JP6730573B2 - Severity assessment support system and program - Google Patents

Description

The present invention relates to a severity evaluation support system or the like that supports evaluation of the severity of spasticity.

Spasticity is a very common symptom as a sequelae of disorders of the central nervous system such as stroke and spinal cord injury, and is a movement disorder characterized by a speed-dependent increase in the tonic stretch reflex associated with tendon reflexes. is there. The Modified Ashworth Scale (MAS) is a typical severity evaluation scale for upper limb spasticity. Doctors and occupational therapists interview patients with spasticity and then subjectively evaluate the severity of spasticity based on MAS evaluation items. Since it is subjectively evaluated, the severity of spasticity depends on the experience of the attending physician and cannot be quantitatively evaluated. Further, in MAS, there is a problem that the resolution for evaluating spasticity is low, and it is difficult to evaluate the degree of recovery of a patient during rehabilitation. Therefore, a method for evaluating spasticity quantitatively and with high resolution is required.

For example, Patent Documents 1 and 2 disclose a device that distinguishes a healthy person from a Parkinson's disease patient by using a force sensor and a gyro sensor.

International Publication No. 2009/154117 International Publication No. 2011/145465

However, both of the devices described in Patent Documents 1 and 2 need to use both the force sensor and the gyro sensor, and the device configuration is complicated.

In addition, spasticity is characterized by a large resistance to passive movement at the beginning of exercise, and a sudden decrease in resistance when moving to a certain point, whereas muscle rigidity seen in patients with Parkinson's disease is similar to passive movement. There is a characteristic that there is continuous resistance inside. Due to such a difference, it is unclear whether or not the apparatus described in Patent Documents 1 and 2 that is most suitable for Parkinson's disease patients can be applied to the evaluation of the severity of spasticity.

The present invention has been made in view of the above-mentioned problems, and an object thereof is to determine the severity of spasticity, with a simple configuration, which can support quantitative and high resolution evaluation. It is to provide a degree evaluation support system.

A first invention for achieving the above-mentioned object is a severity evaluation support system for assisting evaluation of the severity of spasticity, wherein an angle of the joint when the subject's joint is passively flexed and extended. A measuring device that measures information about time change of the, and a calculating device that calculates a parameter used for evaluation of the severity based on the information measured by the measuring device. The spasticity occurrence angle is calculated based on the angular acceleration of the joint in, and the difference obtained by subtracting the low-frequency component from the high-frequency component of the angular acceleration of the joint during extension exercise is changed from negative to positive, from positive to negative. The severity evaluation support system is characterized in that the magnitude of the spasticity is set to the integral value of the interval up to the time . According to the first aspect of the present invention, the spasticity occurrence angle, which is a parameter having quantitative and high resolution, can be obtained with a simple configuration that does not require a force sensor. In particular, in MAS, which is a typical severity evaluation scale for upper limb spasticity, where the spasticity occurrence angle is an evaluation item, the spasticity occurrence angle can be automatically obtained. It can support independent independent quantitative evaluation. Further, the magnitude of spasticity, which is a parameter having quantitative and high resolution, can be obtained with a simple configuration that does not require a force sensor. In particular, spasticity is a movement disorder characterized by a speed-dependent increase in tonic stretch reflex with tendon reflexes, and the size of spasticity in consideration of speed dependence can be automatically obtained. It is possible to support highly quantitative evaluation.

A second aspect of the present invention uses a computer to measure the severity of spasticity based on information measured by a measuring device that measures time-related information about a change in angle of the joint when the subject's joint is passively flexed and extended. Is a program for functioning as a calculation device for calculating a parameter used for the evaluation, wherein the calculation device calculates a spasticity occurrence angle based on the angular acceleration of the joint during extension exercise, and the joint during extension exercise. It is a program to make the integrated value of the interval from the time when the low frequency component is subtracted from the high frequency component of the angular acceleration from negative to positive to the time from positive to negative becomes the size of spasticity. is there. By installing the program of the second invention in a general-purpose computer, the calculation device of the first invention can be obtained.

According to the present invention, it is possible to provide a severity evaluation support system or the like capable of supporting quantitative and high-resolution evaluation of the severity of spasticity with a simple configuration.

Figure showing the outline of the severity assessment support system Flowchart showing the flow of severity evaluation support processing Diagram showing each principal component and movement trajectory in the local coordinate system Diagram showing movement trajectory on two-dimensional plane The figure explaining the coordinate axis of the local coordinate system in the 3rd calculation method. Bird's-eye view of movement loci of the first receiver and the second receiver during flexion and extension movements displayed in the world coordinate system Bird's-eye view of the locus of movement of the second receiver during flexion and extension movements displayed in the local coordinate system The figure which shows the time-dependent change of the angle of the joint in the analysis example 1. The figure which shows the time-dependent change of the angular velocity of the joint in the analysis example 1. The figure which shows the time-dependent change of the angular acceleration of the joint in the example 1 of an analysis. The figure which shows the time change which normalized the angle of joint, angular velocity, and angular acceleration in the analysis example 1 by the maximum of the absolute value of each waveform. The figure which shows the spasticity occurrence angle of each spasticity patient in the analysis example 1. The figure which piled up the angular acceleration which multiplied the moving average 15 and the angular acceleration which multiplied the moving average 31 in the analysis example 1. The figure which shows the difference of the angular acceleration which multiplied the moving average 15 and the angular acceleration which multiplied the moving average 31 in the example 1 of an analysis. The figure which shows the time-dependent change of the angle of the joint in the analysis example 2. The figure which shows the time-dependent change of the angular velocity of joint S0 in the example 2 of an analysis. The figure which shows the time-dependent change of the angular acceleration of joint S0 in the example 2 of an analysis. The figure which shows the time-dependent change which normalized the angle of joint S0 in analysis example 2, the angular velocity, and the angular acceleration by the maximum of the absolute value of each waveform. The figure which shows the spasticity occurrence angle of each spasticity patient in the analysis example 2. The figure which shows the mounting method of the receiver in the example 3 of an analysis. The figure which shows the time-dependent change of the left-right component of the movement distance of a forearm when making an upper arm the origin in the example 3 of an analysis. The figure which shows the movement locus on a two-dimensional plane in the analysis example 3. The figure which shows the time-dependent change of the angle in the analysis example 3. The figure which shows the time-dependent change which normalized the angle, angular velocity, and angular acceleration of joint S0 in the example 4 of analysis by the maximum of the absolute value of each waveform. The figure which shows the spasticity occurrence angle of each spasticity patient in the analysis example 4.

