基于肌张力特征信息检测的痉挛传感器设计与应用
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摘要
为脑卒中患者下肢肌肉痉挛检测及其评定,研制了一种基于肌张力特征信息进而评定痉挛等级的传感器。探讨了痉挛检测及量化评定标准需求,对痉挛传感器的结构进行了设计;针对不同痉挛等级的特征分布情况,基于痉挛特征信息,在改良Ashoworth量表MAS(Modified Ashworth Scale)基础上,进行了下肢关节被动活动过程中肌张力数据的采集实验;相关实验数据有效验证拟定的相关指标:包括肌张力分级阈值,痉挛等级等,实验结果表明痉挛传感器设计可行。
In order to detect and evaluate the muscle spasm of lower extremity for stroke patients,a muscle tension sensor device was developed. First of all,the paper explores the spasm detection and quantitative evaluation of the standard needs. Secondly,the structure of the muscle tension sensor was designed. Then,according to the distribution of the features of different spasticity levels,the experimental data of the muscle tension during the passive activities of the lower extremity joints were collected. Finally,based on the characteristic of spasticity information,the experimental verification was carried out on the basis of MAS( Modified Ashworth Scale). Relevant experimental data validated the proposed relevant indicators: including muscle tone grading threshold,spasticity grade,the experimental results show that the design of muscle tension sensor is feasible.
In order to detect and evaluate the muscle spasm of lower extremity for stroke patients,a muscle tension sensor device was developed. First of all,the paper explores the spasm detection and quantitative evaluation of the standard needs. Secondly,the structure of the muscle tension sensor was designed. Then,according to the distribution of the features of different spasticity levels,the experimental data of the muscle tension during the passive activities of the lower extremity joints were collected. Finally,based on the characteristic of spasticity information,the experimental verification was carried out on the basis of MAS( Modified Ashworth Scale). Relevant experimental data validated the proposed relevant indicators: including muscle tone grading threshold,spasticity grade,the experimental results show that the design of muscle tension sensor is feasible.
引文
[1]Sarah F Eby B S,Heng Zhao,Pengfei Song,et al.Quantifying Spasticity in Individual Muscles Using Shear Wave Elastography[J].Radiology Case Reports,2017,1(2):348-352.
[2]王荣丽,周志浩,席宇诚,等.机器人辅助脑瘫儿童踝关节康复临床初步研究[J].北京大学学报(医学版),2018,50(2):207-212.
[3]卢利萍,桑德春,季淑凤.下肢康复机器人LR2训练对偏瘫患者下肢肌痉挛和ADL能力改善的疗效观察[J].中国康复医学杂志,2018,24(1):45-49.
[4]Ashworth B.Preliminary Trial of Carisoprodol in Multiple Sclerosis[J].The practitioner,1964,192:540.
[5]R W.Bohannon R,M.B.Smith Interrater Reliability on a Modified Ashworth Scale of Muscle Spasticity[J].Physical Therapy,1987,67(2):206-207.
[6]Abdollahi I,Taghizadeh A,Shakeri H,et al.The Relationship between Isokinetic Muscle Strength and Spasticity in the Lower Limbs of Stroke Patients[J].Journal of Bodywork&Movement Therapies,2015,19(2):284-290.
[7]张尚,李晓捷,郭爽.痉挛型和不随意运动型脑性瘫痪儿童疼痛特点及对运动康复的影响[J].中国康复理论与实践,2018,24(2):196-202.
[8]Westbom L,Rimstedt A,Nordmark E.Assessments of Pain in Children and Adolescents with Cerebral Palsy:A Retrospective Population-Based Registry Study[J].Developmental Medicine&Child Neurology,2017,59(8):858-863.
[9]Vivekanand Thanikachalam,Chetan P Phadke,Farooq Ismail,et al.Effect of Botulinum Toxin on Clonus:A Systematic Review[J].Archives of Physical Medicine and Rehabilitation,2017(2):381-390.
[10]Dietz V.Neuronal Plasticity after a Human Spinal Cord Injury:Positive and Negative Effects[J].Experimental Neurology,2012,235(1):110-115.
[11]李宏伟,张韬,冯垚娟,等.外骨骼下肢康复机器人在脑卒中康复中的应用进展[J].中国康复理论与实践,2017,23(7):788-791.
[12]宋在杰.脑卒中患者下肢肌肉痉挛的检测机理及其特征感知获取研究[D].芜湖:安徽工程大学,2018.
[13]Srdan Dordevic,Marco Narici,Rado Pisot,et al.Measurement of Muscle Tension:Dynamic Properties of the MC Sensor during Isometric Muscle Contraction[J].Sensors,2014,14:17848-17863.
[14]吴芳玲,倪瑾,马兆丽.通用型肌张力量表的设计和信度检验[J].中国康复医学杂志,2013,28(2):157-159.
[15]张秀峰.基于HTT的肌电信号分析方法及其在痉挛评定中的应用[D].合肥;合肥工业大学,2017.
[16]Fleuren J F,Voerman G E,Erren-Wolters C V,et al.Stop Using the Ashworth Scale for the Assessment of Spasticity[J].Journal of Neurology,Neurosurgery&Psychiatry,2010,81(1):46-52.
