scholarly journals Estimation of Upper Extremity Movement Performance in Stroke Patients with Artificial Learning Techniques

Author(s):  
Mücahit ÇALIŞAN ◽  
Muhammed Fatih TALU
2017 ◽  
Vol 3 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Ligia C. S. Fonseca ◽  
Annika K. Nelke ◽  
Jörg Bahm ◽  
Catherine Disselhorst-Klug

Abstract:Coping strategies of patients with obstetric brachial plexus palsy (OBPP) are highly individual. Up to now, individual movement performance is assessed by visual observations of physicians or therapists - a procedure, which is highly subjective and lacks objective data. However, objective data about the individual movement performance are the key to evidence-based and individualized treatment. In this paper, a new approach is presented, which provides objective information about the upper extremity movement performance of patients with OBPP. The approach is based on the use of accelerometers in combination with a classification procedure. The movement performance of 10 healthy volunteers and 41 patients with OBPP has been evaluated by experienced physiotherapists and has been assigned to one of 4 categories representing the Mallet Scale (MS) IV to I. Three triaxial-accelerometers were placed at chest, upper arm and wrist of the affected side of the patient. Acceleration signals have been recorded during repetitive movements with relevance regarding daily life. Here, especially the results from the “hand to mouth” task are presented. From the 9 recorded acceleration signals 13 relevant features were extracted. For each of the 13 features 4 thresholds have been determined distinguishing best between the 4 patient categories of the MS and the healthy subjects. With respect to the thresholds each feature value has been assigned to the discrete numbers 0, 1, 2, 3 or 4. Afterwards, each discrete number has been weighted by a factor regarding the correlation between the feature’s value and the MS score. The resulting weighted discrete numbers of all 13 features have been added resulting in a score, which quantifies the individual upper extremity movement performance. Based on this score the movement performance of each patient has been assigned to the classes “very good”, “good”, “regular” and “bad”. All movements of the 10 healthy volunteers were classified as “very good”. The movement performance of two patients MS IV were classified as “very good” as well and the movements of the other 16 patients as “good”. The movements of the entire group of MS III patients fell into the class “regular”. Just one MS II patient was assigned to the class “regular” while the others were classified as “bad”. It was not possible to classify the movements of MS I patients. This was mainly due to the fact that none of these patients MS I was able to complete the task successfully. The developed approach demonstrated its ability to quantify the movement performance of upper extremity movements based on accelerometers. This provides an easy to use tool to assess patient’s movement strategies during daily tasks for diagnosis and rehabilitation.


2017 ◽  
Vol 17 (05) ◽  
pp. 1750080 ◽  
Author(s):  
KRISTINA DAUNORAVIČENĖ ◽  
ARTURAS LINKEL ◽  
JURGITA ŽIŽIENĖ ◽  
JULIUS GRIŠKEVIČIUS ◽  
ALVYDAS JUOCEVIČIUS ◽  
...  

This study focuses on the functional assessment of the upper extremity of stroke patients via analysis of angular kinematics features. Amplitudes and angular velocities of multi-joint movements more precisely describe functional state at different impairment levels. However, the arm movement as a whole could be analyzed by means of joint angle–angle diagrams, which illustrate the 2D trajectory of upper extremity during movement and show the visual ranges of upper extremity in different cycles of motion. The functional range of motion of each upper extremity segment in all patient groups for more accurate assessment of capability was calculated. Moreover, we calculated the area (S) between two curves in joint angle–angle diagrams as a novel index of the complete upper extremity movement range evaluation. Our findings correspond to clinical rates and upper extremity assessment based on joint angle–angle diagrams seems to be a promising method for accurate assessment and/or predicting the outcomes of rehabilitation programs.


PLoS ONE ◽  
2015 ◽  
Vol 10 (5) ◽  
pp. e0126857 ◽  
Author(s):  
Chia-Lin Koh ◽  
Shin-Liang Pan ◽  
Jiann-Shing Jeng ◽  
Bang-Bin Chen ◽  
Yen-Ho Wang ◽  
...  

