高齡化社會造成腦中風人口日益增加，而中風的治療除了初期的手術與後續的藥物之外，復健也是很重要的一環，以期盡量恢復其運動能力。但復健的過程往往是枯燥乏味；一再重複進行單調的動作，而且每天都要施行，使得中風患者復健意願不高，物理治療師也擔心中風患者出了醫院復健中心就不再持續復健。
在本研究中設計了一套行動裝置的復健輔助系統，並分析日常生活中最常見的功能性動作：由坐到站，包含了前端的慣性量測設備、量化復健結果和即時語音回饋，並搭配互動式網頁讓遠端的物理治療師得知院外的復健狀況。
研究中分成兩個階段，第一階段為多維度慣性系統量測：使用多顆多維度慣性系統量測由坐到站，並統計出適合擺放行動裝置的身體位置，以及量測出中風患者和健康受測者的分數區間。第二階段為開發Android應用程式：量測與分析重心轉移時間、站起最大施力、人體質量重心晃動軌跡長度和人體內外側傾斜角度。並進行臨床試驗以驗證系統的可用性。

The stroke patients are increasing by the aging society. The rehabilitation is always associated with surgery or drug treatments, which is a very important part for regaining the movement abilities. However the rehabilitation process is usually tedious, which continuously repeats the same exercise day to day. That frequently makes patient resists the rehabilitation. The physical therapist as well concerns the patient’s rehabilitation after their discharge.
This study proposed a stroke rehabilitation assistant system basing on the mobile device, which could record and analyze the daily fundamental functional movement of “sit to stand”. The system uses the internal inertial measurement devises to quantify the rehabilitation and provides real time voice feedback. Additionally, an interactive website was also offered, which enables the physical therapists to realize the patinet’s rehabilitation all the time.
This is a two-phase study. In the first phase, a multi-inertial measurement unit was used to determine the suitable position for mobile device’s measurement and the scoring. In the second phase, a android application was developed to measure and analyze the weight transfer time, rising max G-force, center of mass sway trajectory length, and medial-lateral tilt angle. A clinical trial had been held for confirming the system availability.

[1] World Health Organization, (2012, March 28). Interesting facts about ageing. Ageing and Life Course, [Online]. Available: http://http://www.who.int/ageing/about/facts/en/.
[2] 行政院主計總處。國情統計通報，第190號，2013年10月。
[3] World Health Organization, “Global burden of stroke,” The Atlas of Heart Disease and Stroke, 2004, pp. 50-51.
[4] 行政院衛生福利部統計處。全民健康保險醫療統計年報，民國92年至民國101年。
[5] 行政院衛生福利部統計處。死因統計，民國101年。
[6] P. C. McLeod, D. B. Kettelkamp, V. Srinivasan and O. L. Henderson, “Measurements of Repetitive Activities of the Knee,” Journal of Biomechanics, Vol. 8, No. 6, pp. 369-370, 1975.
[7] T. P. Andriacchi, G. B. Andersson, R. W. Fermier, D. Stern and J. O. Galante, “A Study of Lower-limb Mechanics during Stair-climbing,” The Journal of bone and joint surgery American volume, Vol. 62, No. 5, pp. 749-757, 1980.
[8] R. A. Berger, P. O. Riley, R. W. Mann and W. A. Hodge, “Total Body Dynamics in Ascending Stairs and Rising from a Chair following Total Knee Arthroplasty,” Proceedings of the 34th Annual Meeting, Orthopedic Research Society, pp. 542, February 1988.
[9] K. Yoshida, H. Iwakura and F. Inoue, “Motion Analysis in the Movements of Standing up from and Sitting down on a Chair,” Scandinavian journal of rehabilitation medicine, Vol. 15, No. 3, pp. 133-140, 1983.
[10] M. E. Tinetti, F. T. Williams and R. Mayewski, “Fall Risk Index for Elderly Patients based on Number of Chronic Disabilities,” The American Journal of Medicine, 80, Vol. 30, No. 3, pp.429-434, 1986.
[11] F. Bloch, M. Thibaud, B. Dugue, C. Breque, A. S. Rigaud and G. Kemoun, “Episodes of falling among elderly people: a systematic review and meta-analysis of social and demographic pre-disposing characteristics,” Clinics, Vol. 65, No. 9, pp.895-903, 2010.
[12] L. G. Branch and A. R. Meyers, “Assessing physical function in the elderly,” Clinics in Geriatric Medicine, Vol. 3, No. 1, pp.29-51, 1987.
[13] J. H. Carr and A. M. Gentile, “The Effect of Arm Movement on the Biomechanics of Standing up,” Human Movement Science, Vol. 13, No. 2, pp.175-193, 1994.