[17]何玉庆,赵忆文,韩建达,等.与人共融-机器人技术发展的新趋势[J].机器人产业,2015(5):74-80.
[18]向馗,李涛,宋全军,等.面向外骨骼助力的肌张力信息实时获取[J].华中科技大学学报,2011,39(2):259-263.
[19]梁敬红,佟剑平,李翔.关节持续被动运动治疗下肢痉挛疗效观察[J].中国康复理论与实践,2008,14(11):1067-1067.
[20]Bar-On Lynn,Molenaers Guy,Aertbeli¨en Erwin,et al.The Relation between Spasticity and Muscle Behavior during the Swing Phase of Gait in Children with Cerebral Palsy[J].Research in Developmental Disabilities,2014,35(12):3354-3364.
[21]Bravo-Esteban E,Taylor J,Abian-Vicen J,et al.Impact of Specific Symptoms of Spasticity on Voluntary Lower Limb Muscle Function,Gait and Daily Activities during Subacute and Chronic Spinal Cord Injury[J].Neuro Rehabilitation,2013,33(4):531-543.
[2]王荣丽,周志浩,席宇诚,等.机器人辅助脑瘫儿童踝关节康复临床初步研究[J].北京大学学报(医学版),2018,50(2):207-212.
[3]卢利萍,桑德春,季淑凤.下肢康复机器人LR2训练对偏瘫患者下肢肌痉挛和ADL能力改善的疗效观察[J].中国康复医学杂志,2018,24(1):45-49.
[4]Ashworth B.Preliminary Trial of Carisoprodol in Multiple Sclerosis[J].The practitioner,1964,192:540.
[5]R W.Bohannon R,M.B.Smith Interrater Reliability on a Modified Ashworth Scale of Muscle Spasticity[J].Physical Therapy,1987,67(2):206-207.
[6]Abdollahi I,Taghizadeh A,Shakeri H,et al.The Relationship between Isokinetic Muscle Strength and Spasticity in the Lower Limbs of Stroke Patients[J].Journal of Bodywork&Movement Therapies,2015,19(2):284-290.
[7]张尚,李晓捷,郭爽.痉挛型和不随意运动型脑性瘫痪儿童疼痛特点及对运动康复的影响[J].中国康复理论与实践,2018,24(2):196-202.
[8]Westbom L,Rimstedt A,Nordmark E.Assessments of Pain in Children and Adolescents with Cerebral Palsy:A Retrospective Population-Based Registry Study[J].Developmental Medicine&Child Neurology,2017,59(8):858-863.
[9]Vivekanand Thanikachalam,Chetan P Phadke,Farooq Ismail,et al.Effect of Botulinum Toxin on Clonus:A Systematic Review[J].Archives of Physical Medicine and Rehabilitation,2017(2):381-390.
[10]Dietz V.Neuronal Plasticity after a Human Spinal Cord Injury:Positive and Negative Effects[J].Experimental Neurology,2012,235(1):110-115.
[11]李宏伟,张韬,冯垚娟,等.外骨骼下肢康复机器人在脑卒中康复中的应用进展[J].中国康复理论与实践,2017,23(7):788-791.
[12]宋在杰.脑卒中患者下肢肌肉痉挛的检测机理及其特征感知获取研究[D].芜湖:安徽工程大学,2018.
[13]Srdan Dordevic,Marco Narici,Rado Pisot,et al.Measurement of Muscle Tension:Dynamic Properties of the MC Sensor during Isometric Muscle Contraction[J].Sensors,2014,14:17848-17863.
[14]吴芳玲,倪瑾,马兆丽.通用型肌张力量表的设计和信度检验[J].中国康复医学杂志,2013,28(2):157-159.
[15]张秀峰.基于HTT的肌电信号分析方法及其在痉挛评定中的应用[D].合肥;合肥工业大学,2017.
[16]Fleuren J F,Voerman G E,Erren-Wolters C V,et al.Stop Using the Ashworth Scale for the Assessment of Spasticity[J].Journal of Neurology,Neurosurgery&Psychiatry,2010,81(1):46-52.
[17]何玉庆,赵忆文,韩建达,等.与人共融-机器人技术发展的新趋势[J].机器人产业,2015(5):74-80.
[18]向馗,李涛,宋全军,等.面向外骨骼助力的肌张力信息实时获取[J].华中科技大学学报,2011,39(2):259-263.
[19]梁敬红,佟剑平,李翔.关节持续被动运动治疗下肢痉挛疗效观察[J].中国康复理论与实践,2008,14(11):1067-1067.
[20]Bar-On Lynn,Molenaers Guy,Aertbeli¨en Erwin,et al.The Relation between Spasticity and Muscle Behavior during the Swing Phase of Gait in Children with Cerebral Palsy[J].Research in Developmental Disabilities,2014,35(12):3354-3364.
[21]Bravo-Esteban E,Taylor J,Abian-Vicen J,et al.Impact of Specific Symptoms of Spasticity on Voluntary Lower Limb Muscle Function,Gait and Daily Activities during Subacute and Chronic Spinal Cord Injury[J].Neuro Rehabilitation,2013,33(4):531-543.