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Isokinetic Robotic Device to Improve Test-Retest and Inter-Rater Reliability for Stretch Reflex Measurements in Stroke Patients with Spasticity
Published on: June 12, 2019
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The Assessment of Upper-Limb Spasticity Based on a Multi-Layer Process Using a Portable Measurement System
Summary
This study developed a novel device to objectively quantify spasticity in stroke patients. The system accurately measures spasticity, offering potential for improved clinical diagnosis and treatment.
Area of Science:
- Biomedical Engineering
- Neurorehabilitation
- Clinical Measurement
Background:
- Spasticity, a common post-stroke complication from upper motor neuron dysfunction, is currently assessed using subjective clinical scales with questionable reliability.
- Existing assessment methods suffer from inter-rater and intra-rater variability, hindering objective quantification of spastic hypertonia.
- There is a need for objective, reliable methods to quantify spasticity severity for effective patient management.
Purpose of the Study:
- To develop and validate a multi-layer assessment system for objective spasticity quantification in post-stroke patients.
- To synchronously record kinematic, biomechanical, and electrophysiological data using a novel exoskeletal device.
- To correlate objective measurements with clinical scales and tonic stretch reflex threshold (TSRT) for validation.
Main Methods:
- Development of a novel exoskeletal measurement device to record kinematic, biomechanical, and surface electromyography (sEMG) data.
- Utilized a modified genetic algorithm to quantify mechanical impedance and viscoelastic properties of the elbow joint.
- Extracted time-frequency features from sEMG signals and employed a support vector regression (SVR) model for data fusion and spasticity severity quantification.
Main Results:
- The developed system objectively quantified spasticity by measuring significant deviations in stiffness and damping components of the spastic arm.
- Strong correlations were found between the proposed system's spasticity assessment and clinical severity scales (R = 0.86, P = 1.67e-5).
- High correlation was also observed between the system's output and the tonic stretch reflex threshold (TSRT) (R = -0.89, P = 3.54e-6).
Conclusions:
- The proposed multi-layer assessment system provides a reliable and objective method for quantifying spasticity in post-stroke patients.
- This technology has the potential to significantly support clinical diagnosis of motor abnormalities.
- Objective spasticity quantification can lead to more precise and effective treatment protocol adjustments.
