本研究再次驗證本實驗室開發之多目標最佳控制方法足以描述跨越障礙物之 控制策略。關於跨越障礙物的動作分析多數使用個關節的狀態變數(state variables)，
例如關節角度、關節力矩等，這些研究確實的幫助我們了解跨越障礙物的動作型 態，但是只用運動學與動力學要探討障礙物高度對於跨越障礙物動作的影響還有 爭議，因為每當障礙物高度改變，某些變數改變，某些變數不變，難以說明跨越 障礙物是與障礙物高度之間無關聯。多目標最佳化控制方法同時考慮人體運動學 與動力學，並搭配多目標最佳化方法，成功的找到一個簡易表示跨越障礙物整體 控制策略的方法。
本研究貢獻主要將多目標最佳控制方法運用在帕金森氏症患者跨越障礙物與 後腳跨越障礙物的運動控制策略討論。
本研究提供正常中老年人之跨越障礙物控制策略，搭配過去年輕人跨越障礙 物策略之結果，可得知年齡對跨越障礙物控制策略的影響。
關於帕金森氏症患者，本研究討論第一期患者健側與患側的差異；第二至三 期患者服藥前後之差異，未來可用於帕金森氏症分級與用藥效果評估之參考。
本研究也提供後腳跨越障礙物之控制策略，探討前後腳跨越障礙物的策略差 異，有助於更進一步的了解跨越障礙物動作的全貌，並提供跨越障礙物控制策略 一個簡易、方便的指標。
未來若多目標最佳控制方法能加入其他平面上取得的運動資訊將可以更完整 的描述控制策略或探討不同動作或不同疾病患者的運動控制策略。
參考文獻
1. Sattin, R.W., Falls among older persons: a public health perspective. Annu Rev Public Health, 1992. 13: p. 489-508.
2. Tinetti, M.E. and M. Speechley, Prevention of falls among the elderly. N Engl J Med, 1989. 320(16): p. 1055-9.
3. Tinetti, M.E., M. Speechley, and S.F. Ginter, Risk factors for falls among elderly persons living in the community. N Engl J Med, 1988. 319(26): p. 1701-7.
4. Lu, T.-W., S.-C. Chen, and H.-C. Chiu, Best-compromise between mechanical energy expenditure and foot clearance predicts leading limb motion during obstacle-crossing. Gait & Posture, 2012. 36(3): p. 552-556.
5. Obeso, J.A., et al., The basal ganglia and disorders of movement:
pathophysiological mechanisms. News in physiological sciences : an
international journal of physiology produced jointly by the International Union of Physiological Sciences and the American Physiological Society, 2002. 17: p.
51-55.
6. Nambu, A., et al., Dynamic Model of Basal Ganglia Functions and Parkinson’s DiseaseThe Basal Ganglia VIII, J.P. Bolam, C.A. Ingham, and P.J. Magill, Editors. 2005, Springer US. p. 307-312.
7. Fung, H.-C., et al., Analysis of the PINK1 gene in a cohort of patients with sporadic early-onset parkinsonism in Taiwan. Neuroscience Letters, 2006.
394(1): p. 33-36.
8. Hoehn, M.M. and M.D. Yahr, Parkinsonism: onset, progression and mortality.
Neurology, 1967. 17(5): p. 427-42.
9. Chen, H.C., et al., Stepping over obstacles: gait patterns of healthy young and old adults. J Gerontol, 1991. 46(6): p. M196-203.
10. Austin, G.P., G.E. Garrett, and R.W. Bohannon, Kinematic analysis of obstacle clearance during locomotion. Gait Posture, 1999. 10(2): p. 109-20.
11. Sparrow, W.A., et al., Characteristics of gait in stepping over obstacles. Hum.
mov. sci. , 1996. 15(4): p. 605-622.
12. Chen, H.L., T.W. Lu, and H.C. Lin, Three-dimensional kinematic analysis of stepping over obstacles in young subjects. Biomed Eng Appl Basis Comm, 2004.
16: p. 157-64.
13. Lu, T.W., H.L. Chen, and S.C. Chen, Comparisons of the lower limb kinematics between young and older adults when crossing obstacles of different heights.
Gait Posture, 2006. 23(4): p. 471-9.
