Study Of Spasticity Assessment And Neurorehabilitation Methods For Upper Limb Muscle Function

Muscle spasticity is a refractory disease of limb motor dysfunction.It is always a difficult problem in the clinical and a hotspot in the field of international rehabilitation medicine research.The neuromuscular characters of muscle groups related to spasm are changed?It is important to study the neuromuscular properties and the biomechanical properties of spasm muscles for quantitative assessment and rehabilitation of spasm.The acquisition and processing of electromyogram(EMG),mechanomyogram(MMG)and biomechanics signals is the precondition of study on corresponding research.It is valuable to study the neurorehabilitation methods based on brain-scalp stimulation and neuroimaging technology.However,at present the evaluation of muscle spasm often only focuses on one functional characteristic of a single muscle,lacks the discussion of multi-mode information of muscle groups,lacks the study on the neuro mechanism of muscle spasm,and lacks the corresponding information detection methods and systems.To solve these problems,this paper collected multi-channel electroencephalogram(EEG),High density EMG and MMG,then evaluated the muscle spasticity with multi-model information fusion analysis.And the properties of neuromuscular and biomechanical within muscle spasm were studied.The muscle assessment method based on patter recognition with EMG and MMG was also studied.The neuroplasticity mechanism of muscle spasm rehabilitation based on transcranial magnetic stimulation and magnetic resonance imaging was discussed.To meet the demand of clinical,EMG and muscle deformation detection methods based on flexible stretchable electrodes were studied,and a portable rehabilitation evaluation system for muscle spasm was developed.This study will improve the understanding on the the mechanism of neurorehabilitation,and provide the theoretical and technical supports for the development of new methods for quantitative assessment and neural rehabilitation for upper-limb spasm.Firstly,aimed to solve the difficult points for the EMG and muscle deformation signal detection,we developed the soft and stretchable electrode and sensor system.In this paper,the fabrication,mechanical and electronic properties of flexible stretchable electrodes are optimized and tested.A method of synchronous acquisition of EMG and deformation information of muscle with flexible electrodes was developed.At the meanwhile,for the purpose of quantitative assessment of muscle spasticity,this study designs a wireless multi-channel acquisition system for synchronous acquisition of EMG and MMG signals.And the self-developed system is portable,easy to use,and clinical popular.Secondly,in this paper,we carried out a study on dual-model information analysis of EEG and EMG in patients with muscle spasm.Neuromuscular electrical properties of patients were studied by dynamic electromyography,muscle co-activation and brain-muscle correlation.An effective new electromyography index was proposed for quantitative evaluation of muscle spasm.Thirdly,the performance of biomechanics analysis assessment is affected by the individual difference,so two normalization factors for biomechanics analysis assessment were investigated: body weight normalization factor and maximum isometrics volunteer contraction normalization factor.And in this study,we investigated the validity and reliability of maximum isometrics voluntary contraction(MIVC)based method for spasticity assessment in post-stroke hemiplegic paralyses.A set of newly proposed three biomechanical features(peak torque,keep time of the peak torque,rise time)were extracted from biomechanical signal recordings and used to evaluate the muscle voluntary activation characteristics of their impaired arms.The validity and reliability of the novel MIVC based spasticity assessment method was evaluated with spearman correlation analysis and intra class correlation coefficients(ICCs)metrics.And we found the index 6)may be an effective and reliable markers for spasticity assessment.Moreover,the four spasticity grades were identified with support vector machine and the classification accuracy of SVM with EMG-MMG was 91.7%.Our results suggest that using the SVM-based method with EMG and MMG to assess elbow spasticity would be suitable for clinical management of spasticity.Finally,to study the clinical effects of scalp acupuncture plus low frequency r TMS in hemiplegic stroke patients.A total of 28 hemiplegic stroke patients were recruited,and functional magnetic resonance imaging and Diffusion tensor imaging were used to explore the neuroplasticity mechanism of limb muscle spasm rehabilitation after stroke at different levels,such as cortical level and limb behavioral level.To sum up,the object of this paper is the upper limb muscle spasm after stroke,was studied from the peripheral,central,and clinical application levels.In this paper,the quantitative evaluation of muscle spasm is carried out from the peripheral level in terms of neuromuscular and biomechanical characteristics of muscle spasm;the neurorehabilitation mechanism of muscle spasm was investigated by transcranial magnetic stimulation and scalp needle in the central level with functional magnetic resonance imaging and diffusion tensor imaging.The flexible stretchable electrodes,EMG,muscle deformation and MMG are studied.Multi-mode information Synchronize acquisition method was used in the clinical application level.The results of this study will be useful for the research and development of upper limb motor function assessment and rehabilitation methods,and it will improve the diagnosis and treatment levels of muscle spasm,and promote the clinical application of muscle spasticity assessment and rehabilitation.