Centro de Investigación en Computación, Instituto Politécnico Nacional, Juan de Dios Bátiz Avenue, 07738, Mexico City, Mexico.
Department of Electrical and Computer Engineering, University of Michigan-Dearborn, Evergreen Road, Dearborn, MI, 48128, USA.
Med Biol Eng Comput. 2019 Feb;57(2):463-476. doi: 10.1007/s11517-018-1894-0. Epub 2018 Sep 13.
Parkinson's disease (PD) is a progressive disorder that affects motor regulation. The Unified Parkinson's Disease Rating Scale sponsored by the Movement Disorder Society (MDS-UPDRS) quantifies the illness progression based on clinical observations. The leg agility is an item in this scale, yet only a visual detection of the features is used, leading to subjectivity. Overall, 50 patients (85 measurements) with varying motor impairment severity were asked to perform the leg agility item while wearing inertial sensor units on each ankle. We quantified features based on the MDS-UPDRS and designed a fuzzy inference model to capture clinical knowledge for assessment. The model proposed is capable of capturing all details regardless of the task speed, reducing the inherent uncertainty of the examiner observations obtaining a 92.35% of coincidence with at least one expert. In addition, the continuous scale implemented in this work prevents the inherent "floor/ceil" effect of discrete scales. This model proves the feasibility of quantification and assessment of the leg agility through inertial signals. Moreover, it allows a better follow-up of the PD patient state, due to the repeatability of our computer model and the continuous output, which are not objectively achievable through visual examination. Graphical abstract ᅟ.
帕金森病(PD)是一种进行性疾病,影响运动调节。由运动障碍协会(MDS-UPDRS)赞助的统一帕金森病评定量表根据临床观察量化疾病进展。腿部敏捷性是该量表中的一个项目,但仅使用对特征的视觉检测,导致主观性。总体而言,有 50 名(85 次测量)运动障碍严重程度不同的患者被要求在每个脚踝上佩戴惯性传感器单元的同时执行腿部敏捷性项目。我们根据 MDS-UPDRS 对特征进行了量化,并设计了一个模糊推理模型来捕捉评估的临床知识。所提出的模型能够捕获所有细节,而与任务速度无关,减少了获得至少一位专家一致的 92.35%的内在测试者观察的不确定性。此外,本工作中实施的连续量表防止了离散量表的固有“地板/天花板”效应。该模型证明了通过惯性信号对腿部敏捷性进行量化和评估的可行性。此外,由于我们的计算机模型和连续输出的可重复性,它允许更好地跟踪 PD 患者的状态,而这是通过视觉检查无法客观实现的。图摘要 ᅟ.