Biomechanical Models and Objective Metrics for Spasticity Rehabilitation

痉挛是一种由大脑或神经损伤引起的慢性神经肌肉疾病，影响着全球约1200万人。它表现为异常的肌肉僵硬，导致疼痛并干扰运动，影响平衡和日常功能。评估痉挛的严重程度是为患者选择适当治疗以预防进行性畸形的关键步骤。然而，当前的临床评估依赖于基于感知的评级。已知主观评级不一致且不敏感，因此无法准确监测药物或治疗的效果。为了便于更好的诊断，该项目旨在通过便携式传感器手套系统提供生物力学指标，以高精度评估痉挛。灵敏、一致的测量将使临床医生能够检查治疗是否有效缓解痉挛症状。便携式系统还将促进频繁的远程评估，以便能够及时干预，降低成本并改善患者护理。在整个项目期间，研究人员和学生将在拉迪儿童医院举办年度活动，为圣地亚哥当地的肢体残疾儿童提供演示和传播资源，并在当地社区开展STEM外展活动。该项目的目标是通过多型号传感器手套捕捉痉挛肌肉的动态特征，以获得对痉挛的物理机制的新见解。临床医生将戴上传感器手套，同时进行标准评估演习，以测量患者的肌肉阻力和运动轨迹。这种可穿戴工具结构紧凑，用户友好，不像现有的生物力学设备，操作复杂，并受到笨重的限制，限制传感器，造成安全和临床采用障碍。该项目将进行关键的可行性研究，以监测接受常规治疗的患者队列。第一个目标是通过生物力学模型来表征痉挛肌肉，从而定量地将治疗效果与特定生物力学特性的变化联系起来。这项研究将导致知识有关的生物力学特性是最相关的建立一个客观的规模，以跟踪随着时间的推移痉挛的管理。 第二个目标是通过监督机器学习结合机器人标准来提高测量标准化，以减少伪影并最大限度地提高痉挛监测中的评估者间和评估者内一致性。第三个目标是促进护理人员的护理点测量，以实现密切跟踪患者对临床访视以外的治疗的反应的家庭评估。该系统的用户界面和分析算法将与康复临床医生团队和护理人员密切合作开发，以消除实际临床使用的障碍，并促进未来的远程医疗。该奖项反映了NSF的法定使命，并通过使用基金会的智力价值和更广泛的影响审查标准进行评估，被认为值得支持。

Spasticity is a chronic neuromuscular disorder due to brain or nerve damages that affects roughly 12 million people worldwide. It is manifested as an abnormal muscle stiffness that causes pain and interferes with movement, impacting balance and daily functions. Evaluating the severity of spasticity is a crucial step in selecting appropriate treatments for patients to prevent progressive deformities. However, current clinical evaluations rely on ratings based on perception. The subjective ratings are known to be inconsistent and not sensitive and as such fail to accurately monitor the effects of medications or therapies. To facilitate better diagnosis, this project aims to deliver biomechanical metrics for evaluating spasticity with high accuracy through a portable sensor glove system. The sensitive, consistent measurements will allow clinicians to inspect whether a therapy effectively relieves spasticity symptoms. The portable system will also facilitate frequent remote assessments to enable timely interventions, reduce costs, and improve patient care. Throughout this duration of this project, the investigators and students will host annual AccessAbility Fair at Rady Children’s Hospital to provide demonstrations and to disseminate resources for local San Diego children with physical disabilities and conduct STEM outreach activities in local communities.The goal of this project is to capture the dynamic characteristics of spastic muscles through a multi-model sensor glove, in order to gain new insights into the physical mechanisms of spasticity. The clinicians would wear the sensor glove while carrying out standard evaluation maneuvers to measure a patient’s muscle resistance and movement trajectories. This wearable tool is compact and user friendly, unlike prior biomechanical devices that are complex to operate and limited by unwieldy, constraining sensors that pose safety and clinical adoption barriers. This project will carry out key feasibility studies to monitor patient cohorts undergoing routine treatments. The first objective is to characterize spastic muscles through biomechanical models, and thereby quantitatively connect the effects of treatments to changes in specific biomechanical properties. The research will lead to knowledge concerning which biomechanical properties are the most relevant for establishing an objective scale to track the management of spasticity over time. The second objective is to improve measurement standardization through supervised machine learning in combination with a robotic standard, to mitigate artifacts and maximize the inter- and intra-rater consistency in monitoring spasticity. The third objective is to facilitate point-of-care measurements by caregivers, to enable at-home assessment that closely tracks the patients’ response to therapies outside of clinical visits. The system user interface and analysis algorithms will be developed in close collaboration with the rehabilitation clinician team and caregivers, to dismantle the barriers to practical clinical use and facilitate telemedicine in the future.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.