Objective Assessment Of Hemiplegic Gait In Stroke Patients With Abnormal Function Of Liver Storing Blood Based On Wearable Devices

BackgroundThe liver and blood make the nutrition of tendons and vessels sufficient,which means that the liver can maintain the smooth flow of qi and blood,so that the limbs move flexibly.Liver does not hide the fact that dysfunctional liver storing blood.The liver does not regulate blood normally.It is manifested as limb muscle and vessel malnutrition,resulting in limb spasm and movement disorders.The location of stroke is in the liver.One of the pathogenesis of hemiplegic gait after stroke is that the liver does not store blood and spasm of tendons and vessels.At present,the function of the liver stores blood disorder lead to limb dysfunction on the basis of the assessment tools mainly related disease patients complained of or physicians rating scale of signs of subjective judgment and limb function classification.The three-dimensional gait analysis system provides an objective standard for the evaluation of gait abnormalities,but the evaluation method is complex to operate and needs to be tested in specialized laboratories.Under the guidance of traditional Chinese medicine theory,wearable devices based on three-axis acceleration sensors,as a supplement to the traditional Chinese medicine gaze posture,are expected to propose a new method for this problem.ObjectiveThe theoretical research mainly discusses the syndrome differentiation basis of the syndrome of liver can’t storing blood,and provides theoretical guidance for the objective evaluation of the abnormal function of liver storing blood.To explore the sensitive indicators to distinguish the hemiplegic gait and construct the evaluation model of hemiplegic gait after stroke without hepatic blood,so as to provide data support for future research on the degree of hemiplegic gait and the improvement after intervention in stroke patients without hepatic blood.Materials and methods1 Study on the symptoms and clinical features of the syndrome of lliver failing to store bloodBased on the mining of Traditional Chinese Medicine(TCM)medical records database and TCM symptom and pathogenesis database,we used Φ correlation analysis method to analyze the symptoms and clinical characteristics(symptom unit,symptom location,symptom nature,symptom aggravation and relief factors)of the syndrome of lliver failing to store blood,summarized and established the corresponding relationship of symptom unit and symptom location of the syndrome of lliver failing to store blood,and explained the pathogenesis.Finally,the common symptoms of stroke patients of lliver failing to store blood were determined.2 Clinical study of hemiplegic gait in stroke patients without hepatic blood accumulationThis research adopts the clinical gait analysis technology based on the principle of a portable data acquisition device,respectively the gait gait and hemiplegic gait subjects for health testing.The subjects walked continuously for 30 meters in a designated place according to their daily state.The acceleration signal of the subjects during continuous walking was recorded in real time by a three-axis acceleration sensor.Matlab2020b data analysis software was used to extract the relevant kinematic parameters of the subjects during walking.SPSS24.0 and SAS6.12 software were used to analyze the gait parameters.SPSS24.0 software was used to analyze the differences of gait parameters between groups by t test and non-parametric test.ROC curves were constructed for gait parameters with significant differences between the two groups to study the independent diagnostic value of gait parameters for symptoms related to hemiplegic gait and hepatic vascular dysfunction,and the diagnostic value was visualized.SAS6.12 statistical software was used to analyze the comprehensive diagnostic value of each gait parameter for hemiplegic gait and liver-blood dysfunction related symptoms by using unconditional Logistic multiple stepwise regression analysis,and a diagnostic model was established to explore its intrinsic physiological and pathological implications.Results1 Symptoms and clinical features of liver failure to store bloodThe main symptom units of liver failure to store blood are clonus,convulsion,mouth and eye distortion,speech,amyotrophy,muscle pain,muscle sour,skin numbness,dysphagia,mouth and lip numbness,hands and feet peristalsis,Bradycardia of muscles and veins,Binocular upview and so on.The main symptom sites of liver failure to store blood are head,eyes,tongue,upper limbs,lower limbs,etc.The main symptoms of the syndrome included spasm,numbness,atrophy,tremor,deviation,numbness,vertigo,tinnitus,convulsion,shaking,easily starched,dilated pupils,fleeing pain,and speech.The aggravation and remission factors of the symptoms of the syndrome were aggravation of anger,aggravation of trauma,aggravation of cold,and relief of warmth.In summary,the common symptoms of stroke patients with liver non-hiding blood type are hemiplegia,limb numbness,vertigo,language astringency,dysphagia,hand and foot peristalsis,mouth and eyes deviation,spasm2 Experimental study of hemiplegic gait in stroke patients without hepatic blood accumulation(1)In this study,103 subjects with hemiplegic gait and 58 subjects with healthy gait were collected.The basic information such as gender,age,height,weight,FAC scale and other basic information of the two groups were matched by propensity score and other methods according to the sample grouping standard,49 cases in the control group and 92 cases in the experimental group were finally included.The control group included 22 males and 27 females,with an average age of(62.49± 11.89),average height of(168.59±6.48)cm,and average weight of(70.55±8.47)kg.The experimental group included 57 males and 35 females,with an average age of(61.54± 11.39)years,an average height of(169.82±6.44)cm,and an average weight of(72.59±6.48)kg.There were 43 patients with FAC grade Ⅱ or Ⅲ and 49 patients with FAC grade Ⅳ or Ⅴ.The results showed that there was no significant difference in the basic information between the two groups(P>0.05).