Application of Multi-Dimensional Intelligent Visual Quantitative Assessment System to Evaluate Hand Function Rehabilitation in Stroke Patients
Abstract
:1. Introduction
2. Materials and Methods
2.1. General Information
2.2. Methods
- (1)
- MDIVQAS: Based on the pathological motor characteristics of hemiplegic hand and a set of post-stroke hand function rehabilitation evaluation actions corresponding to the Brunnstrom scale, Fugl-Meyer Rating Scale and range of motion measurement, it is a computer-aided technology-based assessment tool. Using the comprehensive quantitative evaluation method of healthy hand modeling and comparison evaluation of the affected hand, the 3D spatial position and motion vector information of various joints of the phalanx, metacarpal and wrist were acquired in real time with the help of video equipment, and then various motion parameters of the hand joint were analyzed as the system parameters of the hand function evaluation standard. In order to prevent the ambiguity and subjectivity in the guidance process of the standard movement demonstration, At the bottom left of the screen, there is a 3D animation of the action being evaluated to achieve a consistent demonstration of standard hand movements. The assessment items included three parts as forearm, wrist and hand, with a total of 10 movements, including ulnar wrist deviation, wrist dorsiextension, five fingers adduction and abduction, forearm pronation, forearm supination, spherical grip, cylindrical grip, thumb flexion and extension, thumb abduction and thumb rotation.
- (2)
- Measuring AROM with protractor: A universal protractor was used to measure the forearm pronation, forearm supination, ulnar deviation, wrist dorsiextension and the angle between the fingers of the five fingers [9].
- (3)
- FMA-UE [15,16]: It mainly includes movement, speed, coordination and reflex activities, with a total of 66 points, and each item is scored on a 3-level scale: that is, 0 points, unable to perform; 1 point, partially implemented; 2 points, fully implemented. Among them FMA-W/H is a part of the FMA rating scale, which evaluates the wrist and hand. There are 12 items in total, each item is 0~2 points, full score is 24 points. The higher the score, the better the motor function of the upper limb is indicated.
- (4)
- Brunnstrom Scale [7,17]: upper limb and hand parts; each is divided into stage I–VI, and the higher the level, the better the motor function. Stage I: no exercise; Stage II: slight flexion; Stage III: flexion but not extension; Stage IV: the thumb can be pinched and loosened, and the fingers can be extended semi-randomly in a small area; Stage V: can do spherical or cylindrical grip, and can be free to extend the whole finger, but the range of size is not equal; Stage VI: full range extension of various grips, but with less speed and accuracy than the healthy side.
- (5)
- ARAT [18,19]: Consisting of 4 subscales (grasp, grip, pinch and gross motion), which mainly evaluates the ability of the affected hand to handle objects of different sizes, weights and shapes. ARAT requires a standardized assessment toolbox, consisting of 19 items with a full score of 57, and each item is scored in a 4-point order (0: unable to complete any part of the task within 60 s, 1: complete part of the task within 60 s, 2: The task is completed, but the difficulty is very high or the time is too long (5~60 s), 3 points: the normal completion within 5 s). Each of ARAT’s subscales is arranged in a hierarchical order, testing the most difficult items first, then the easiest and then increasing the items in turn. The higher the score, the better the feature.