[14] R. B. Shepherd and A. M. Gentile, “Sit-to-stand: Functional relationship between upper body and lower limb segments,” Human Movement Science, Vol. 13, No. 6, pp.817-840, 1994.
[15] Q. Yen. (2014, February 22). NHI to cancel insurance for physical therapy treatment, [Online]. Available: http://www.chinapost.com.tw/taiwan/national/national-news/2014/02/22/401231/NHI-to.htm.
[16] J. D. Spence, “Intensive risk factor control in stroke prevention,” F1000 Prime Reports, Vol. 5, pp.1-11, 2013.
[17] G. A. Donnan, M. Fisher, M. Macleod and S. M. Davis, “Stroke,” The Lancet, Vol. 371, No. 9624, pp.1612-1623, 2008.
[18] L. Z. Barry, M. Marvin and S. C. Lawrence, “HEART BOOK,” The Lancet, Vol. 371, No. 9624, pp.215-233, 2008.
[19] M. P. Lindsay, G. Gubitz, M. Bayley, M. D. Hill, C. Davies-Schinkel, S. Singh and S. Phillips, “Canadian best practice recommendations for stroke care,” F1000 Prime Reports, Vol. 179, No. 12, pp.S1-S25, 2008.
[20] R. Easell, N. Bayona and J. Bitensky, “Background Concepts in Stroke Rehabilitation,” Evidence Based Review of Stroke Rehabilitation, 2013, pp.1-44.
[21] A. Andersson, L. A. Levin, B. Oberg and L. Mansson, “Health care and social welfare costs in home-based and hospital-based rehabilitation after stroke,” Scandinavian Journal of Caring Sciences, Vol. 16, No. 4, pp.386-392, 2002.
[22] L. Legg and P. Langhorne, “Therapy-Based Rehabilitation for Stroke Patients Living at Home,” Stroke, Vol. 35, No. 4, pp.1022-1023, 2004.
[23] K. Andrews and J. Steward, “Stroke Recovery: He Can But Does He? ,” Rheumatology and rehabilitation, Vol. 18, No. 1, pp.43-48, 1979.
[24] R. Forkan, B. Pumper, N. Smyth, H. Wirkkala, M. A Ciol and A. Shumway-Cook, “Exercise adherence following physical therapy intervention in older adults with impaired balance,” Physical Therapy, Vol. 86, No. 3, pp.401-410, 2006.
[25] R. E. Mayagoitia, J. C. Lotters, P. H. Veltink and H. Hermens, “Standing balance evaluation using a triaxial accelerometer,” Gait and Posture, Vol. 16, No. 1, pp.55-59, 2002.
[26] S. R. Lord, S. M. Murray, K. Chapman, B. Munro and A. Tiedemann, “Sit-to-stand performance depends on sensation, speed, balance, and psychological status in addition to strength in older people,” The Journals of Gerontology: Series A, Vol. 57, No. 9, pp.539-543, 2002.
[27] M. o'loughlin, “Human Anatomy,” A First Look at Antomy, 2004, pp. 1-16.
[28] C. Franco, A. Fleury, P. Y. Gumery, B. Diot, J. Demongeot and N. Vuillerme, “iBalance-ABF: a smartphone-based audio-biofeedback balance system,” IEEE Transactions on Biomedical Engineering, Vol. 60, No. 1, pp.211-215, 2013.
[29] B. C. Lee, J. Kim, S. Chen and K. H. Sienko, “Cell phone based balance trainer,” Journal of NeuroEngineering and Rehabilitation, Vol. 9, No. 10, pp.1-14, 2012.
[30] A. Goodney, J. Jung, S. Needham and S. Poduri, “Dr. Droid: Assisting Stroke Rehabilitation Using Mobile Phones,” Lecture Notes of the Institute for Computer Sciences, Social Informatics and Telecommunications Engineering, Vol. 76, pp.231-242, 2012.
[31] A. R. Burdi, D. F. Huelke, R. G. Snyder and G. H. Lowrey, “An Overview of Anatomical Considerations of Infants and Children in the Adult World of Automobile Safety Design,” Journal of Biomechanics, Vol. 2, No. 3, pp.267-280, 1969.
[32] C. Ellis-Hill, J. Robison, R. Wiles, K. McPherson, D. Hyndman and A. Ashburn, “Going home to get on with life: patients and carers experiences of being discharged from hospital following a stroke,” Disability and Rehabilitation, Vol. 31, No. 2, pp.61-72, 2009.
