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共济失调患者上肢运动功能受限的定量评估

Quantitative evaluation of functional limitation of upper limb movements in subjects affected by ataxia.

作者信息

Menegoni F, Milano E, Trotti C, Galli M, Bigoni M, Baudo S, Mauro A

机构信息

Bioengineering Department, Politecnico di Milano, Milan, Italy.

出版信息

Eur J Neurol. 2009 Feb;16(2):232-9. doi: 10.1111/j.1468-1331.2008.02396.x.

Abstract

BACKGROUND AND PURPOSE

The design of useful and effective treatment strategies for movement disorders largely depends on the ability to objectively quantify changes in performances, providing reliable outcome measures. Evaluation of ataxia remains mainly assigned to different clinical scales, providing a semi-quantitative assessment. The aim of this study was to quantitatively characterize functional changes in upper limb movements in ataxic patients, using an optoelectronic system for objective measurements.

METHODS

Fourteen patients with cerebellar ataxia and 27 healthy subjects were analyzed using an optoelectronic system with passive markers during pointing task and hand-to-mouth movement. Quantitative parameters capable of characterizing ataxic movements were defined using recorded kinematics.

RESULTS

In both the considered functional movements, ataxic patients showed increased adjustment during the last phase of movement. The movement was less smooth than that in controls, with a fragmented trajectory presenting more direction changes than controls.

CONCLUSIONS

The proposed protocol allows the quantitative characterization of the motion pattern of ataxic subjects in a non-invasive way. We believe that this analysis could represent a good tool for ataxia evaluation in a clinical context such as neurorehabilitation.

摘要

背景与目的

运动障碍实用且有效的治疗策略设计很大程度上取决于客观量化表现变化的能力,从而提供可靠的结果测量。共济失调的评估主要仍依赖于不同的临床量表,提供的是半定量评估。本研究的目的是使用光电系统进行客观测量,定量描述共济失调患者上肢运动的功能变化。

方法

在指向任务和手到嘴运动期间,使用带有被动标记的光电系统对14例小脑共济失调患者和27名健康受试者进行分析。利用记录的运动学定义能够表征共济失调运动的定量参数。

结果

在两种所考虑的功能运动中,共济失调患者在运动的最后阶段显示出更多的调整。运动比对照组更不平稳,轨迹碎片化,方向变化比对照组更多。

结论

所提出的方案能够以非侵入性方式定量描述共济失调受试者的运动模式。我们认为,这种分析在神经康复等临床背景下可能是评估共济失调的一个良好工具。

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