Y. Quijano-González funcional del A. Melendez-Calderón ... TIEs para la Salud... · Cerebral...
Transcript of Y. Quijano-González funcional del A. Melendez-Calderón ... TIEs para la Salud... · Cerebral...
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Congreso e-Salud: “Las TIEs y la Salud en
México”
Sorting Block Box: Dispositivo para la
valoración funcional del
miembro superior de niños con
parálisis cerebral
Y. Quijano-González1
A. Melendez-Calderón2
E. Burdet3
D. Villanueva-Ayala4
J. C. Pérez-Moreno4
J. E. Chong-Quero1
1ITESM CEM, Department of Mechatronics2Northwestern University, USA3Imperial College London, UK4CRIT, México
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Congreso e-Salud: “Las TIEs y la Salud en México”
Agenda
• Background
• State of the Art
• Development
• Preliminary Results
• Future Work
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Congreso e-Salud: “Las TIEs y la Salud en México”
Background
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Congreso e-Salud: “Las TIEs y la Salud en México”
Cerebral Palsy
• Permanent progressive disorder
• Central Nervous System injuries
• Multiple causes
• Affects psychomotor skills and quality of life
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Congreso e-Salud: “Las TIEs y la Salud en México”
Cerebral Palsy
• World incidence2 to 2.5 cases per 1000 children born
• UNICEF80% of the population with some form of physical disability, live in developing countries
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Congreso e-Salud: “Las TIEs y la Salud en México”
Cerebral Palsy in Mexico…• 3 cases per 10,000 infants with spastic hemiparesis
• Ministry of Health estimates that the ninth cause of visits to the National System for Integral Family Development is CP
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Congreso e-Salud: “Las TIEs y la Salud en México”
Cerebral Palsy
Affects psychomotor skills and quality of life
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Congreso e-Salud: “Las TIEs y la Salud en México”
Rehabilitation
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Congreso e-Salud: “Las TIEs y la Salud en México”
Clinical Assessment Scales
Scores based on observed parameters from the subject of study, in addition to observations taken with physical examination
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Congreso e-Salud: “Las TIEs y la Salud en México”
Instrumented Sorting Block Box for Children
• Imperial College London
• CRIT
• INR
• ITESM CEM
Aim improve the assessment of the motor impairment degree in the upper limb
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Congreso e-Salud: “Las TIEs y la Salud en México”
State of the Art
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Congreso e-Salud: “Las TIEs y la Salud en México”
Clinical Assessment Scales
25 clinical evaluation assessments for the upper limb according to WHO
• Action Research Arm Test (ARAT)
• Box and Block Test
• Fugl-Meyer Test
• Nine Hole Peg Test
• Sequential Occupational Dexterity Assessment (SODA)
• Smith Hand Function Evaluation
• Upper Extremity Function Test
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Congreso e-Salud: “Las TIEs y la Salud en México”
Assessment Devices
Motion Capture (1990 to present)
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Congreso e-Salud: “Las TIEs y la Salud en México”
Assessment Devices
IMU’s (2001 to present)
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Congreso e-Salud: “Las TIEs y la Salud en México”
However…
Published papers of quantitative assessments for the
upper limb with children with CP:
• 17 articles, only 8 include clinical assessments
• 100% use MOCAP systems
• Sample sizes: 5 - 34
• Ages: 2-29 years old
E. Jaspers, K. Desloovere, H. Bruyninckx, G. Molenaers, K. Klingels, and H. Feys, “Review of
quantitative measurements of upper limb movements in hemiplegic cerebral palsy.,” Gait & posture,
vol. 30, no. 4, pp. 395–404, Nov. 2009.