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. FIG. 1 is a diagram showing an overview of a severity evaluation support system. As shown in FIG. 1, a severity evaluation support system 1 includes a measuring device 2 that measures information about a temporal change in an angle of a joint S0 when a joint S0 of a subject S is passively flexed and extended, and a measuring device. The calculation device 3 calculates parameters used for evaluation of the severity of spasticity based on the information measured by 2.

The measuring device 2 is a three-dimensional position/orientation measuring device using a magnetic sensor, and includes a transmitter 20 composed of three-axis orthogonal coils, a first receiver 21 and a second receiver 22 also composed of three-axis orthogonal coils, And a controller 23 for controlling these. The first receiver 21 and the second receiver 22 are the first sensor and the second sensor as referred to in the present invention.

Since the diameter of the coil is sufficiently smaller than the distance between the transmitter 20 and the first receiver 21 and the second receiver 22, each coil can be regarded as one point. When a current is applied to the coil of the transmitter 20 to excite it, a magnetic field is generated. The first receiver 21 and the second receiver 22 receive a pulsed magnetic field generated by exciting the transmitter 20, and a current flows through the coils by electromagnetic induction. The controller 23 detects the currents flowing through the coils of the first receiver 21 and the second receiver 22, performs AD conversion, and transmits the measurement data to the calculation device 3 by wireless communication. The measurement data is relative position information (x, y, z) and attitude information (azimuth, elevation, roll) between the transmitter 20 and the first receiver 21 and the second receiver 22.

The calculation device 3 is a notebook PC (abbreviation of “Personal Computer”) or the like, a CPU (abbreviation of “Central Processing Unit”) as a control unit, a memory as a main storage unit, and an HDD (“A” as an auxiliary storage unit). Hard disk drive), a flash memory, a storage medium as an external storage unit, a liquid crystal display as a display unit, a keyboard or a mouse as an input unit, a touch panel display, a wireless module as a wireless communication unit, and the like. An OS (abbreviation of “Operating System”) and application programs are stored in the HDD or flash memory as auxiliary storage means, and the measurement data received from the measuring device 2 is also stored. The CPU of the calculation device 3 reads the OS and the application program from the auxiliary storage unit and stores them in the main storage unit, controls the other devices while accessing the main storage unit, and executes the processing described later.

The measuring device 2 is not limited to the magnetic sensor, and may be an ultrasonic sensor, a gyro sensor, an electric goniometer, or the like as long as it can measure information about the time change of the angle of the joint S0. The calculation device 3 is not limited to the notebook PC, but may be a desktop PC, a tablet terminal, a smartphone, or the like. Further, the measurement device 2 and the calculation device 3 are not limited to wireless communication and may be wired communication.

FIG. 2 is a flowchart showing the flow of the severity evaluation support processing. The case of an elbow joint will be described below. As shown in FIG. 2, a doctor, an occupational therapist, or the like (hereinafter, referred to as “doctor, etc.”) wears the first receiver 21 on the upper arm S1 of the subject S and the second receiver 22 on the forearm S2 of the subject S. Attach (step 1).

It is desirable that the first receiver 21 be attached to a position on the humerus bone of the upper arm S1 that has moved 3 to 5 cm from the olecranon of the joint S0 in the acromion direction. It is desirable that the second receiver 22 be attached to a position where the back side of the forearm S2 is moved to the carpal joint side by 3 to 5 cm from a line connecting the medial epicondyle and the lateral epicondyle of the joint S0. By mounting the first receiver 21 and the second receiver 22 in this manner, the displacement due to the expansion and contraction of muscles is unlikely to occur. Further, the first receiver 21 and the second receiver 22 may be sewn on the surface of the supporter. Thereby, the subject S can smoothly wear the first receiver 21 and the second receiver 22, and the first receiver 21 and the second receiver 22 do not directly touch the skin of the subject S.

The present invention can be applied to upper limb spasticity and lower limb spasticity other than the elbow joint. The first receiver 21 is attached to the first portion on one side connected to the joint S0, and The receiver 22 is attached to the second portion on the other side connected to the joint S0. The first receiver 21 and the second receiver 22 may measure only the posture information, or may measure both the posture information and the position information.

Next, the doctor or the like flexes and extends the joint S0 of the elbow of the subject S, and the measuring device 2 measures the information regarding the time change of the angle of the joint S0 (step 2).

A doctor or the like supports the elbow of the subject S with the left hand, grasps the wrist of the subject S with the right hand, and applies force to the right hand to bend and extend the upper limb of the subject S. For example, the initial posture is a state in which the angle between the upper arm S1 and the forearm S2 is a right angle. After the arm of the subject S is extended from the initial posture to an angle at which the arm of the subject S is fully extended, the subject S is bent again to the angle of the initial posture.

Next, the measurement device 2 transmits the measurement data to the calculation device 3 by wireless communication, and the calculation device 3 stores the measurement data in the auxiliary storage means or the like (step 3).

The controller 23 measures, for example, position information and posture information at 60 Hz. The coordinate system of the measurement data is a right-handed system for the transmitter 20, the first receiver 21, and the second receiver 22, and the measurement data is stored, for example, in a ZYX type Euler angle.

Here, the coordinate system and the Euler angle will be described. The coordinate system can be classified into a world coordinate system and a local coordinate system. The world coordinate system is a coordinate system common to all objects and is also called an absolute coordinate system. In the world coordinate system, even if an object moves, the coordinate system itself does not move. The local coordinate system is a coordinate system unique to each object and is also called a relative coordinate system. In the local coordinate system, the coordinate system itself moves and rotates as the object moves and rotates. The world coordinate system and the local coordinate system can be converted to each other. The Euler angle is a local coordinate system, and there are 12 ways to select a rotating axis. At the ZYX Euler angles, the posture information (azimuth, elevation, roll) is determined by rotating the Z axis, the Y axis, and the X axis in this order. The Euler angle and the rotation matrix are mutually convertible.

Next, the calculation device 3 calculates a parameter used to evaluate the severity of spasticity based on the measurement data (step 4). The parameter used to evaluate the severity of spasticity is, for example, a parameter indicating a spasticity occurrence angle or a magnitude of spasticity.

The characteristic of spasticity is that a resistance force that is caught when the forearm S2 is extended appears. Therefore, in the embodiment of the present invention, attention is paid to the second receiver 22 attached to the forearm S2. When analyzing the movement locus, the movement locus length, velocity, and acceleration vary depending on the mounting positions of the first receiver 21 and the second receiver 22 even if the movement is the same. Therefore, in order to quantitatively detect the catch, which is a symptom of spasticity, without being affected by the mounting positions of the first receiver 21 and the second receiver 22, there is a change in the angle between the upper arm S1 and the forearm S2, that is, the joint S0. Pay attention.