2.3. MDIVQAS
2.3.1. Overall Design Scheme of MDIVQAS
2.3.2. Hardware Platform of MDIVQAS
2.4. Statistical Analysis
3. Results
3.1. Reliability of MDIVQAS
3.2. Validity of MDIVQAS
3.2.1. Correlation between MDIVQAS, FMA-W/H, Brunnstrom and ARAT Assessment
3.2.2. Correlations MDIVQAS and Protractor Measurement
3.3. Reactivity before and after Treatment
3.3.1. Comparison of Differences of MDIVQAS, FMA-UE, FMA-W/H, Brunnstrom and ARAT before and after Treatment
3.3.2. Comparison of the Difference between MDIVQAS and Protractor Measurement of AROM in the Increase of Joint Motion before and after Treatment
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Movement (n = 24) | Cronbach’s Alpha | N of Items |
---|---|---|
Wrist ulnar deviation | 0.989 | 3 |
Wrist dorsiextension | 0.993 | 3 |
Finger adduction and abduction | 0.987 | 3 |
Forearm pronation | 0.998 | 3 |
Forearm supination | 0.998 | 3 |
Cylindrical grip | 0.981 | 3 |
Spherical grip | 0.990 | 3 |
Thumb abduction | 0.976 | 3 |
Thumb flexion and extension | 0.989 | 3 |
Thumb rotation | 0.994 | 3 |
Hand function 10 movements overall | 0.989 | 30 |
Item | n | P25 | P50 | P75 | Z | P |
---|---|---|---|---|---|---|
Ulnar deviation increase A | 37 | 0.0 | 1.0 | 5.0 | −0.184 b | 0.854 |
Ulnar deviation increase B | 37 | 0.0 | 0.0 | 6.0 | ||
Forearm pronation increase A | 37 | −1.5 | 1.0 | 11.5 | −0.516 b | 0.606 |
Forearm pronation increase B | 37 | 0.0 | 3.0 | 10.0 | ||
Forearm supination increase A | 37 | −0.5 | 2.0 | 20.0 | −1.034 c | 0.301 |
Forearm supination increase B | 37 | 0.0 | 0.0 | 10.0 | ||
Wrist dorsiextension increase A | 37 | −0.5 | 3.0 | 17.5 | −0.403 c | 0.687 |
Wrist dorsiextension increase B | 37 | 0.0 | 3.0 | 15.0 | ||
Increase in angle between the fingers 1A | 37 | −0.5 | 1.0 | 7.0 | −1.267 b | 0.205 |
Increase in angle between the fingers 1B | 37 | 0.0 | 0.0 | 12.0 | ||
Increase in angle between the fingers 2A | 37 | 0.0 | 2.0 | 5.0 | −0.502 b | 0.616 |
Increase in angle between the fingers 2B | 37 | 0.0 | 0.0 | 5.0 | ||
Increase in angle between the fingers 3A | 37 | 0.0 | 1.0 | 4.0 | −0.868 b | 0.386 |
Increase in angle between the fingers 3B | 37 | 0.0 | 0.0 | 7.0 | ||
Increase in angle between the fingers 4A | 37 | 0.0 | 1.0 | 2.0 | −1.783 b | 0.075 |
Increase in angle between the fingers 4B | 37 | 0.0 | 0.0 | 5.0 |
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Du, Y.; Shi, Y.; Ma, H.; Li, D.; Su, T.; Meidege, O.Z.; Wang, B.; Lu, X. Application of Multi-Dimensional Intelligent Visual Quantitative Assessment System to Evaluate Hand Function Rehabilitation in Stroke Patients. Brain Sci. 2022, 12, 1698. https://0-doi-org.brum.beds.ac.uk/10.3390/brainsci12121698
Du Y, Shi Y, Ma H, Li D, Su T, Meidege OZ, Wang B, Lu X. Application of Multi-Dimensional Intelligent Visual Quantitative Assessment System to Evaluate Hand Function Rehabilitation in Stroke Patients. Brain Sciences. 2022; 12(12):1698. https://0-doi-org.brum.beds.ac.uk/10.3390/brainsci12121698
Chicago/Turabian StyleDu, Yuying, Yu Shi, Hongmei Ma, Dong Li, Ting Su, Ou Zhabayier Meidege, Baolan Wang, and Xiaofeng Lu. 2022. "Application of Multi-Dimensional Intelligent Visual Quantitative Assessment System to Evaluate Hand Function Rehabilitation in Stroke Patients" Brain Sciences 12, no. 12: 1698. https://0-doi-org.brum.beds.ac.uk/10.3390/brainsci12121698