction of the ball to prevent it touch the walls (threshold of AROM).
Eight individuals with ACL reconstruction participated in the study. Participants were asked to exercise with KABIS for 30 minute. Physiologic data were collected before and after the exercise. The two evaluation test of joint position sense test (JPS) and body sway of single support test (BSSS), there were significant differences ( p＜0.05 ) between before and after played the game. the other two evaluation test of the hold duration of single support test (SST) and knee sway of single support test (KSSS), there were no significant differences ( p≧0.05 ) between before and after played the game.
In this research, we provide a new idea to solve the loss of pro-prioception with ACL-deficient or ACL reconstructed. And future medical trials are required to establish clinical efficacy in rehabilitation.
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