可攜式偏癱患者伸手動作分析系統

Abstract

腦血管疾病(cerebral vascular accident, CVA or stroke)，大約有三分之二的中風患者發病後，無法用偏癱側上肢進行功能性動作，進而影響日常生活自理的能力。因此，對於如何恢復病患之上肢功能是一大重點。然而在進行有效的治療前，需先進行上肢功能的評估。目前常用之臨床量表與運動學的動作分析儀，皆須要有受過專業人員操作，故本研究的目的是藉由簡單的儀器設計並同時以時域與頻域分析進行中風患者之上肢功能評估，藉以幫助醫療人員得到更方便有效的評估。 本研究首先改良現有之系統，以嵌入式系統取代筆記型電腦，並以Linux為核心進行開發，降低系統操作的複雜度與系統成本。而在運動學特徵分析方面，以LabVIEW撰寫分析程式，分析經由系統取得的原始訊號，取得其速度、加速度、距離、頻率等特徵值，找出中風患者之上肢運動功能中最有效之特徵，以達到簡易上肢功能評估之目的。 本研究收取了13位受測者(正常人4位與中風患者9位)的上肢運動學資料並加以分析。根據本研究分析結果發現，在加速度與頻率上，中風患者與正常人之間有顯著的不同，但在上肢功能喪失者的程度上則並無法分辦出明顯的不同，而在距離、速度、時間上則能明確的分辦出的上肢功能喪失患者程度的不同。

Cerebral vascular accident (CVA, or stroke) is in the top three causes of death in Taiwan. About two-thirds of stroke survivors cannot use the upper limb in affective side to perform functional movements and daily life tasks. Therefore how to regain their upper limb function is a major focus . However before an effective treatment can be conducted, the residual upper limb function needs to be assessed. The most commonly used methods such as clinical instruments and kinematics movement analysis. However, these methods need to beperformed by well-train professional personnel. In this study, we try to implement a simple device to perform the upper limb function assessment both on time and frequency domain to help medical personnel to have more convenient and effective assessment. First improvement to the existing system is complete by replacing of the original system with a Linux based embedded system to reduce complexity and costs. A kinematics analysis software written by LabVIEW is used to extract the kinematic features such as speed, acceleration, distance, frequency. According the data obtained from the stroke survivor , the most effective features to represent the upper limb motor function of stroke survivors can be found and used as reference by the clinical therapists and achieve the purpose of simply the assessment of upper limb function. Kinematic data from 13 subject’s upper limbs (4 normal subject and 9 stroke patients) were collected in this study. According our results, we found significant differences between stroke patients and healthy individuals in acceleration and frequency but no significant difference within varying severities of functions loss in upper limbs. Maximal movement distances, maximal reaching speed, and time cost for reaching can be used to distinguish patients with different severities of function loss in upper limbs.