In the embodiment of the present invention, the method of calculating the angle of the joint S0 includes a first calculation method that uses only posture information, and a second calculation method and a third calculation method that use posture information and position information. Hereinafter, these three calculation methods will be described.

<First angle calculation method>
In the first calculation method, the calculation device 3 uses only the posture information (azimuth, elevation, roll) of the measurement data as the origin of the local coordinate system to rotate the second receiver 22 about the Y axis. The angle of the joint S0 is calculated by the component. The rotation component of the second receiver 22 can be represented by the coordinate system of the first receiver 21, which is a local coordinate system. For example, when the flexion extension movement of the elbow is represented by the coordinate system of the first receiver 21, it mainly rotates about the Y axis, so the angle around the Y axis of the second receiver 22 with the first receiver 21 as the origin is set. , The angle of the joint S0.

The specific calculation method is as follows. The calculation device 3 calculates the first rotation matrix using the posture information measured by the first receiver 21. Next, the calculation device 3 calculates the second rotation matrix using the posture information measured by the second receiver 22. Then, the calculation device 3 calculates the product of the second rotation matrix and the inverse matrix of the first rotation matrix to obtain the angle of the joint S0.

According to the first calculation method, the angle of the joint S0 can be calculated if there is at least a measuring device capable of measuring the posture information (three-degree-of-freedom information). When only the posture information is used, the initial posture of the subject S needs to be constant (90 degrees in the present embodiment).

<Second angle calculation method>
In the second calculation method, the calculation device 3 uses the position information (x, y, z) and the posture information (azimuth, elevation, roll) of the measurement data to localize the first part to which the first receiver 21 is attached. The movement locus of the second portion on which the second receiver 22 is mounted when the origin of the coordinates is calculated is calculated, the movement locus is approximated by an arc, the center coordinates of the circle formed by the arc are calculated, and the center coordinates are set as the rotation center. The angle of the joint S0 is calculated based on the rotation angle of the moving trajectory.

FIG. 3 is a diagram showing each principal component and movement locus in the local coordinate system. FIG. 4 is a diagram showing a movement trajectory on a two-dimensional plane. In order to approximate the movement locus with an arc, the calculation device 3 performs principal component analysis on the movement locus displayed in the local coordinate system and arranges it on a two-dimensional plane.

In FIG. 3, the movement path of the second part where the second receiver 22 is attached, which is plotted by using the first part where the first receiver 21 is attached as the origin of the local coordinates, and the first principal component calculated by the principal component analysis. ~ The vector of the third principal component is shown superimposed. The X axis, Y axis, and Z axis shown in FIG. 3 are coordinate axes of the local coordinate system. The curve that draws the arc is the movement trajectory of the second receiver 22.

The calculation device 3 obtains a two-dimensional plane on which the movement trajectory is arranged from the plane composed of the first principal component and the second principal component. FIG. 4 shows the locus of movement of the first principal component and the second principal component on the two-dimensional plane. The horizontal axis is the inner product of the first principal component and the movement trajectory, and the vertical axis is the inner product of the second principal component and the movement trajectory. The first part where the first receiver 21 is attached is the origin of the coordinates. The calculation device 3 assumes the movement locus shown in FIG. 4 as an arc and estimates the center coordinates of the arc. For the estimation process of the center coordinates of the circular arc, a known technique such as using a circle equation approximated by the least square method or using a vertical bisector can be applied.

Next, the calculation device 3 converts the center coordinates of the circle into the local coordinate system. Specifically, the procedure is as follows.
(1) Obtain the product of the unit vector of the first principal component and the x component of the center of the circle.
(2) Obtain the product of the unit vector of the second principal component and the y component at the center of the circle.
(3) The inner product of the position vector of each measurement point forming the movement trajectory and the unit vector of the third principal component is obtained, and the median of the inner product set is obtained.
(4) Obtain the product of the third principal component and (3).
(5) The sum of (1), (2) and (4) is taken.

Next, the calculation device 3 calculates the angle of the joint S0 by obtaining the vector connecting the center coordinates of the circle and each measurement point forming the movement trajectory and calculating the inner product between the vectors for each measurement point. Specifically, the calculation device 3 first obtains a vector heading to the first measurement point forming the movement trajectory from the center coordinates and sets it as a reference vector. Next, the calculation device 3 sequentially calculates, from the center coordinates, the second, third,... Then, the calculation device 3 calculates the inner product of the reference vector and the vector related to each measurement point, and sets it as the angle of the joint S0 at each measurement point with respect to the initial posture.

According to the second calculation method, the angle of the joint S0 can be calculated regardless of the initial posture of each receiver. Therefore, the artificial influence at the time of wearing is reduced, and the angle of the joint S0 can be calculated more accurately.

<Third angle calculation method>
The third calculation method is a method of calculating the angle of the joint S0 so that the protractor is applied to the plane on which the joint S0 rotates in the flexion extension movement. In the third calculation method, the calculation device 3 converts the position information and the posture information measured by the second receiver 22 into the local coordinate system having the mounting position of the first receiver 21 as the origin and also into the local coordinate system. The position information measured by the second receiver 22 is subjected to coordinate conversion in which the position of the joint S0 is translated in parallel by the amount of the displacement of the mounting position of the first receiver 21, and the position information measured by the second receiver 22 after the coordinate conversion is performed. From the measurement start position, the angle formed by the vector connecting the coordinates and the origin indicated by the first frame and the vector connecting the coordinates indicated by the second and subsequent frames of the position information measured by the second receiver 22 after coordinate conversion and the origin is calculated. And the angle of the joint S0 is calculated based on the rotation angle from the measurement start position. When the joint S0 is an elbow, the rotation center of the joint S0 in the third calculation method is the olecranon.

FIG. 5 is a diagram illustrating the coordinate axes of the local coordinate system in the third calculation method. FIG. 5A is a diagram of the right elbow of the subject S viewed from the axial direction of the rotation axis of the joint S0 in the flexion extension movement. FIG. 5B is a diagram of the right elbow of the subject S viewed from the longitudinal direction of the upper arm S1.

As shown in FIG. 5, the coordinate axes of the local coordinate system in the third calculation method have the mounting position of the first receiver 21 as the origin, the longitudinal direction of the upper arm S1 is the X axis, and the axis of the rotation axis of the joint S0 in the flexion extension motion. The direction is defined as the Y-axis, and the direction orthogonal to the X-axis and the Y-axis is defined as the Z-axis. The positive direction of the X axis is from the origin to the center of rotation of the joint S0, the positive direction of the Y axis is from the origin to the inside of the body of the subject S, and the positive direction of the Z axis is the direction from the origin to the upper arm S1. And In FIG. 5, the positive direction of the X-axis is from right to left of the paper, the positive direction of Y-axis is from the back to the front of the paper, and the positive direction of Z-axis is from the bottom to the paper.

