School of Electronics and Information Engineering, Chonbuk National University, 664-14 1Ga, Deokjin-dong, Jeonju, Jeonbuk 561-756, Republic of Korea.
Med Eng Phys. 2011 Jan;33(1):62-9. doi: 10.1016/j.medengphy.2010.09.002. Epub 2010 Oct 6.
The clinical scales used for the evaluation of the spasticity have some drawbacks, in spite of their simplicity and ease of assessment, and their inter- and intra-rater reliability remains controversial. The aim of this study is to develop a portable system for the objective and reliable evaluation of the spasticity based on the K-means clustering of the tonic stretch reflex threshold (TSRT) and to compare the discrimination performance of the level of spasticity determined by our method with that by the conventional modified Ashworth scale (MAS). Fifteen hemiplegic patients (7 males and 8 females, age: 63.5±15.6) participated in the study. The average and standard deviation values of the TSRTs were 127.9±1.6, 121.8±1.5 and 117.9±1.3 in groups G1, G2 and G3, respectively, and there were significant differences between the TSRTs of each group (p<0.05). Also, our groups classified by the criteria of the TSRT had a strong negative correlation (r=-0.95, r(2)=0.90, p<0.05) between the level of spasticity and TSRTs. These results demonstrated that our system could be clinically more useful for the quantitative and reliable discrimination of the spasticity than the conventional MAS.
尽管临床痉挛评估量表具有简单易用的特点,且其评估者间和评估者内信度尚存争议,但仍存在一些缺陷。本研究旨在开发一种基于紧张性牵张反射阈(tonic stretch reflex threshold,TSRT)的 K-均值聚类的便携式痉挛客观评估系统,并比较我们的方法确定的痉挛水平的判别性能与传统改良 Ashworth 量表(modified Ashworth scale,MAS)的判别性能。15 例偏瘫患者(7 名男性,8 名女性;年龄:63.5±15.6 岁)参与了本研究。在 G1、G2 和 G3 组中,TSRT 的平均值和标准差分别为 127.9±1.6、121.8±1.5 和 117.9±1.3,各组之间的 TSRT 存在显著差异(p<0.05)。此外,我们根据 TSRT 标准对分组的结果显示,痉挛程度与 TSRT 之间具有很强的负相关性(r=-0.95,r(2)=0.90,p<0.05)。这些结果表明,与传统 MAS 相比,我们的系统在痉挛的定量和可靠判别方面可能具有更临床价值。