RU2665957C2 - Method for increasing the information content of stabilometric research and a hardware complex for its implementation - Google Patents

Abstract

FIELD: medicine.SUBSTANCE: group of inventions relates to medicine. Method for increasing informativity of stabilometric research is carried out with the help of a hardware complex for recording and analyzing the parameters of the motor stereotype of a person. Simultaneously with the stabilometric investigation, stereophotogrammetric tracking of the spatial coordinates of the marks placed on the body of the subject is carried out in order to assess their relative location in space and to determine, on the basis of these data, the statodynamic characteristics of the structures of the musculoskeletal system. By adding the block of averaging the spatial coordinates of the marks, an accurate estimate of the oscillations of the center of gravity is possible. Hardware complex for recording and analyzing the main parameters of the motor stereotype of a person in space and time integrates one or more stabilizers and a computer vision system. Computer vision system operates on the principle of stereophotogrammetry using two methods of calibration – with a calibration object and direct measurement of depth for better binding to the test markers applied to the body and detailing the movements of the subject by optical methods.EFFECT: registration and evaluation of the human postural system is achieved by stabilographic investigation and stereophotogrammetric tracking of the placed spatial coordinates of the marks on the body both during the classical stabilometry using the platform and independently, moreover, by adding the averaging unit of spatial coordinates, the data of the total movement of the marks (center of gravity) in overwhelming majority of cases can replace the classical stabilogram.2 cl, 11 dwg

Description

The invention relates to medicine and can be used in posturology, neurology, traumatology and orthopedics, therapy, kinesiotherapy, manual therapy, applied kinesiology, osteopathy, health rooms, school, sports, military and departmental medicine, as well as in the rehabilitation of adults and children with pathology nervous system and musculoskeletal system, in assessing the functional state, pre-trip and post-trip control, as well as in scientific research.

A new medical science has appeared - posturology. She is engaged in the study of muscle tone, posture, human balance and the mechanisms of its maintenance. The main links of the postural system are the nervous and musculoskeletal (Gage P.M., Weber B., Bonnier L. et al. Posturology. Regulation and imbalance of the human body. St. Petersburg, St. Petersburg International Medical Academy, 2008.)

The main instrument of a posturologist is a stabilometric platform - a device that allows you to record the projection of the total center of mass of a person standing on a platform of a person, its movement in time (Babsky EB, Gurfinkel BC, Romel EL A new way to study the stability of a person’s standing // Physiol. Journal of the USSR. - 1955. - T. 12, No. 3. - S. 423-426, Bizzo G., Guillet M., Patat A. et al. Specifications for building a vertical force platform designed for clinical stabilometry / / Med. & Biol. Eng. & Comput, 1985. - N23. - p. 474-476, patent for the invention of the Russian Federation No. 2093074 from 10.20.1997, patent for the invention of the Russian Federation No. 20958025 from 10.11.1997). It should be noted that in addition to stabilometry using the platform, there are options for stabilometry using accelerometric sensors mounted on the human body (copyright certificate No. 1752348 A61, 1992). The method of spatial stabilometry by means of three-component telemetric accelerometers began to develop (Zagorodni N.V., Polyaev B.A., Skvortsov D.V., Karpovich N.I., Damazh A.V. Damage, Spatial stabilometry by means of three-component telemetric accelerometers Journal Physiotherapy exercise and sports medicine, No. 3 (11), 2013, 4-10 pp.). The human postural system is formed in the process of development and growth. The vertical position of the body is ensured by the properties of its musculoskeletal system, the state of the foot system - lower limbs - pelvis - spine - head. The physiological curves of the spine also contribute to the upright posture. The muscular system ensures the maintenance of the posture, and the leading role belongs to the muscles of the pelvic girdle, where the center of gravity of the body is located. It is believed that in the normal position of the brain, a vertical model of the body is created on the basis of proprioceptive afferentation, the center of gravity of which should coincide with the sample. Only in this case will postural muscle balance be ensured in the vertical position of the body with minimal muscle costs. In case of a mismatch of the centers of gravity, a feedback based correction is created in the control system of the ODE, which seeks to smooth out this discrepancy by expanding the stability area (Vasilieva L.F. Visual diagnosis of violations of the statics and dynamics of the human musculoskeletal system. - Ivanovo, 1996 . - 110 p., L. Vasilyeva Lewit K Diagnosis of muscular dysfunction by inspection. - // in Rehabilitation of the spine - Williams and Willkins, 1995 - p. 113-142, RF patent No. 2152166 dated 09/10/1999, RF patent No. 2136209.) With minimal energy consumption.