(Coordinate transformation)
The calculation device 3 converts the position information and the posture information measured by the second receiver 22 into a local coordinate system having the mounting position of the first receiver 21 as an origin, and measures the second receiver 22 converted into the local coordinate system. Coordinate conversion is performed in which the position information is moved in parallel by a shift amount between the rotation center of the joint S0 and the mounting position of the first receiver 21.

An error is likely to occur near the center of rotation of the joint S0 because the skin is displaced during rotation. Therefore, the first receiver 21 is mounted at a position slightly apart from the center of rotation of the joint S0 and moves in parallel with respect to the deviation from the center of rotation of the joint S0, thereby suppressing the occurrence of an error. The amount of deviation between the rotation center of the joint S0 and the mounting position of the first receiver 21 may be measured when the first receiver 21 is mounted, and may be input to the calculation device 3, or may be input at a predetermined position. The calculation device 3 may store the predetermined position by mounting the first receiver 21.

For example, when the first receiver 21 is mounted at a position displaced from the center of rotation of the joint S0 by 3 cm toward the first site, the calculation device 3 uses the X of the position information measured by the second receiver 22 converted into the local coordinate system. Subtract 3 cm from the components. The process of correcting the deviation between the rotation center of the joint S0 and the mounting position of the first receiver 21 may be performed not only on the X component but also on the Z component.

Further, the mounting position of the second receiver 22 is preferably near the ulna that serves as a rotation axis in the rotation of the forearm. As a result, it is possible to suppress the occurrence of an error due to the rotation of the forearm. In particular, the mounting position of the second receiver 22 is preferably within the range from the center of rotation of the elbow to 1/3 of the total length of the ulna.

(Calculation of rotation angle from measurement start position)
The position information and the posture information measured by the first receiver 21 and the second receiver 22 exist in a plurality of frames in one measurement. First, the calculation device 3 sets the coordinates indicated by the first frame of the position information measured by the second receiver 22 after coordinate conversion as the measurement start position, and calculates the vector VR connecting the measurement start position and the origin. Next, the calculation device 3 calculates a vector VN connecting the coordinates indicated by the Nth frame (N is an integer of 2 or more) of the position information measured by the second receiver 22 after the coordinate conversion and the origin. Then, the calculation device 3 calculates the angle θ formed by VR and VN as the rotation angle from the measurement start position. The calculation device 3 stores the VR calculated by the first measurement, and uses the stored VR for the second and subsequent measurements that are continuously performed without removing each sensor.

(Calculation of the angle of the joint S0)
When the Y component of the cross product of VR and VN (VR×VN) in the local coordinate system is positive, the calculation device 3 sets the angle φ of the joint S0 to 90°−θ and calculates the cross product of VR and VN (VR×VN). When the Y component in the local coordinate system is negative, the angle φ of the joint S0 is set to 90°+θ.

According to the third calculation method, the calibration (=the process of correcting the deviation between the rotation center of the joint S0 and the mounting position of the first receiver 21) is performed only for the first measurement, and each sensor is continuously removed without being removed. The calibration is not necessary for the second and subsequent measurements performed later. In addition, since the angle of the joint S0 is calculated on the plane in which the joint S0 rotates in the flexion extension movement, it follows the movement or inclination of the joint S0 in an unexpected direction, and the parameters such as the spasticity occurrence angle described later are accurate. It can be calculated well.

The calculating device 3 may use the moving average in order to reduce fine noise regardless of any of the first to third calculating methods. The moving average is a method of smoothing time series data, and outputs the average of the latest n pieces of data. The moving average may be a simple moving average, a weighted moving average, an exponential moving average, or the like, but any one may be used.

According to the first calculation method to the third calculation method, the time change of the angle of the joint S0 can be calculated, so that the calculation device 3 can also calculate the angular velocity and the angular acceleration of the joint S0.

<Calculation of spasticity occurrence angle>
The calculation device 3 calculates the spasticity occurrence angle based on the angular acceleration of the joint S0 during the extension exercise. For example, the calculation device 3 sets the time at which the angular acceleration of the joint S0 is distorted as the spasticity occurrence time, and the angle of the joint S0 at the spasticity occurrence time as the spasticity occurrence angle.

In MAS, which is a typical severity evaluation scale for upper limb spasticity, the spasticity occurrence angle is an evaluation item, but the severity assessment support system 1 can automatically obtain the spasticity occurrence angle. Can support quantitative evaluation independent of experience.

<Calculation of spasticity>
The calculation device 3 calculates the difference between the high-frequency component and the low-frequency component of the angular acceleration of the joint S0 during extension motion from the time when the difference becomes negative to the time when the difference becomes positive to negative. Size.

Here, the high frequency component of the angular acceleration means the angular acceleration multiplied by the moving average having a small moving average score. Further, the low frequency component of the angular acceleration means an angular acceleration multiplied by a moving average having a large moving average score. If the moving average score is low, the degree of smoothing is low, and if the moving average score is high, the degree of smoothing is high.

For example, the cutoff frequency when the moving average score is multiplied by 15 and the cutoff frequency when the moving average score is multiplied by 31 is calculated as follows.

From the equation (1), the cutoff frequency for the moving average of 15 is 1.77 Hz, and the cutoff frequency for the moving average of 31 is 0.86 Hz. Therefore, when the sampling interval is 60 Hz and the moving average 15 and the moving average 31 are used, the calculation device 3 calculates the angular acceleration in the section of 0.86 Hz to 1.77 Hz during extension motion as the magnitude of spasticity. .. Here, the high-frequency component of the angular acceleration passed through a low-pass filter with a cut-off frequency of 1.77 Hz, and the low-frequency component of the angular acceleration passed through a low-pass filter with a cut-off frequency of 0.86 Hz. It is a time series signal of angular velocity.

Assuming that the flexion extension motion of the elbow is a rotational motion by two rigid bodies of the upper arm S1 and the forearm S2, the torque of the forearm S2 can be considered to be proportional to the angular acceleration. Therefore, the magnitude of the spastic resistance can be approximated and evaluated by obtaining the amount of change in the angular acceleration in a certain band.

Where spasticity is a movement disorder characterized by speed-dependent increase in tonic stretch reflex with tendon reflex, the severity assessment support system 1 automatically obtains the magnitude of spasticity considering speed dependence. Therefore, reliable and quantitative evaluation can be supported.

