Quantitative Investigation of Synergy Movement Patterns Using Kinematics Data in Stroke Patients

• Main Authors: SHER, YUNG-JI, 佘永吉
• Other Authors: Chen, Jia-Jin
• Format: Others
• Language: zh-TW
• Published: 1997
• Online Access: http://ndltd.ncl.edu.tw/handle/51462803884090082093

碩士 === 國立成功大學 === 醫學工程研究所 === 86 === AbstractThe prevalence of stroke, which is caused from hemorrhage or infarction in the brain, has been substantial in Taiwan. The prognosis of stroke is different due to the injured areas of the brain. Brunnstrom developed the assessment of sequential recovery stages in hemiplegia commonly used by physical therapists. This assessment describes qualitatively two major characteristics of synergy and spasticity. Synergy is defined by simultaneous co-contraction of agonist and antagonist as well as synergist, which lead to changes of angular motion of several joints. Due to lack of quantitative investigation, the objective of this research was to characterize the synergy patterns for lower limbs movement in stroke patients by using kinematics data analysis. More specifically, a 3space trace system was used to record the kinematics data, then the relationships for synergy patterns between hip, knee, and ankle joint trajectory during the time sequence of movement were quantitatively analyzed and characterized. The experiment of lower limb movements include flexion in supine position and extension in sidelying. The study is to test the hypothesis that synergy characteristics could be quantified from the trajectory of joint movements.Experiment group included seven stroke patients recruited from the National Cheng-Kung University Hospital. Control group consisted of seven able- bodied subjects in order to establish able-bodied patterns for comparative evaluation. The movement testing was required for pre-training until consistency and reproducible to increase intra-reliability. Neuromuscular control is velocity-dependent, environmental factors and bio-feedback are highly likely to influence in synergy movement. High speed movement would like to minimize these interference; therefore, subjects in both groups were requested to perform the tested movement with their fastest speed. Subjects were repeated thirty times in every trial for averaging out variations and increasing reliability in this dynamic nature. Kinematics data was collected with 3space fastrak system and four receivers with overall sampling rate at 120 Hz. The receivers, which were placed on pelvis, thigh, shank and foot, had recorded angular movement data of hip, knee, and ankle joints including flexion, extension, abduction, adduction, internal and external rotation. Ten landmarks were need for Euler angle transformation including both anterior and posterior iliac spine, epicondyles, malleolus, 1st, and 5th metatarsal head.The results show that different patterns could be happened in normal subjects. Hip rotation is different between CVA and normal subjects. Brunnstrom clinic evaluation of CVA can be characterized by this quantitative assessment. The synergy association between the paired joint angles could be identified by regression analysis. Statistical analysis were sufficient in further systematic study including regression analysis for correlation and association, least-square error method, linear or nonlinear best-fit, determining correlation coefficients, statistical significance, and piecewised linearlization for time sequence activity. 3SPACE is needed to be reconsidered in this kinematics study.(Keywords: cerebral vascular accident, CVA, stroke, hemiplegia, synergy)