Multi-finger coordination in healthy subjects and stroke patients: a mathematical modelling approach
Multi-finger coordination in healthy subjects and stroke patients: a mathematical modelling approach
复制标题
DOI：
10.1186/1743-0003-8-19
复制
发表时间：
2011-04-20
影响因子：
5.1
通讯作者：
Ferrarin, Maurizio
中科院分区：
文献类型：
--
作者：
Carpinella, Ilaria;Jonsdottir, Johanna;Ferrarin, Maurizio
背景：大约60%的中风幸存者经历手功能障碍，限制了日常活动的执行。目前已经提出了几种方法来客观地量化手指关节的运动范围（ROM），而很少有研究存在的多手指协调在手部运动。目前的工作分析了这方面，通过提供一个完整的表征的空间和时间方面的手的运动，通过数学建模的多关节手指运动在健康受试者和中风patients.Methods：手打开和关闭的运动进行了检查，在12名健康志愿者和14偏瘫中风幸存者通过光电运动学分析。计算所有手指的掌指关节（MCPJ）和近端指间关节（IPJ）的屈曲/伸展角，并通过四参数双曲正切函数进行数学表征。通过决定系数（R（2））和均方根误差（RMSE）分析所选模型的准确性。重测信度用组内相关系数（ICC）和重测误差来量化。通过分析描述手部运动学和关节间、手指间协调的角度和时间方面的参数的可能差异，比较健康对照者和中风受试者的表现。结果：所选模型准确地表征了手部张开和闭合的角度轮廓，无论是在健康对照者还是在中风受试者中（R（2）> 0.973，RMSE < 2.0度）。重测信度被认为是优秀的，与ICC > 0.75和评论错误与其他方法获得的。与健康对照组的比较显示，偏瘫手运动受损不仅在关节ROM，但也在运动的时间方面：峰值速度显着下降，手指间协调减少了50%以上，关节间协调模式高度中断。特别是，典型的近端到远端的开口顺序在健康受试者中发现的（在手闭合期间反向），在IPJ和MCPJ运动之间表现出异常高延迟或反向运动序列的中风受试者中改变。所提出的方法已被证明是一个有前途的工具，一个完整的客观表征的空间和时间方面的手运动在中风，为每个特定患者的康复治疗的更有针对性的计划和治疗结果的定量评估提供进一步的信息。
Background: Approximately 60% of stroke survivors experience hand dysfunction limiting execution of daily activities. Several methods have been proposed to objectively quantify fingers' joints range of motion (ROM), while few studies exist about multi-finger coordination during hand movements. The present work analysed this aspect, by providing a complete characterization of spatial and temporal aspects of hand movement, through the mathematical modelling of multi-joint finger motion in healthy subjects and stroke patients.Methods: Hand opening and closing movements were examined in 12 healthy volunteers and 14 hemiplegic stroke survivors by means of optoelectronic kinematic analysis. The flexion/extension angles of metacarpophalangeal (MCPJ) and proximal interphalangeal joints (IPJ) of all fingers were computed and mathematically characterized by a four-parameter hyperbolic tangent function. Accuracy of the selected model was analysed by means of coefficient of determination (R(2)) and root mean square error (RMSE). Test-retest reliability was quantified by intraclass correlation coefficient (ICC) and test-retest errors. Comparison between performances of healthy controls and stroke subjects were performed by analysing possible differences in parameters describing angular and temporal aspects of hand kinematics and inter-joint, inter-digit coordination.Results: The angular profiles of hand opening and closing were accurately characterized by the selected model, both in healthy controls and in stroke subjects (R(2) > 0.973, RMSE < 2.0 degrees). Test-retest reliability was found to be excellent, with ICC > 0.75 and remarking errors comparable to those obtained with other methods. Comparison with healthy controls revealed that hemiparetic hand movement was impaired not only in joints ROM but also in the temporal aspects of motion: peak velocities were significantly decreased, inter-digit coordination was reduced of more than 50% and inter-joint coordination patterns were highly disrupted. In particular, the stereotypical proximal-to-distal opening sequence (reversed during hand closing) found in healthy subjects, was altered in stroke subjects who showed abnormally high delay between IPJ and MCPJ movement or reversed moving sequences.Conclusions: The proposed method has proven to be a promising tool for a complete objective characterization of spatial and temporal aspects of hand movement in stroke, providing further information for a more targeted planning of the rehabilitation treatment to each specific patient and for a quantitative assessment of therapy's outcome.