Hereinafter, Analysis Examples 1 to 3 by the severity evaluation support system 1 will be described.

<Analysis example 1>
In Analysis Example 1, measurement data of 6 healthy subjects and 7 spastic patients were used. All healthy subjects were in their twenties, 4 males and 2 females. The spastic patients A to G were 49 to 81 years old (average age 65.6 years old), 3 males and 4 females. Further, the spastic patients had an MAS score of “1” (there was an increase in longitudinal muscle tone. There was some resistance at the end of the range of motion due to catching and disappearing during flexion and extension).

As the measuring device 2, "G4" (a three-dimensional position measuring device utilizing electromagnetic field) manufactured by POLHEMUS, USA was used. The first receiver 21 was attached to a position on the humerus bone of the upper arm S1 that moved 3 to 5 cm from the olecranon of the joint S0 toward the acromion. The second receiver 22 was attached to a position where the back side of the forearm S2 was moved to the carpal joint side by 3 to 5 cm from the line connecting the medial epicondyle and lateral epicondyle of the joint S0.

One session consists of measuring 5 times "movement to extend the initial posture (90 degrees) from the subject's arm to the full extension (about 0 degrees) and bend it to the initial posture" five times in succession. A total of 4 sessions were measured, with 2 sessions per arm per person. In the case of spasticity patients, the arm with no symptom of spasticity was measured first to have them understand the measurement contents, and then the arm with symptom of spasticity was measured.

In the analysis example 1, the calculation device 3 uses only the attitude information (azimuth, elevation, roll) of the measurement data as the origin of the local coordinate system with the first receiver 21 and the rotation component around the Y axis of the second receiver 22. Then, the angle of the joint S0 was calculated (first calculation method).

FIG. 6 is a bird's-eye view showing the movement loci of the first receiver 21 and the second receiver 22 mounted on the left arm of the spastic patient A who have symptoms of spasticity in the world coordinate system. The X axis, the Y axis, and the Z axis are coordinate axes of the world coordinate system. As shown in FIG. 6, since the movement trajectory of the second receiver 22 repeatedly draws an arc, it can be seen that the flexion extension movement of the forearm S2 is measured. Further, although the doctor or the like supported and fixed the upper arm S1 at the time of measurement, it can be seen that the elbow portion is moving when plotted in the world coordinate system. In other words, in the world coordinate system, it is understood that not only the component of the flexion and extension motion of the arm but also the pitching and rolling of the arm and the shaking of the trunk are measured in a superimposed manner.

FIG. 7 is a bird's-eye view of the locus of movement of the second receiver 22 displayed in local coordinates of the first receiver 21 attached to the left arm having the spastic symptoms of the spastic patient A during flexion and extension exercises. Here, the local coordinate system means a coordinate system created by the X-axis, Y-axis, and Z-axis of the first receiver 21 with the first receiver 21 attached to the upper arm S1 as the origin. The X axis, Y axis, and Z axis shown in FIG. 7 are coordinate axes of the local coordinate system. When the movement locus of the second receiver 22 is plotted in the local coordinate system and the movement locus of the second receiver 22 relative to the first receiver 21 is seen, the vertical pitching and rolling of the arm, which is superimposed as a bias component, You can see that the shaking of the trunk has been removed.

FIG. 8 is a diagram showing changes over time in the angle of the joint S0 in Analysis Example 1. 8(a) is a healthy person and FIG. 8(b) is a spastic patient. The horizontal axis represents time and the vertical axis represents angle. The period surrounded by the dotted rectangle is during extension exercise. Since the initial posture is set to 90 degrees, the angle decreases as it extends. Therefore, when the inclination of the waveform is negative, it indicates extension movement, and when the inclination of the waveform is positive, it indicates bending movement. Comparing FIG. 8(a) and FIG. 8(b), the spastic patient in FIG. 8(b) takes a longer time to perform the extension motion and the flexion motion than the healthy subject in FIG. 8(a). You can see that it took. Moreover, it can be seen that the waveform of FIG. 8B has a smaller amplitude than the waveform of FIG. In FIG. 8, a moving average with a moving average score of 15 is multiplied in order to reduce fine noise during angle display.

FIG. 9 is a diagram showing a change over time in the angular velocity of the joint S0 in Analysis Example 1. 9(a) is a healthy person, and FIG. 9(b) is a spastic patient. The horizontal axis represents time and the vertical axis represents angular velocity. The period surrounded by the dotted rectangle is during extension exercise. The value of the angular velocity is 0 degree/second at the start of the operation, and has a negative value during extension movement and a positive value during flexion movement. Comparing FIGS. 9A and 9B, it can be seen that the waveform of FIG. 9A has a larger amplitude than the waveform of FIG. 9B. Further, the waveform of FIG. 9A has a shape close to a sine wave, whereas the waveform of FIG. 9B has a shape close to a triangular wave. In FIG. 9, a moving average with a moving average score of 15 is multiplied in order to reduce fine noise during angular velocity display.

FIG. 10 is a diagram showing changes over time in the angular acceleration of the joint S0 in Analysis Example 1. 10(a) is a healthy person, and FIG. 10(b) is a spastic patient. The horizontal axis represents time and the vertical axis represents angular acceleration. The period surrounded by the dotted rectangle is during extension exercise. From FIG. 10(a), it is understood that the angular acceleration of a healthy person is a negative component at the start of extension, and the inclination is almost constant and rises during extension exercise. On the other hand, FIG. 10B shows that the angular acceleration of the spastic patient has a negative component at the start of extension, and the angular acceleration increases as the extension exercise is performed, but distortion occurs in the middle. In FIG. 10, a moving average with a moving average score of 15 is multiplied in order to reduce fine noise when displaying the angular acceleration.

FIG. 11 is a diagram showing changes over time in which the angle, angular velocity, and angular acceleration of the joint S0 in Analysis Example 1 are normalized by the maximum absolute value of each waveform. 11(a) is a healthy person, and FIG. 11(b) is a spastic patient. The horizontal axis is time, and the vertical axis is an arbitrary unit. The period surrounded by the dotted rectangle is during extension exercise. Comparing FIG. 11(a) and FIG. 11(b), there is not much difference in angle and angular velocity, but there is a large difference in angular acceleration between a healthy person and a spastic patient. As shown in FIG. 11B, only in the case of a spastic patient, there is distortion in the curve of angular acceleration during extension motion. Here, in the embodiment of the present invention, the high frequency component in the temporal change of the angular acceleration of the joint S0 during the extension motion is defined as distortion. In particular, the inflection point of the acceleration that occurs at the earliest time after the start of the extension motion is defined as the "start time of spasticity".

