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杜氏肌营养不良症患者上肢被动关节阻抗识别的综述。

Review of upper extremity passive joint impedance identification in people with Duchenne Muscular Dystrophy.

作者信息

Filius Suzanne J, Papa Kyriacos, Harlaar Jaap

机构信息

Department of BioMechanical Engineering, Delft University of Technology, Mekelweg 2, Delft, 2628 CD, South-Holland, The Netherlands.

Department of Orthopedics and Sports Medicine, Erasmus MC University Medical Center, Dr. Molewaterplein 40, Rotterdam, 3015 GD, South-Holland, The Netherlands.

出版信息

J Neuroeng Rehabil. 2025 Jan 25;22(1):13. doi: 10.1186/s12984-024-01537-0.

DOI:10.1186/s12984-024-01537-0
PMID:39863905
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11763138/
Abstract

Duchenne Muscular Dystrophy (DMD) progressively leads to loss of limb function due to muscle weakness. The incurable nature of the disease shifts the focus to improving quality of life, including assistive supports to improve arm function. Over time, the passive joint impedance (Jimp) of people with DMD increases. Force-based controlled motorised arm supports require a clear distinction between the user's movement intention and passive forces, such as passive Jimp. Therefore, Jimp identification is essential. This review aims to define Jimp, identify factors influencing it, and outline experimental methods used for quantification, with a focus on the upper extremities in DMD. A literature review was performed in May 2021 and updated in March 2024 using SCOPUS, PubMed, IEEEXplore, and WebOfScience. The results reveal confusion in definitions and show various Jimp measuring practices for both DMD and individuals without muscle weakness. This study presents an overview and lists important parameters affecting passive Jimp, such as the joint's position, velocity and the multi-articular nature of the upper arm muscles. For personalised passive Jimp compensation in arm supports, ramp-type perturbations with constant velocity across the full joint range appear most optimal for identifying the elevated and non-linear nature of the passive Jimp in DMD.

摘要

杜兴氏肌肉营养不良症(DMD)会因肌肉无力而逐渐导致肢体功能丧失。由于该疾病无法治愈,因此关注点转向改善生活质量,包括提供辅助支持以改善手臂功能。随着时间的推移,DMD患者的被动关节阻抗(Jimp)会增加。基于力的受控电动手臂支撑需要明确区分用户的运动意图和被动力,例如被动Jimp。因此,Jimp识别至关重要。本综述旨在定义Jimp,识别影响它的因素,并概述用于量化的实验方法,重点关注DMD患者的上肢。2021年5月进行了文献综述,并于2024年3月使用SCOPUS、PubMed、IEEEXplore和WebOfScience进行了更新。结果显示定义存在混淆,并且展示了针对DMD患者和无肌肉无力个体的各种Jimp测量方法。本研究进行了概述,并列出了影响被动Jimp的重要参数,例如关节位置、速度以及上臂肌肉的多关节特性。对于手臂支撑中的个性化被动Jimp补偿,在整个关节范围内以恒定速度进行斜坡式扰动似乎最适合识别DMD患者被动Jimp的升高和非线性特性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/604c/11763138/2ebc3cce19de/12984_2024_1537_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/604c/11763138/2ebc3cce19de/12984_2024_1537_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/604c/11763138/2ebc3cce19de/12984_2024_1537_Fig1_HTML.jpg

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本文引用的文献

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A Dynamic Submaximal Fatigue Protocol Alters Wrist Biomechanical Properties and Proprioception.一种动态亚极量疲劳方案会改变手腕的生物力学特性和本体感觉。
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Requirements for Eliciting a Spastic Response With Passive Joint Movements and the Influence of Velocity on Response Patterns: An Experimental Study of Velocity-Response Relationships in Mild Spasticity With Repeated-Measures Analysis.
被动关节运动诱发痉挛反应的要求及速度对反应模式的影响:一项采用重复测量分析的轻度痉挛速度-反应关系的实验研究
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Effect of Stretching of Spastic Elbow Under Intelligent Control in Chronic Stroke Survivors-A Pilot Study.智能控制下痉挛性肘关节伸展对慢性卒中幸存者的影响——一项初步研究
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IEEE Trans Biomed Eng. 2022 Jul;69(7):2192-2201. doi: 10.1109/TBME.2021.3138398. Epub 2022 Jun 17.
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