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，全世界大约有1200万人受到影响。它表现为肌肉异常僵硬，引起疼痛，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的治疗方法以防止进行性畸形的关键步骤。然而，目前的临床评估依赖于基于感知的评分。主观评分是不一致的，不敏感的，因此不能准确地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高精度评估痉挛的生物力学指标。这种灵敏、一致的测量方法将允许临床医生检查一种疗法是否有效地缓解痉挛症状。便携式系统还将促进频繁的远程评估，以实现及时干预，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雷迪儿童医院举办年度无障碍博览会，为圣地亚哥当地的身体残疾儿童提供示范和传播资源，并在当地社区开展STEM外展活动。该项目的目标是通过多模型传感器手套捕捉痉挛肌肉的动态特征，以获得痉挛的物理机制的新见解。临床医生将戴上传感器手套，同时进行标准的评估操作，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，不像以前的生物力学设备，操作复杂，受笨重的传感器的限制，构成安全和临床应用障碍。该项目将开展关键的可行性研究，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。这项研究将使人们了解哪些生物力学特性与建立一个客观的尺度来跟踪痉挛的管理最相关。第二个目标是通过与机器人标准相结合的监督机器学习来提高测量标准化，以减轻伪影，并最大限度地提高监测痉挛的内部和内部一致性。第三个目标是促进护理人员的护理点测量，使家庭评估能够密切跟踪患者对临床就诊外治疗的反应。系统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。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识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.