For example, the calculation device 3 calculates the spasticity occurrence angle as follows.
(1) The calculation device 3 calculates the extension movement period of the joint S0 from the relative positions of the first receiver 21 and the second receiver 22 (for example, both ends of the arc shown in FIG. Since it is the end point of, it is possible to specify the extension exercise period from the start of extension exercise to the end of extension exercise).
(2) The calculation device 3 obtains an inflection point that changes from increase to decrease for the time series data of the angular acceleration (which has been subjected to arbitrary moving average processing) in each extension movement period, and the inflection that appears first. The time at the point is defined as the “start time of spasticity”.
(3) The calculation device 3 sets the angle of the joint S0 at the start time of this spasticity to be the “spasticity occurrence angle”.
In this way, the calculation device 3 can automatically determine the spasticity occurrence angle.

12: is a figure which shows the spasticity occurrence angle of each spasticity patient in the analysis example 1. FIG. The white line is the average value of the spasticity occurrence angles of 5 times measured at the first time and the black line is the second time, and the black bar is the standard deviation. It can be seen from FIG. 12 that, except for subjects D and G who are spastic patients, there is no significant difference between the first and second spasticity occurrence angles with a risk rate p<0.05. That is, it can be seen that the reproducibility of the inspection is high. The reason why a significant difference occurs between the subject D and the subject G is the deviation of the initial posture at the start of the first and second measurements. The initial posture was adjusted by a doctor so that the angle between the upper arm and the forearm of the subject was 90 degrees. At the time of analysis, the angle, angular velocity, and angular acceleration were calculated assuming that the initial posture was 90 degrees. Therefore, the initial postures of the subject D and the subject G were slightly deviated from 90 degrees at the first or second time, and a significant difference occurred due to the deviation of the initial postures.

FIG. 13 is a diagram in which the angular acceleration multiplied by the moving average 15 and the angular acceleration multiplied by the moving average 31 in Analysis Example 1 are superimposed. 13(a) is a healthy person, and FIG. 13(b) is a spastic patient. The horizontal axis represents time and the vertical axis represents angular acceleration. The period surrounded by the dotted rectangle is during extension exercise. Comparing FIG. 13A and FIG. 13B, the intersection point where the angular acceleration of the moving average 15 and the angular acceleration of the moving average 31 intersect is healthy in a period in which the angular acceleration during extension motion increases from the minimum value. It can be seen that there is one person and two or more patients with spasticity. Based on this knowledge, "whether or not spasticity has occurred" can be automatically determined based on whether or not there are two or more intersections during the period. In FIG. 13A, no large distortion can be observed in the angular acceleration of the moving average 15, and the angular acceleration of the moving average 31 is smoothed and the amplitude decreases. On the other hand, in FIG. 13B, distortion occurs in the angular acceleration of the moving average 15, and the angular acceleration of the moving average 31 has a smoothed distortion and is close to a sine wave. As a result, a plurality of points of intersection are generated between the distortion waveform of the angular acceleration of the moving average 15 and the waveform of the angular acceleration of the moving average 31 which is close to the sine wave.

FIG. 14 is a diagram showing the difference between the angular acceleration multiplied by the moving average 15 and the angular acceleration multiplied by the moving average 31 in Analysis Example 1. FIG. 14A shows a healthy person, and FIG. 14B shows a spasticity patient. The horizontal axis represents time and the vertical axis represents angular acceleration. The period surrounded by the dotted rectangle is during extension exercise. In FIG. 14A, the slope at the start of extension is negative, the waveform is convex downward, and the slope is positive thereafter, and does not intersect the horizontal axis (the angular acceleration does not become 0 deg/s ² ). .. On the other hand, in FIG. 14B, at the start of extension, the inclination is negative, the waveform is convex downward, and then the waveform is convex upward, and intersects the horizontal axis (the angular velocity becomes 0 deg/s ² again). This creates a closed section. In the graph shown in FIG. 14B, the calculation device 3 sets an upwardly convex closed section at the time of extension motion as an integration section, and sets the integrated value as the magnitude of spasticity. That is, the integration interval of the magnitude of spasticity is an interval from the time when the difference obtained by subtracting the low-frequency component from the high-frequency component of the angular acceleration of the joint S0 during extension motion becomes from negative to positive, to the time from positive to negative. Is. Here, in the graph shown in FIG. 14B, the high frequency component is the angular acceleration multiplied by the moving average 15, and the low frequency component is the angular acceleration multiplied by the moving average 31.

From FIG. 12, except for the test subject D and the test subject G who are spasticity patients, there is no significant difference between the first and second spasticity occurrence angles at the risk rate p<0.05, and the spasticity occurrence angle is almost constant for each subject. Met. Since the severity of spasticity is determined by the spasticity occurrence angle in MAS, the result that the spasticity occurrence angle is almost constant for each subject is that the spasticity occurrence angle was correctly calculated by the calculation method according to the embodiment of the present invention. To support When the subjects are arranged in order of decreasing severity based on the spasticity occurrence angle, B (48.34 degrees), C (49.46 degrees), E (52.32 degrees), A (55.44 degrees), D( 58.39 degrees), F (72.54 degrees), and G (81.70 degrees). Here, in the magnitude comparison of the spasticity occurrence angle, the average value of the first and second times was used.

In the calculation method according to the embodiment of the present invention, the “difference in angular acceleration obtained by multiplying the moving average 15 and the moving average 31” is calculated as “the period during which the difference between the two is positive in the extension motion” (“the magnitude of spasticity shown in FIG. 14”). The integration level was evaluated as the size of the spasticity. Such an evaluation method can be proposed as a simple and highly reliable quantitative evaluation method instead of the conventional diagnosis that relies on the subjectivity of a doctor or the like.

<Analysis example 2>
In Analysis Example 2, the same measurement data as Analysis Example 1 was used. In the analysis example 2, the calculation device 3 uses the position information (x, y, z) and the posture information (azimuth, elevation, roll) of the measurement data to determine the local coordinates of the first part to which the first receiver 21 is attached. The movement locus of the second portion to which the second receiver 22 is attached when the origin of is calculated, the movement locus is approximated by an arc, the center coordinates of the circle formed by the arc are calculated, and the center coordinates are set as the center of rotation. The angle of the joint S0 was calculated based on the rotation angle of the movement trajectory (second calculation method).