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Venkadesan Rajendran ◽  
Deepa Jeevanantham ◽  
Céline Larivière ◽  
Ravinder-Jeet Singh ◽  
Lisa Zeman ◽  
...  

Abstract Background Many therapeutic interventions are performed by physiotherapists to improve upper extremity function and/or activities of daily living (ADL) in stroke patients. Mirror therapy (MT) is a simple technique that can be self-administered by the patients with intact cognition following patient education by a skilled physiotherapist. However, the effectiveness of self-administered MT in post-stroke patients in upper extremity function remains unclear. Therefore, the objective of this study is to examine the effectiveness of MT in improving upper extremity function and recovery in acute stroke patients. Methods This study is a single-center, prospective, randomized, open-label, controlled trial with blinded outcome evaluation (PROBE design), in which a total of 36 eligible acute stroke patients will be randomly assigned to control (n=18) and experimental group (n=18). Participants in the control group will receive regular rehabilitation interventions whereas participants in the experimental group will receive MT education in addition to their regular interventions for 4 weeks. Study outcome The primary outcome measure will be upper extremity function that will be measured using the Fugl-Meyer Assessment scale and the Wolf Motor Function Test. The secondary outcome measure will be behaviors related to ADL as estimated using the Modified Barthel Index. Outcome measures will be assessed at baseline and at 4 weeks post-rehabilitation intervention/MT. Results A two-way repeated analysis of variance (ANOVA) with time and group effects will be used to analyze between-group differences. The level of significance will be set at P < 0.05. Conclusion The results of the study will provide critical information to include self-administered MT as an adjuvant to regular interventions and may facilitate recovery of the upper extremity function of stroke patients. Trial registration ClinicalTrials.gov NCT04542772. Registered on 9 September 2020. Protocol version: Final 1.0.


Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Katharina Stibrant Sunnerhagen ◽  
Hanna C Persson

Introduction Reduced upper extremity function after stroke has previously been reported in 70-80% of patients with stroke in the acute stage and is one of the most common impairments after acute stroke impaired motor function, both in upper and lower extremity, influence the stroke unit care and planning of the rehabilitation, partly due to the economic costs. There is limited information in upper extremity function within the first days after a stroke. Prior studies include either both first and recurrent stroke or only one type of stroke. Objectives To investigate the frequency impaired arm and hand function in an unselected group of patients with first occasion of stroke. Method All patients at a stroke unit at Sahlgrenska University Hospital were assessed during 18 months. From the hospital records, the patients were identified, the patient charts were read and first stroke diagnosis was confirmed (by either imaging or clinical assessment). Impaired upper extremity function was defined in the following manner: assessed with the Modified Motor Assessment Scale (M-MAS UAS -95) by physiotherapist working at the stroke unit within 72 hours after stroke onset or if this was found in the patients chart, other standardized assessments of upper extremity function performed by the physical therapist, the occupational therapist or the physicians on the ward. Results During the study period 984 patients with first ever stroke (438 women 44.5%) were admitted to the stroke unit. A total of 213 patients were not at the stroke unit within 72 hours after onset and therefore excluded; 90 patients had unclear stroke onset time, 49 patients were located at another ward, 36 patients were in the intensive care unit, 25 in other hospitals in Sweden and 12 patients were hospitalized in another country. There were 771 patients over 18 years old at the stroke unit within 72 hours after stroke onset. Of these 56 patients (7.3%), were not living in the catchment area and therefore excluded. Of the 715 patients living in the geographical catchment area, 58, (8.1%) hade other upper extremity injury prior the stroke onset. Of the remaining first ever stroke patients (n=657), 311 patients (47.3%) hade impaired arm and hand function within 72 hours after stroke onset. Conclusion The frequency of impaired upper extremity function in this unselected population of first occasion of stroke is lower than previously reported. The Copenhagen stroke study noted 69 % impaired at admission and 43 % at one week. This indicates that today’s stroke patients present less frequent with impaired motor function in the upper extremity. However, they may have difficulties in functional activities which may influence content of rehabilitation process.


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