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Congreso e-Salud: “Las TIEs y la Salud en México”
Metrics: CP Subjects
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Congreso e-Salud: “Las TIEs y la Salud en México”
Metrics: CP Subjects
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Congreso e-Salud: “Las TIEs y la Salud en México”
Development
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Congreso e-Salud: “Las TIEs y la Salud en México”
Hardware
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Congreso e-Salud: “Las TIEs y la Salud en México”
Smoothness Metrics
• Spectral Arc-length Metric(SALM)
• Logarithmic DimensionlessJerk Metric (LDJM)
• Peaks metric (PM)
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Congreso e-Salud: “Las TIEs y la Salud en México”
Experimental Protocol
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Congreso e-Salud: “Las TIEs y la Salud en México”
Experimental Protocol
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Congreso e-Salud: “Las TIEs y la Salud en México”
Preliminary Results
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Congreso e-Salud: “Las TIEs y la Salud en México”
Assessment of Upper Limb Using the Sorting Block Box
• 2 phase movement:oReaching - Filling
oReaching - Unfilling
• 11 subjectso9 healthy
o3 with CP
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Congreso e-Salud: “Las TIEs y la Salud en México”
Results
Speed profiles
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Congreso e-Salud: “Las TIEs y la Salud en México”
Results
Metrics Comparison
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Congreso e-Salud: “Las TIEs y la Salud en México”
Conclusions
• Smoothness metrics differentiate between:• Healthy and CP children
• Impaired and less-impaired sides
• Correlation between metrics shows that:• PM and Time are almost the same
• SALM is the most independent smoothness metric
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Congreso e-Salud: “Las TIEs y la Salud en México”
Future Work
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Congreso e-Salud: “Las TIEs y la Salud en México”
THANK YOU
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Congreso e-Salud: “Las TIEs y la Salud en México”
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Congreso e-Salud: “Las TIEs y la Salud en México”
Comparison of 4 Different Smoothness Metrics for the Quantitative Assessment of Movement’s Quality in the Upper Limb of Subjects with Cerebral Palsy
19 subjects:
• 9 healthy
• 10 with CP
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Congreso e-Salud: “Las TIEs y la Salud en México”
ResultsTime domain analysis
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Congreso e-Salud: “Las TIEs y la Salud en México”
WeeFIM Scores
Subject Alias PathologyPersonal Care (max
score: 56)
Mobility (max
score: 35)Cognition (max
score: 35)Total
Subject 1 Left Sided Hemiparesis 46 30 35 111
Subject 2 Right Sided Hemiparesis 21 26 11 58
Subject 3 Left Sided Hemiparesis 8 5 5 18
Subject 4Double Sided Hemiparesis,
Predominant Left12 5 8 25
Subject 5 Double Sided Hemiparesis 14 10 14 38
Subject 6 Right Sided Hemiparesis 8 5 5 18
Subject 7 Left Sided Hemiparesis 26 21 14 61
Subject 8 Right Sided Hemiparesis 17 29 17 63
Subject 9 Right Sided Hemiparesis 24 28 28 80
Subject 10 Left Sided Hemiparesis 17 20 12 49
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Congreso e-Salud: “Las TIEs y la Salud en México”
ResultsSmoothness Metrics
WeeFIMMobility: 5Total: 18
WeeFIMMobility: 5Total: 25
WeeFIMMobility: 10
Total: 38
WeeFIMMobility: 10
Total: 38
WeeFIMMobility: 5Total: 18
WeeFIMMobility: 30Total: 111
WeeFIMMobility: 21
Total: 61
WeeFIMMobility: 26
Total: 58
WeeFIMMobility: 29
Total: 63
WeeFIMMobility: 28
Total: 80
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Congreso e-Salud: “Las TIEs y la Salud en México”
Results
Smoothness Metrics
WeeFIMMobility: 30Total: 111
WeeFIMMobility: 5Total: 18
WeeFIMMobility: 5Total: 25
WeeFIMMobility: 10
Total: 38
WeeFIMMobility: 21
Total: 61
WeeFIMMobility: 26
Total: 58
WeeFIMMobility: 5Total: 18
WeeFIMMobility: 29
Total: 63
WeeFIMMobility: 28
Total: 80
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Congreso e-Salud: “Las TIEs y la Salud en México”
Conclusions
• Time domain analysiso Differences between control and testing groupso Can’t differentiate between affected sides (testing group)
• Smoothness metricso MAPR fluctuates(below/above the control group average)
Lack of consistencyo PM presents abrupt hops
When computed for the affected side of an hemiparetic subjecto LDJM, SALM
• Coherent quantification of the movement• Higher magnitude for affected-sides• Magnitude differences smaller with LDJM than SALM• Coherent relation with WeeFIM scores