Y. Quijano-González funcional del A. Melendez-Calderón ... TIEs para la Salud... · Cerebral...

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

Congreso e-Salud: “Las TIEs y la Salud en México”

Agenda

• Background

• State of the Art

• Development

• Preliminary Results

• Future Work


Background


Cerebral Palsy

• Permanent progressive disorder

• Central Nervous System injuries

• Multiple causes

• Affects psychomotor skills and quality of life


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


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


Cerebral Palsy

Affects psychomotor skills and quality of life


Rehabilitation


Clinical Assessment Scales

Scores based on observed parameters from the subject of study, in addition to observations taken with physical examination


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


State of the Art


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


Assessment Devices

Motion Capture (1990 to present)


Assessment Devices

IMU’s (2001 to present)


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.


Metrics: CP Subjects


Development


Hardware


Smoothness Metrics

• Spectral Arc-length Metric(SALM)

• Logarithmic DimensionlessJerk Metric (LDJM)

• Peaks metric (PM)


Experimental Protocol


Preliminary Results


Assessment of Upper Limb Using the Sorting Block Box

• 2 phase movement:oReaching - Filling

oReaching - Unfilling

• 11 subjectso9 healthy

o3 with CP


Results

Speed profiles


Results

Metrics Comparison


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


Future Work


THANK YOU


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


ResultsTime domain analysis


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 4Double Sided Hemiparesis,

Predominant Left12 5 8 25

Subject 5 Double Sided Hemiparesis 14 10 14 38







ResultsSmoothness Metrics

WeeFIMMobility: 5Total: 18


WeeFIMMobility: 10

Total: 38

WeeFIMMobility: 10

Total: 38



WeeFIMMobility: 21

Total: 61

WeeFIMMobility: 26

Total: 58

WeeFIMMobility: 29

Total: 63

WeeFIMMobility: 28

Total: 80


Results

Smoothness Metrics




WeeFIMMobility: 10

Total: 38

WeeFIMMobility: 21

Total: 61

WeeFIMMobility: 26

Total: 58


WeeFIMMobility: 29

Total: 63

WeeFIMMobility: 28

Total: 80


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

Y. Quijano-González funcional del A. Melendez-Calderón ... TIEs para la Salud... · Cerebral...

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