Development of a clinician worn device for the evaluation of abnormal muscle tone.
Development of a clinician worn device for the evaluation of abnormal muscle tone.
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开发用于评估异常肌张力的临床医生佩戴设备。
DOI：
10.1109/embc.2014.6944523
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Giuffrida,JosephP
中科院分区：
文献类型：
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作者：
Brokaw,ElizabethB;Heldman,DustinA;Plott,RobertJ;Rapp,EdwardJ;Montgomery,ErwinB;Giuffrida,JosephP
神经性疾病，如脑瘫，通常会导致异常的肌肉过度活动，对受影响肢体的功能使用产生负面影响。脑瘫患者经常出现痉挛和肌张力障碍的混合症状，很难区分这些类型的异常音调的影响。不同类型的异常音调对脑深部刺激和巴氯芬等治疗的反应不同。传统的临床评估技术为区分异常音调特征和治疗后的变化提供了最少的信息。量化异常肌张力特征的设备可以帮助区分不同类型异常肌肉张力的影响，并有助于量化治疗效果。本文讨论了MyoSenseTM的研制和初步评价，这是一种临床医生佩戴的用于量化和区分异常肌肉张力的设备。MyoSense在临床医生操作受影响肢体的过程中评估方向、速度和力量，其方案类似于评估异常音调的传统做法。对MyoSense设备的评估显示，使用机械设备来模拟异常肌张力，可以很好地分辨异常肌张力特征。使用一种直接模拟传统临床评估异常音调的程序，MyoSense数据与模拟轮廓显示出良好的相关性，痉挛状态为0.8，高张力状态为0.93。对不同肢体操作速度的平均变化进行评估，以减轻加速和机械影响，结果是MyoSense数据与0.99的痉挛、抓住痉挛和肌张力障碍的模拟曲线相关。总体而言，这些结果显示了MyoSense设备未来的临床评估前景。
Neurological disorders such as cerebral palsy commonly result in abnormal muscle hyperactivity that negatively effects functional use of the affected limbs. Individuals with cerebral palsy often present with a mix of spasticity and dystonia, and it can be difficult to distinguish between the effects of these types of abnormal tone. Different types of abnormal tone respond differently to treatments such as deep brain stimulation and baclofen. Conventional clinical evaluation techniques provide minimal information for distinguishing abnormal tone characteristics and changes from treatment. Devices that quantify abnormal tone characteristics can help distinguish between the effects of different types of abnormal muscle tone, and help to quantify treatment effects. This paper discusses the development and initial evaluation of MyoSenseTM, a clinician worn device for the quantification and differentiation of abnormal muscle tone. MyoSense evaluates the orientation, speed, and force during clinician manipulation of the affected limbs with a protocol that is similar to conventional practice for evaluating abnormal tone. Evaluation of the MyoSense device, using a mechanical apparatus to simulate abnormal muscle tone, showed good resolution of abnormal tone characteristics. Using a procedure directly modeled after conventional clinical evaluation of abnormal tone, MyoSense data showed good correlation with simulated profiles, 0.8 for spasticity and 0.93 for hypertonia. Evaluation of average change across different limb manipulation speeds, to mitigate acceleration and mechanical effects, resulted in MyoSense data correlations to simulated profiles of 0.99 for spasticity, spasticity with a catch, and dystonia. Overall these results show promise for future clinical evaluation of the MyoSense device.