微型传感器运动捕获系统对脑卒中偏瘫患者上肢够物功能的定量评估  

A quantitative analysis of the kinematics of reaching by hemiplegic stroke patients using microsensor motion capture

作　　者：罗春[1] 黄真[1] 谢斌[1] 黄帅 吴健康 

机构地区：[1]北京大学第一医院康复医学科,北京100034 [2]中国科学研究院传感网络与应用联合研究中心

出　　处：《中华物理医学与康复杂志》2012年第2期104-107,共4页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的探讨微型传感器运动捕获系统在评估脑卒中偏瘫患者上肢够物功能异常特征方面的可行性。方法23例脑卒中偏瘫患者（患者组），平均年龄（61±11）岁（46-78岁），与-10例年龄匹配的健康老年人（健康组）参与本研究。受试者坐在椅子上用偏瘫侧手（患者组）或右手（健康组）够取放在肩前方距肩一臂长处的杯子。4个可采集三维运动轨迹、速度及平滑度的传感器小盒分别固定在脊柱、上臂、前臂和手上。受试者经2次练习后进行4次正式评测。选取肩肘关节平均速度、峰速度、角度分散度、加速度熵及关节间协调性、肩关节运动幅度等10个参数。采用Fugl-Meyer上肢功能评定量表（删除手功能部分）对患者上肢功能进行评估。用独立样本秩和检验比较患者组和健康组之间数据的差异，用Spearman相关分析比较患者的上述参数与Fugl-Meyer上肢运动功能评分的相关性。结果采用微型传感器运动捕获系统评估脑卒中偏瘫患者上肢够物功能的上述运动学参数与健康组比较差异有统计学意义（P〈0．05）。患者组的肩肘关节平均速度、峰速度、关节间协调性、肩关节运动幅度等与Fugl-Meyer上肢运动功能评分有相关性（P〈0．05）；但肩肘关节角度分散度、加速度熵等参数与Fugl-Meyer上肢运动功能评分无相关。结论微型传感器运动捕获系统可定量评测脑卒中偏瘫患者在三维实际环境中够物的多关节运动学特征，可为优化临床治疗提供客观依据。Objective To evaluate the feasibility of using a microsensor motion capture unit （MCU） to assess the reaching characteristics of hemiplegic stroke patients. Methods Twenty-three hemiplegic stroke patients with an average age of （61 ±11） years and ten normal subjects of matching age were asked to sit on a chair and use the affected arm （for the patients） or the right arm （for the normal subjects） to reach for a cup on a table just in front of the shoulder at arm＇s length away. Four small sensor boxes which could detect movement and its speed and smoothness in three dimensions were fixed to the subject＇s spine, upper arm, forearm and hand. The test was repeated four times after two trial runs. The average velocity, peak velocity, degree of joint dispersion, entropy of acceleration, joint coordination and active range of motion （AROM） of the shoulder were analyzed. The patients and normal subjects were statistically compared. The results were correlated with Fugl-Meyer upper extremity scores using Spearman correlation analysis. Results All of the measured variables showed significant differences between the patients and normal subjects. In the correlation study, the average velocity, peak velocity, AROM of the shoulder and joint coordination showed significant correlation with the Fugl-Meyer scores. There was, however, no significant correlation between degree of dispersion of the shoulder or elbow joints or the entropy of acceleration （which represented the quality of movement） and Fugl-Meyer upper extremity scores. Conclusions The results suggest that microsensor MCUs can quantitatively assess the kinematics of reaching among hemiplegic stroke patients. They can provide valuable and objective data about the functional quMity of multiple joint movements in three dimensions.

关 键 词：脑卒中 偏瘫 够物 运动学 定量分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]