[33] P. N. Mechael, “The Case for mHealth in Developing Countries,” Innovations: Technology, Governance, Globalization, Vol. 4, No. 1, pp.103-118, 2009.
[34] C. J. Wu, S. Y. Wu, P. C. Chen and Y. S. Lin, “An innovative smartphone-based otorhinoendoscope and its application in mobile health and teleotolaryngology,” Journal of Medical Internet Research, Vol. 16, No. 3, pp.1-16, 2014.
[35] R. C. Van Lummel, E. Ainsworth, U. Lindemann, W. Zijlstra, L. Chiari, P. V. Campen and J. M. Hausdorff, “Automated approach for quantifying the repeated sit-to-stand using one body fixed sensor in young and older adults,” Gait & Posture, Vol. 38, No. 1, pp.153-156, 2012.
[36] R. B. Shepherd and A. M. Gentile, “Sit-to-stand:functional relationships between upper body and lower limb segments,” Human Movement Science, Vol. 13, No. 6, pp.817-840, 1994.
[37] M. V. Rodosky, T. P. Andriacchi and G. B. Andersson, “The influence of chair height on lower limb mechanics during rising,” Journal of Orthopaedic Research, Vol. 7, No. 2, pp.266-271, 1989.
[38] G. Roy, S. Nadeau, D. Gravel, F. Malouin, B. J. McFadyen and F. Piotte, “The effect of foot position and chair height on the asymmetry of vertical forces during sit-to-stand and stand-to-sit tasks in individuals with hemiparesis,” Clinical Biomechanics, Vol. 21, No. 6, pp.585-593, 2006.
[39] J. H. Carr, E. G. John and R. B. Shepherd, “Some biomechanical characteristics of standing up at three different speeds: implications for functional training,” Physiotherapy Theory and Practice, Vol. 18, No. 2, pp.47-53, 2002.
[40] J. Zhao, J. Jia, H. Wang and W. Li, “A Novel Threshold Accelerometer With Postbuckling Structures for Airbag Restraint Systems,” IEEE Sensors Journal, Vol. 7, No. 8, pp.1102-1109, 2007.
[41] Analog Devices Inc., Digital Accelerometer, June 2007.
[42] H. Sternberg and H. Sternberg, “Qualification Process for MEMS Gyroscopes for the Use in Navigation Systems,” Proceedings of the 5th Symposium on Mobile Mapping Technology, pp.285-292, 2008.
[43] A. Edelstein, “Advances in magnetometry,” Journal of Physics: Condensed Matter, Vol. 19, No. 16, pp.165217-165244, 2007.
[44] A. G. Cutti, A. Giovanardi, L. Rocchi, A. Davalli and R. Sacchetti, “ Ambulatory measurement of shoulder and elbow kinematics through inertial and magnetic sensors,” Medical & Biological Engineering & Computing, Vol. 46, No. 2, pp.169-179, 2007.
[45] H. Ghasemzadeh and B. Prabhakaran, “A Body Sensor Network With Electromyogram and Inertial Sensors: Multimodal Interpretation of Muscular Activities,” IEEE Transactions on Information Technology in Biomedicine, Vol. 14, No. 2, pp.198-206, 2010.
[46] M. Schulze, T. Calliess, M. Gietzelt, K. H. Wolf, T. H. Liu, F. Seehaus, R. Bocklage, H. Windhagen and M Marschollek, “Development and clinical validation of an unobtrusive ambulatory knee function monitoring system with inertial 9DoF sensors,” IEEE Engineering in Medicine and Biology Society, pp.1968-1971, 2012.
[47] Xsens Inc., Xsens MTw: Miniature Wireless Inertial Motion Tracker for Highly Accurate 3D Kinematic Applications, 2013.
[48] Xsens Inc., Mtw-leaflet MTw Development Kit, 2013.
[49] Texas Instruments Inc., TI HealthTech Fitness Guide, 2013.
[50] K. Seifert and O. Camacho, “ Implementing Positioning Algorithms Using Accelerometers,” Freescale Semiconductor Application Note, 2007.
[51] W. G. Janssen, D. G. Külcü, H. L. Horemans, H. J. Stam, J. B. Bussmann, “Sensitivity of accelerometry to assess balance control during sit-to-stand movement,” IEEE Transactions on Neural Systems and Rehabilitation Engineering, Vol. 16, No. 5, pp.479-484, 2008.
[52] R. Meier, “Introducing the Development Framework,” Professional Android 4 Application Development, pp.14-20, 2012.
[53] B. Evjen, “Application and Page Frameworks,” Professional ASP.NET 4 in C# and VB, pp.32-40, 2010.