In order to realize an individualized and specialized rehabilitation assessment of remoteness and intelligence, we set up a remote intelligent assessment system of upper limb movement function of post-stroke patients during rehabilitation. By using the remote rehabilitation training sensors and client data sampling software, we collected and uploaded the gesture data from a patient's forearm and upper arm during rehabilitation training to database of the server. Then a remote intelligent assessment system, which had been developed based on the extreme learning machine (ELM) algorithm and Brunnstrom stage assessment standard, was used to evaluate the gesture data. To evaluate the reliability of the proposed method, a group of 23 stroke patients, whose upper limb movement functions were in different recovery stages, and 4 healthy people, whose upper limb movement functions were normal, were recruited to finish the same training task. The results showed that, compared to that of the experienced rehabilitation expert who used the Brunnstrom stage standard table, the accuracy of the proposed remote Brunnstrom intelligent assessment system can reach a higher level, as 92.1%. The practical effects of surgery have proved that the proposed system could realize the intelligent assessment of upper limb movement function of post-stroke patients remotely, and it could also make the rehabilitation of the post-stroke patients at home or in a community care center possible.
For the questions of deeply researching abnormal neuromuscular coupling and better evaluating motor function of stroke patients with motor dysfunction, an effective intermuscular coherence analysis method and index are studied to explore the neuromuscular oscillation and the pathomechanism of motor dysfunction, based on which an assessment standard of muscle function is established. Firstly, the contrastive analysis about the intermuscular coherence of antagonistic muscle of affected and intact upper limbs of stroke patients was conducted. Secondly, a significant indicator of Fisher's Z-transformed coherence significant indicator was defined to quantitatively describe the coupling differences in certain functional frequency domain between surface electromyogram (sEMG) of affected and intact sides. Further more, the relationship between intermuscular coherence and motor task was studied. Through the analysis of intermuscular coherence during elbow flexion-extension of affected and intact sides, we found that the intermuscular coherence was associated with motor task and the stroke patients exhibited significantly lower beta-band intermuscular coherence in performing the task with their affected upper limbs. More conclusion can be drawn that beta-band intermuscular coherence has been found concerned with Fugle-Meyer scale, which indicates that beta-band intermuscular coherence could be an index assisting in evaluating motor function of patients.
Objective To explore the consistency between the iKcare® grading system and Brunnstrom staging in evaluating upper and lower limb motor function in stroke patients. Methods From May 2018 to May 2020, stroke patients who met the standards in 34 medical institutions in China were recruited. The iKcare® grading system and Brunnstrom staging were used to evaluate the motor function of the upper and lower limbs of the subjects, respectively. The Kappa consistency test was used to evaluate the consistency between the two evaluation methods. Results A total of 340 eligible subjects were included, including 230 males and 110 females, with an average age of (61.44±12.77) years old, and an average course of disease of (62.96±42.53) days. The results showed that the Kappa evaluated for upper limb staging was 0.597 (P<0.001), and the Kappa evaluated for lower limb staging was 0.514 (P<0.001). Conclusions The evaluation results of iKcare® grading and Brunnstrom staging have moderate consistency. The iKcare® grading system can be used as an assessment tool for remote rehabilitation of motor function in stroke patients, but there is still room for improvement.
Objective To evaluate the reliability and validity of the three-dimensional motion capture analysis system COFT-Motion® in evaluating the active range of motion of upper limbs in healthy subjects, and provide objective basis for its clinical application. Methods From January to March 2022, healthy subjects were publicly recruited for enrollment. The evaluator applied the three-dimensional motion capture analysis system COFT-Motion® and angle ruler to evaluate the active range of motion of the shoulder joint (flexion, extension, adduction, abduction) and elbow joint (flexion, extension) in healthy subjects. Pearson correlation analysis was used to evaluate validity, and intraclass correlation coefficient (ICC) was used to evaluate reliability. Results There was a positive correlation between the measurements of COFT-Motion® and the angle ruler of the active range of motion of upper limbs in healthy subjects. The Pearson correlation coefficients for active range of motion of the shoulder joint (flexion, extension, adduction, abduction) and elbow joint (flexion, extension) were 0.913, 0.964, 0.961, 0.941, 0.864, and 0.919, respectively (P<0.05). The results of using COFT-Motion® by different evaluators to evaluate the active range of motion of healthy subjects’ shoulder joints (flexion, extension, adduction, abduction) and elbow joints (flexion, extension) showed that the ICC values were 0.892, 0.942, 0.961, 0.988, 0.989, and 0.928, respectively (P<0.05). The results of repeated evaluations by the same evaluator showed that the ICC values were 0.795, 0.916, 0.900, 0.868, 0.918, and 0.911, respectively (P<0.05). Conclusion The application of the three-dimensional motion capture analysis system COFT-Motion® in healthy subjects has good validity and reliability. However, due to the limited sample size and subject of the study, further promotion and application of the system still need to be further explored.
Objective To construct the expert consensus on comprehensive rehabilitation assessment system for the elderly in the hospital and community. MethodsMedline, Embase, Cochrane Library, China National Knowledge Infrastructure and VIP databases were searched for geriatric rehabilitation assessment materials from June 2016 to June 2021. The primary items were summarized through literature review and research group discussion, and then Delphi method was used among 20 experts in geriatric rehabilitation medicine to develop consensus-based core items for the elderly comprehensive rehabilitation assessment system. Results A total of 158 references were included. Through integration, sorting and screening, the research team initially formulated 41 items and four major sections including cardiopulmonary exercise, sensory perception, cognition and psychology (speech contained), and swallowing, urination and defecation. The effective recovery rates of the two rounds of experts consultation were both 100%, the mean expert authority coefficient was 0.92±0.05, the variation coefficients were 0.174±0.043 and 0.172±0.063, respectively; the Kendall coefficients of concordance were 0.587 and 0.601, with P values<0.05 for both, respectively. Finally, The comprehensive rehabilitation assessment system for the elderly including 16 items would be formed. Conclusion The expert consensus on comprehensive rehabilitation assessment system for the elderly constructed by Delphi method includes motor, sensory perception, cognition, swallowing, speech, cardiopulmonary, defecation, mental and psychological elements, which are identified with high recognition and consistency from experts.