14. Lu, T.-W., H.-C. Yen, and H.-L. Chen, COMPARISONS OF THE INTERJOINT COORDINATION BETWEEN LEADING AND TRAILING LIMBS WHEN
CROSSING OBSTACLES OF DIFFERENT HEIGHTS. J Biomech, 2007. 40, Supplement 2(0): p. S163.
15. Yen, H.C., et al., Age effects on the inter-joint coordination during obstacle-crossing. J Biomech, 2009. 42(15): p. 2501-6.
16. Huang, S.-C., et al., Age and height effects on the center of mass and center of pressure inclination angles during obstacle-crossing. Medical Engineering
& Physics, 2008. 30(8): p. 968-975.
17. Chou, L.S. and L.F. Draganich, Stepping over an obstacle increases the motions and moments of the joints of the trailing limb in young adults. J Biomech, 1997.
30(4): p. 331-7.
18. Chou, L.S. and L.F. Draganich, Increasing obstacle height and decreasing toe-obstacle distance affect the joint moments of the stance limb differently when stepping over an obstacle. Gait Posture, 1998. 8(3): p. 186-204.
19. Chen, H.L. and T.W. Lu, Comparisons of the joint moments between leading and trailing limb in young adults when stepping over obstacles. Gait Posture, 2006.
23(1): p. 69-77.
20. Anderson, F.C. and M.G. Pandy, A Dynamic Optimization Solution for Vertical Jumping in Three Dimensions. Comput Methods Biomech Biomed Engin, 1999.
2(3): p. 201-231.
21. Pandy, M.G., B.A. Garner, and F.C. Anderson, Optimal control of non-ballistic muscular movements: a constraint-based performance criterion for rising from a chair. J Biomech Eng, 1995. 117(1): p. 15-26.
22. Chou, L.S., S.M. Song, and L.F. Draganich, Predicting the kinematics and kinetics of gait based on the optimum trajectory of the swing limb. J Biomech, 1995. 28(4): p. 377-85.
23. Nubar, Y. and R. Contini, A minimal principle in biomechanics. Bull. Math.
Biophys., 1961. 23: p. 377-390.
24. Zarrugh, M.Y., Power requirements and mechanical efficiency of treadmill walking. J Biomech, 1981. 14(3): p. 157-65.
25. Armand, M., J.P. Huissoon, and A.E. Patla, Stepping over obstacles during locomotion: insights from multiobjective optimization on set of input parameters.
IEEE Trans Rehabil Eng, 1998. 6(1): p. 43-52.
26. Pandy, M.G., F.C. Anderson, and D.G. Hull, A parameter optimization approach for the optimal control of large-scale musculoskeletal systems. J Biomech Eng, 1992. 114(4): p. 450-60.
27. Chao, E.Y.-S. and K. Rim, Application of optimization principles in determining the applied moments in human leg joints during gait. J Biomech, 1973. 6(5): p.
497-510.
28. Hurmuzlu, Y., C. Basdogan, and J.J. Carollo, Presenting joint kinematics of human locomotion using phase plane portraits and Poincaré maps. J Biomech, 1994. 27(12): p. 1495-1499.
29. Ju, M.S. and J.M. Mansour, Simulation of the double limb support phase of human gait. J Biomech Eng, 1988. 110(3): p. 223-9.
30. Onyshko, S. and D.A. Winter, A mathematical model for the dynamics of human locomotion. J Biomech, 1980. 13(4): p. 361-368.
31. Amirouche, F.M.L. and S.K. Ider, Simulation and analysis of a biodynamic human model subjected to low accelerations—A correlation study. Journal of Sound and Vibration, 1988. 123(2): p. 281-292.
32. Hatze, H., A three-dimensional multivariate model of passive human joint torques and articular boundaries. Clinical Biomechanics, 1997. 12(2): p.
128-135.
33. McFadyen, B.J. and H. Carnahan, The superimposed adjustments for obstacle clearance and level-to-stair transition during normal human gait. J Biomech, 1994. 27(6): p. 809.
34. Lu, T.-W., Geometric and mechanical modelling of the human locomotor system.
1997.
35. Dempster, W.T., Space requirement of the seated operator. 1955: Aerospace Medical Research Laboratories, Ohio.
36. Chen, Z.-Y., Movement analysis in patients with Parkinson's disease during walking and obstacle crossing.2012: National Taiwan Univercity, Taiwan.