FIG. 15 is a diagram showing changes over time in the angle of the joint S0 in Analysis Example 2. Fig. 15(a) is a healthy person, and Fig. 15(b) is a spasticity patient. The horizontal axis represents time and the vertical axis represents angle. The period surrounded by the dotted rectangle is during extension exercise. Since the initial posture is set to 90 degrees, the angle decreases as it extends. Therefore, when the inclination of the waveform is negative, it indicates extension movement, and when the inclination of the waveform is positive, it indicates bending movement. Comparing FIG. 15(a) and FIG. 15(b), the amplitudes of both waveforms do not change, and the spasticity patient of FIG. 15(b) extends and bends as compared to the healthy person of FIG. 15(a). It can be seen that it took a longer time to do. In FIG. 15, a moving average with a moving average score of 15 is multiplied in order to reduce fine noise during angle display.

FIG. 16 is a diagram showing a change over time in the angular velocity of the joint S0 in Analysis Example 2. 16(a) is a healthy person, and FIG. 16(b) is a spastic patient. The horizontal axis represents time and the vertical axis represents angular velocity. The period surrounded by the dotted rectangle is during extension exercise. The value of the angular velocity is 0 degree/second at the start of the operation, and has a negative value during extension movement and a positive value during flexion movement. The waveform in FIG. 16A has a shape close to a sine wave, whereas the waveform in FIG. 16B has a shape close to a triangular wave. In FIG. 16, a moving average with a moving average score of 15 is multiplied in order to reduce fine noise during angular velocity display.

FIG. 17 is a diagram showing a change over time in the angular acceleration of the joint S0 in Analysis Example 2. 17(a) is a healthy person, and FIG. 17(b) is a spastic patient. The horizontal axis represents time and the vertical axis represents angular acceleration. The period surrounded by the dotted rectangle is during extension exercise. Comparing FIGS. 17(a) and 17(b), it can be seen that the waveform in FIG. 17(b) is distorted during extension movement. In FIG. 17, a moving average with a moving average score of 15 is multiplied in order to reduce fine noise when displaying the angular acceleration.

FIG. 18 is a diagram showing changes over time in which the angle, angular velocity, and angular acceleration of the joint S0 in Analysis Example 2 are normalized by the maximum absolute value of each waveform. 18(a) is a healthy person, and FIG. 18(b) is a spastic patient. The horizontal axis is time, and the vertical axis is an arbitrary unit. The period surrounded by the dotted rectangle is during extension exercise. Comparing FIG. 18(a) and FIG. 18(b), there is not much difference in angle and angular velocity, but there is a large difference in angular acceleration between a healthy person and a spastic patient. In FIG. 18B, the curve of the angular acceleration is distorted during the extension movement. The calculation device 3 calculates the strain occurrence time, and sets the angle of the joint S0 at the strain occurrence time as the spasticity occurrence angle.

FIG. 19 is a diagram showing the spasticity occurrence angle of each spasticity patient in Analysis Example 2. The white line is the average value of the spasticity occurrence angles of 5 times measured at the first time and the black line is the second time, and the black bar is the standard deviation. It can be seen from FIG. 19 that, except for subjects D and G who are spastic patients, no significant difference occurs at the risk rate p<0.05 between the first and second spasticity occurrence angles. However, it can be seen that there is a difference between the average values of the first time and the second time of the subjects C and F, and the standard deviation is large.

Comparing FIG. 8 and FIG. 15, it can be confirmed that in the analysis example 2, the range of motion of the extension and flexion motion of the healthy person and the spastic patient is larger than that of the analysis example 1. In the analysis example 1 using only the posture information, the rotation angle of the second receiver 22 around the y axis as viewed from the first receiver 21 was calculated, but the center of the flexion extension movement of the elbow was not accurately captured. On the other hand, in the analysis example 2 using the position information and the posture information, the center of the flexion extension motion is calculated and the angle change from the center is analyzed, so that the range of motion of the elbow can be widely and accurately evaluated.

Further, it can be seen from FIG. 19 that the spasticity occurrence angle in Analysis Example 2 differs in the average value of the first and second times for each subject, and the standard deviation value may be large. It was found that the reason why the average values of the first and second spasticity occurrence angles are different and the value of the standard deviation is large is that there is a problem in the mounting method of the receiver at the time of measurement. That is, it was found that the first receiver 21 may not be able to follow the humerus because the skin and muscles are present between the first receiver 21 attached to the humerus S1 and the humerus. In particular, when a doctor or the like passively extends and extends the arm having spasticity in a patient with spasticity, the first receiver 21 is not rotated (flexed/extended) around the y-axis, but a twist component (moves left and right x This problem remarkably occurred when moving while adding a rotation component about the axis). Since the first receiver 21 was unable to follow the humerus, the left and right components during extension and flexion of the patient with spasticity were superimposed and measured. As a result, it was confirmed that the moving locus subjected to the principal component analysis did not become an arc due to the influence of the left and right components, and an error occurred when calculating the rotation center around the y axis.

<Analysis example 3>
In order to solve the problem in the analysis example 2, in the analysis example 3, the first receiver 21 is attached via a jig that is in close contact with the medial epicondyle and lateral epicondyle of the humerus of the subject S.

FIG. 20 is a diagram illustrating a method of mounting the receiver in Analysis Example 3. The subject was equipped with the first receiver 21b and the second receiver 22 via the jig 24. For comparison, the subject was also fitted with the first receiver 21a without the jig 24.

The jig 24 was made of free plastic. The jig 24 has two depressions on the inner side and is shaped so as to match the inner and outer epicondyles of the humerus. The jig 24 that closely contacts the medial epicondyle and lateral epicondyle follows the humerus without displacement during extension and flexion, so that the first receiver 21b mounted via the jig 24 also follows the movement of the humerus. ..

The subject of analysis example 3 was one young person, and the motion to be measured was passive elbow flexion/extension motion. The measurer supported the subject's medial epicondyle and lateral epicondyle with the left hand from above the jig 24, grasped the subject's wrist with the right hand, and exerted force on the right hand to perform flexion and extension movements of the subject's upper limb. In this flexion extension motion, the motion includes left and right components during extension, and the state where the angle between the upper arm S1 and the forearm S2 is a right angle is the initial posture of the flexion extension motion. From the initial posture (90 degrees), the subject's arm was extended at an arbitrary speed to the angle at which the subject's arm was fully extended, and then flexed again to the angle of the initial posture. The “motion of extending from the initial posture (90 degrees) to the angle at which the subject's arm fully extends (about 0 degrees) and bending again to the initial posture (90 degrees)” in one measurement is performed by the first receivers 21a and 21b. A series of extension and flexion motions were measured twice by applying a force in the positive direction of the y-axis, twice by applying a force in the negative direction of the y-axis, and twice without applying a force to the y-axis component.

