Development of an equipment to detect and quantify muscular spasticity

Dissertação para obtenção do Grau de Mestre em Engenharia BiomédicaSpasticity consists of a muscular tonus alteration caused by a flawed central nervous system which results in a hypertonic phenomenon. The presence of spasticity is normally noticeable by the appearance of a denoted velocity dependent “rigidity” throughout the passive mobilization of an affected limb which can be a potential source of constraints in subject independency by negatively affecting the accomplishment of daily basic tasks. Spasticity treatment usually comprises high cost methods and materials. There is also a strict relation between the spasticity grade and the dose that has to be applied to attain the desired effective result. These two facts justify the need for a more precise equipment to detect and quantify muscular spasticity. In the present days, three main groups of spasticity quantification methods coexist: the clinical scales, electrophysiological measurements and the biomechanical measurements. The most used ones are the clinical scales, especially the Modified Ashworth Scale. These scales quantify spasticity based on the perception of muscular response sensed by an operator. In a different field of approach, many instruments have been built to quantify biomechanical magnitudes that have shown direct relation with spasticity. Unfortunately, most of these instruments had either inappropriate size for clinical use, weak result correlation both inter and intra-subject, or a noticeable result dependence on the operator. The objective of this project was to create a reliable method for spasticity detection and quantification that could: be of easy and fast application, have no need for a specialized operator, be portable and present good repeatability and independency from the operator in the produced results. The resulting prototype, named SpastiMed, is a motorized and electronically controlled device which through analysis of the produced signal presented irrefutable proof of its capacity to detect and possibly quantify spasticity while gathering the important characteristics mentioned

An approach for spasticity quantification based on the stretch reflex threshold

Spasticity is a common and complex motor disorder that affects more than 12 million persons in the world. There are several studies on spasticity quantification in the literature but there is still a need for measurement improvements. This paper presents the design of a mechatronic device for spasticity quantification, in joint of ankle, elbow and knees. This approach is based on the velocity dependent of the tonic stretch reflexes. The relevant variables, the measurement range and the adequate measurement systems are selected. The data acquisition system, board and software, are also defined and tested in laboratory. Next step consists of the system validation in clinical environment

Biomedical device for spasticity quantification based on the velocity dependence of the stretch reflex threshold

Spasticity is a common and complex motor disorder that affects more than 12 million persons in the world. There are several studies on spasticity quantification in the literature but there is still a need for measurement improvements. This paper presents the validation, in clinical environment, of a mechatronic medical device, dedicated, and specially designed and constructed for spasticity quantification, in joint of ankle, elbow and knees. This approach is based on the velocity-dependent of the Stretch Reflex threshold. The relevant variables, the measurement range and the adequate measurement systems are indicated. The reliability of the developed mechatronic medical system is confirmed by data acquisition and analysis, following a systematic methodology, also presented in the paper

A mechatronic device for spasticity quantification

Spasticity is a common and complex motor disorder that affects more than 12 million persons in the world. There are several studies on spasticity quantification in the literature but there is still a need for measurement improvements. This paper presents the design of a mechatronic device for spasticity quantification, in joint of ankle, elbow and knees. This approach is based on the velocity dependent of the tonic stretch reflexes. The relevant variables, the measurement range and the adequate measurement systems are selected. The data acquisition system, board and software, are also defined and tested in laboratory. The proposed system was tested in rehabilitation clinical environment and the corresponding results are presented in this article.The authors are grateful to Portuguese Research Centers Algoritmi and CT2M for financial support. The authors are also grateful to Fisimaia rehabilitation clinic in Maia and his patients

Manually controlled instrumented spasticity assessments: a systematic review of psychometric properties

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Development, Test and Validation of a Mechatronic Device for Spasticity Quantification

Abstract Spasticity is a common pathological phenomenon in clinical practices, frequently expressed as a stroke, multiple sclerosis or cerebral palsy. The accurate quantification of spasticity allows early action to prevent the potentially irreversible consequences. The aim of this work is to develop and implement a mechatronic device for the accurate quantification of spasticity, which is able to differentiate spasticity from other motor disorders. The proposed method is based on the quantification of the tonic stretch reflex threshold (TSRT) for the assessment of the range of motion of the limb affected by spasticity. In order to validate the developed device, experimental trials have been conducted, considering the flexor muscle of the elbow joint. The developed device was tested, first in a laboratory environment with healthy subjects and secondly, in a clinical environment with the collaboration of patients with spasticity. The evaluations in th clinical environment were performed on three different days in order to evaluate the reproducibility of the obtained results. The experimental trials confirm the sensibility, reproducibility and reliability of spasticity quantification based on the TSRT method. This project has been developed in cooperation with the Hospital of Braga and Fisimaia rehabilitation clinic, both in Portugal

Robot-Aided Systems for Improving the Assessment of Upper Limb Spasticity: A Systematic Review

This article belongs to the Special Issue Sensors Technology for Medical Robotics.Spasticity is a motor disorder that causes stiffness or tightness of the muscles and can interfere with normal movement, speech, and gait. Traditionally, the spasticity assessment is carried out by clinicians using standardized procedures for objective evaluation. However, these procedures are manually performed and, thereby, they could be influenced by the clinician’s subjectivity or expertise. The automation of such traditional methods for spasticity evaluation is an interesting and emerging field in neurorehabilitation. One of the most promising approaches is the use of robot-aided systems. In this paper, a systematic review of systems focused on the assessment of upper limb (UL) spasticity using robotic technology is presented. A systematic search and review of related articles in the literature were conducted. The chosen works were analyzed according to the morphology of devices, the data acquisition systems, the outcome generation method, and the focus of intervention (assessment and/or training). Finally, a series of guidelines and challenges that must be considered when designing and implementing fully-automated robot-aided systems for the assessment of UL spasticity are summarized