Development of a clinical method for the rehabilitative evaluation of spasticity

痉挛是指由于脑血管意外等中枢神经系统功能障碍而导致的高张力。痉挛会影响人们日常生活中的饮食、步态等活动，导致自主活动障碍，在临床上，痉挛主要是根据受检者对被动伸展的抵抗力的特点，通过主观印象来评价的。然而，这种痉挛状态的临床评估方法有一些局限性，如定性和可靠性差。此外，有关痉挛的实质特征和康复干预效果的科学证据尚不清楚。本研究旨在开发一种使用手持测量设备进行痉挛的临床评估方法。手持式测量装置由带有压力传感器的Palmer板、皮带和模拟输出组成。在被动伸展时，通过检测手持式测量设备上的模拟信号来测量痉挛程度。手持测量装置输出的模拟信号以1 kHz的采样频率转换为数字信号。用生物信息分析软件(Kissei-Comtec，BIMUTAS II)对转换后的数字信号进行分析。从幅度和波形两个方面分析了痉挛的特点，初步认为该手持式测试装置是一种实用的痉挛测试工具。

Spasticity is defined as hypertonicity due to dysfunction of central nervous system such as cerebro-vascular accident. Activities of daily living such as eating and gait are affected by spasticity, resulting in disorders of voluntary movement.In clinical field, spasticity has been evaluated by subjective impression of the examiner based on the characteristics of resistance to passive stretching. However, this clinical evaluation method for spasticity has several limitations, such as being qualitative and poor reliability. Furthermore, the scientific evidence regarding the substantial characteristics of spasticity and the effects of intervention in rehabilitation is not clear.This study aimed to develop a clinical evaluation method for spasticity using a handheld measurement device. The handheld measurement device consisted of a palmer plate with pressure sensor, belt, and an analogue output. Spasticity was measured through the detection of the analogue signals from the handheld measurement device attached to the palmer aspect of examiner during passive stretch. Analogue signals from handheld measurement device were converted to digital signals at 1kHz sampling frequency. The converted digital signals were analyzed by using a bio-information analyzing software (Kissei-comtec, BIMUTAS II). The characteristics of spasticity were analyzed based on the amplitude and waveform.From the above pilot study, it was thought that this handheld measurement device was a useful clinical tool for the measurement of spasticity.