FIG. 21 is a diagram showing changes over time in the left and right components of the movement distance of the forearm when the upper arm is the origin in Analysis Example 3. 21A, the first receiver 21a without the jig 24 is the origin, and FIG. 21B is the first receiver 21b with the jig 24 as the origin. The horizontal axis represents time, and the vertical axis represents the movement distance of the y-axis component. It can be seen that the amplitude in FIG. 21A is about 0.03 m to 0.06 m. On the other hand, the amplitude of FIG. 21B is about 0.01 m to 0.02 m, and it can be seen that the left and right components are smaller than that of FIG. 21A.

FIG. 22 is a diagram showing a movement trajectory on a two-dimensional plane in Analysis Example 3. 22A, the first receiver 21a without the jig 24 is the origin, and FIG. 22B is the first receiver 21b with the jig 24 as the origin. The horizontal axis is the inner product of the first principal component and the trajectory, and the vertical axis is the inner product of the second principal component and the trajectory. In FIG. 22A, the movement locus on the two-dimensional plane is a waveform similar to an arc-like waveform and a waveform close to a straight line, and the reproducibility of the second principal component in the principal component analysis is poor, and the trajectories do not match. You can see that it is fluctuating. On the other hand, in FIG. 22B, it can be seen that the movement trajectory on the two-dimensional plane draws an arc, there is little variation in the second principal component in the principal component analysis, and the trajectories match. Further, it can be seen that the movement distance of the movement trajectory of FIG. 22B is smaller than that of the movement trajectory of FIG.

23: is a figure which shows the time-dependent change of the angle in the analysis example 3. FIG. In FIG. 23A, the first receiver 21a without the jig 24 is the origin, and in FIG. 23B, the first receiver 21b with the jig 24 is the origin. The horizontal axis represents time and the vertical axis represents angle. The period surrounded by the dotted rectangle is during extension exercise. In FIG. 23(a), the range of motion from the initial posture of 90 degrees is about 140 degrees, and the range of motion is calculated excessively, whereas in FIG. 23(b) it is about 90 degrees, and the actual range is about 90 degrees. It can be seen that the movable range close to the motion can be calculated.

As described above, when the first receiver 21b via the jig 24 is used as the origin, the fluctuation of the left and right components of the moving distance of the forearm can be suppressed more than the first receiver 21a without the jig 24. It was Further, when the first receiver 21b via the jig 24 is used as the origin, a reproducible arc can be obtained when the principal component analysis is applied to the movement trajectory. The coefficient of determination r ² when assuming that the movement locus to which the principal component analysis is applied is a circle is 0.744 when the origin is the first receiver 21a without the jig 24, while the jig 24 is It was improved to 0.909 when the first receiver 21b through the origin was used as the origin. Therefore, it can be said that in Analysis Example 3, the center of the circle could be calculated more accurately.

<Analysis Example 4>
In analysis example 4, the same measurement data as analysis example 1 was used. In the analysis example 4, the calculation device 3 converts the position information and the posture information measured by the second receiver 22 into a local coordinate system having the mounting position of the first receiver 21 as the origin and also into the local coordinate system. The position information measured by the second receiver 22 is subjected to coordinate conversion in which the position information measured by the second receiver 22 after the coordinate conversion is performed by translating the position information measured by the second receiver 22 in parallel with the displacement between the rotation center of the joint S0 and the mounting position of the first receiver 21. An angle formed by a vector connecting the coordinates indicated by the first frame and the origin and a vector connecting the coordinates indicated by the second and subsequent frames of the position information measured by the second receiver 22 after the coordinate conversion and the origin is calculated from the measurement start position. The rotation angle is set, and the angle of the joint S0 is calculated based on the rotation angle from the measurement start position (third calculation method).

FIG. 24 is a diagram showing changes over time in which the angle, angular velocity, and angular acceleration of the joint S0 in Analysis Example 4 are normalized by the maximum absolute value of each waveform. FIG. 24(a) is a healthy person, and FIG. 24(b) is a spastic patient. The horizontal axis is time and the vertical axis is an arbitrary unit. The period surrounded by the dotted rectangle is during extension exercise. Comparing FIG. 24(a) and FIG. 24(b), there is not much difference in angle and angular velocity, but there is a large difference in angular acceleration between a healthy person and a spastic patient. In FIG. 24B, the curve of the angular acceleration is distorted during the extension movement. The calculation device 3 calculates the time of occurrence of strain, and sets the angle of the joint S0 at the time of occurrence of strain as the spasticity occurrence angle.

FIG. 25 is a diagram showing the spasticity occurrence angle of each spasticity patient in Analysis Example 4. The left side of each subject is the average value for the first time, and the right side is the average value of 5 times of spasticity occurrence angles measured at the second time, and the black bar is the standard deviation. As shown in FIG. 25, the occurrence angle of spasticity was almost constant for each subject. This supports the fact that the spasticity occurrence angle was calculated correctly.

The preferred embodiments of the severity evaluation support system and the like according to the present invention have been described above with reference to the accompanying drawings, but the present invention is not limited to such examples. It is obvious to those skilled in the art that various changes or modifications can be conceived within the scope of the technical idea disclosed in the present application, and it is obvious that they also belong to the technical scope of the present invention. Understood.

1.........Severity assessment support system 2.........Measurement device 3.........Calculation device 20.........Transmitter 21.........First receiver (first sensor)
22.........Second receiver (second sensor)
23.........Controller 24.........Jig S......Subject S0.........Joint S1.... ..... Upper arm S2 ......... Forearm

Claims (2)

A severity evaluation support system that supports evaluation of the severity of spasticity,
A measuring device that measures information about the time change of the angle of the joint when passively flexing and extending the joint of the subject,
Based on the information measured by the measuring device, a calculating device for calculating the parameters used for the evaluation of the severity,
Equipped with
The calculation device calculates the spasticity occurrence angle based on the angular acceleration of the joint during extension exercise, and the difference obtained by subtracting the low frequency component from the high frequency component of the angular acceleration of the joint during extension exercise is from negative to positive. A severity evaluation support system, wherein the magnitude of spasticity is an integral value from a time point at which the time becomes positive to a time time at which the time becomes positive . The computer, based on the information measured by the measuring device that measures the information about the time change of the angle of the joint when passively flexing and extending the joint of the subject, based on the parameters used to evaluate the severity of spasticity. A program for operating as a calculation device for calculating,
The calculation device calculates the spasticity occurrence angle based on the angular acceleration of the joint during extension exercise, and subtracts the low frequency component from the high frequency component of the angular acceleration of the joint during extension exercise, from negative to positive. A program that causes the integrated value of the interval from the time of becoming to the time of becoming positive to negative to be the size of the spasticity .