(2)According to the TCM symptom observation table,the common symptoms of 92 subjects with hemiplegic gait were collected,and the results showed that the incidence of hemiplegia,limb peristalsis,spasm,vertigo and limb numbness were high.Among them,hemiplegia,spasm and limb peristalsis were objective symptoms,limb numbness and vertigo were subjective sensory symptoms.The subjects with hemiplegic gait were grouped according to the above five symptoms.From the 49 normal gait subjects,the subjects with the same basic information such as gender,age,and height as the above five symptom groups were matched at baseline.After baseline matching,50 subjects were in the hemiplegia group and 49 subjects were in the non-hemiplegia group,with a total of 99 subjects.There were 49 people in the limb numbness group and 43 people in the non-limb numbness group,a total of 92 people.There were 23 patients in the seizure group and 23 patients in the non-seizure group,a total of 46 patients.There were 26 patients in the vertigo group and 26 patients in the non-vertigo group,a total of 52 patients.There were 40 patients in the hand-foot peristalsis group and 40 patients in the non-hand-foot peristalsis group,a total of 80 patients.(3)Statistical analysis of gait parameters between the normal gait group and the hemiplegic gait group,between the normal gait group and the mild and moderate stroke group,between the normal gait group and the healthy side and the affected side of the experimental group,and between the symptomatic group and the asymptomatic group showed that:Triaxial Acceleration Mean(TAM),Triaxial Acceleration Force(TAF),Triaxial Acceleration Balance Mean(TABM),Triaxial Acceleration Balance Standard Deviation(TABS),Triaxial Acceleration Balance Variation Coefficient(TABCV),Coronal Axis Balance Mean(CABM),Coronal Axis Balance Standard Deviation(CABS),Coronal Axis Combined Displacement Coefficient of Variation(CABCV),Vertical Axis Balance Mean(VABM),Vertical Axis Balance Standard Deviation(VABS),Vertical Axis Balance Variation Coefficient(VABCV),Sagittal Axis Balance Mean(SABM),Sagittal Axis Balance Standard Deviation(SABS),Sagittal Axis Balance Variation Coefficient(SABCV),Pace Velocity(PV),Step Size(SS)and Step Frequency(SF)showed significant difference.The results showed that the balance and exercise ability of the subjects with abnormal liver function were worse than those with normal liver function.(4)ROC curves were constructed for gait parameters with significant differences between the normal gait group and the hemiplegic gait group,and between the symptomatic group and the asymptomatic group.① Triaxial Acceleration Mean(TAM),Triaxial Acceleration Force(TAF),Step Size(SS)have high value in the diagnosis of hemiplegic gait alone.② Triaxial Acceleration Mean(TAM),Triaxial Acceleration Force(TAF),Step Size(SS)and Step Frequency(SF)have high value in the diagnosis of hemiplegia separately;Pace Velocity(PV)and Step Size(SS)have high value in the diagnosis of limb numbness.Triaxial Acceleration Mean(TAM),Pace Velocity(PV)and Step Size(SS)have high value in the diagnosis of the brotherhood of peristalsis alone.Triaxial Acceleration Mean(TAM),Triaxial Acceleration Force(TAF),Step Size(SS)and Step Frequency(SF)have high value in the diagnosis of spasm separately.Triaxial Acceleration Mean(TAM),Step Size(SS)and Step Frequency(SF)have high value in the diagnosis of vertigo separately.(5)The comprehensive diagnostic value of gait parameters for the hemiplegic gait group and the non-hemiplegic gait group,the symptomatic group and the asymptomatic group were studied by using the unconditional Logistic multiple stepwise regression analysis.① Triaxial Acceleration Mean(TAM)and Step Frequency(SF)had a significant negative effect on the hemiplegic gait.The combined consideration of these two gait parameters has high diagnostic value for hemiplegic gait.② Triaxial Acceleration Mean(TAM)and Step Size(SS)had a significant negative effect on hemiplegia.Combined consideration of these two gait parameters has high diagnostic value for hemiplegia.Step Size(SS)has a significant negative effect on limb numbness.Comprehensive consideration of this gait parameter has a high diagnostic value for limb numbness.Step Size(SS)has a significant negative effect on hand-foot peristalsis,and the comprehensive consideration of this gait parameter has a high diagnostic value for hand-foot peristalsis.Coronal Axis Balance Mean(CABM)has a significant positive effect on spasm.Stride Size(SS)and Stride Frequency(SF)had a significant negative effect on spasm.Combined consideration of these three gait parameters has high diagnostic value for spasm.Step Size(SS)and Step Frequency(SF)have a significant negative effect on vertigo.Combined consideration of these two gait parameters has a high diagnostic value for vertigo.Conclusions1 According to the theoretical research,the deficiency of blood in the liver can be divided into two aspects:deficiency of blood and deficiency of blood.The syndrome differentiation of viscera of stroke patients with hemiplegic gait is mainly liver accumulation,and the syndrome of liver not accumulation of blood runs through the whole syndrome differentiation.Hemiplegia,limb numbness,spasm,vertigo and limb peristalsis are the main symptoms of patients with hemiplegic gait after stroke.At present,the development of Traditional Chinese Medicine has always adhered to the innovation on the basis of inheritance.Under the condition of not contradicting the core concept of traditional Chinese medicine,the TCM diagnosis and treatment process can be justified based on the theory of aspiration posture of traditional Chinese medicine combined with biological engineering.2 Among the gait parameters obtained by the triaxial acceleration sensor,step length,step speed,step frequency,anti-gravity extension,moving speed and strength,and balance ability can be used as sensitive indicators to distinguish hemiplegic gait after stroke and healthy gait.Based on relevant sensitive indicators,the construction of objective assessment models can help to formulate and monitor rehabilitation plans,and play a huge role in the diagnosis and treatment of neuromotor disorders as an effective alternative to more complex biomechanical measures.