Usually the stabilographic complex includes a personal computer, a stable platform and a set of sensors for picking up physiological signals (ECG, EMG with the appropriate performance). Strength sensors are attached to the platform on which the person is standing, with which the reactions of the supports are measured, and then the coordinates of the CP provided by the person on the power-sensitive surface of the stabilized platform are calculated. Computer stabilographic research does not require much time and is suitable for mass surveys of the population, comfortable, highly informative, valid and multifunctional. To assess postural function, the following stabilographic methods are prioritized: stabilographic test, optokinetic test, Romerg test and head rotation test, samples with a distal bite and different support surfaces. (Kapteyn TS, Bles W., Njiokiktjien Ch. J. et al. Standardization in platform Stabilometry being a part of posturography // Agressologie, 1983. - N24, Vol. 7. - p. 321-326., RF patent No. 2175851 from 2001, RF patent No. 22165733 from 2001, RF patent No. 2380035 from 2010). The registered signal can be processed using the methods of the statokinesegram, stabilogram, histogram, spectral analysis, analysis of vectors, diagrams, preference zone, coherent analysis and animator, etc. The developed methods of vector stabilization analysis made it possible to effectively use the method of stabilography in assessing the functional state of a person (G. Ivanova E., Skovrtsov D.V., Klimov L.V. Evaluation of postural functions in clinical practice.Journal "Russian National Research West ik of restorative medicine No. 1⋅2014 pp. 19-25, Usachev VI, Mokhov DE Possibilities of stabilometric vector analysis in the diagnosis of postural disorders // Materials of the I International Symposium "Clinical Posturology, Posture and Bite. St. Petersburg . - 2004. - S. 32-41., Patent BY No. 17473 of 08.30.2013). After the examination, the express information for the doctor is a printed protocol that contains various signal processing options for samples with the calculation of numerous coefficients. The progress of posturology is associated with the development of new technology - stabilometric platforms and podographs, as well as improving the methods of analysis of stabilographic signals (Skvortsov D.V. Clinical analysis of movements. Stabilometry. - M.: NMF "MBN", 2000. - 188 pp., Plum S. S. Domestic computer stabilization: technical level, functionality and application // Medical Technology Magazine. - Issue 1, January-February. - Moscow. Medicine, 2005. - 32-36 p., Sliva A. S., Voinov I.D., Plum S.S. Development of methods and means of computer stabil afii. Proceedings of the SFU Engineering. Special Issue. 2010. No9 (110) pp 158-164.). The introduction of numerous samples into the study (head turns, bite, support) made it possible to significantly expand the applicability of the method. (Usachev V.I., Mokhov D.E. Stabilometry in posturology. St. Petersburg: Publishing House SPbMAPO, pp. 8-10, 2004.).

It is important to note that the stabilographic signal has two-dimensional characteristics, and reflects fluctuations in the center of pressure of a person only in the horizontal plane. Many researchers noted the imperfection of stabilographic analysis to assess the body's postural system and pointed out the need for a comprehensive assessment taking into account the parameters of the locomotor system. Only with the help of special tests does the stable platform make it possible, and then indirectly, to assess the state of the musculoskeletal system and the contribution of the movements of the body and its parts to the oscillations of the general center of pressure. So, the known method for detecting postural imbalance by the method of podography, stabilization and plumb (Liebenson G. Rehabilitation of the Spine. 1996, Vasilieva LF Visual diagnosis of violations of the statics and dynamics of human ODE. Ivanovo, 1996, pp. 9-14). Based on the change in the center of gravity during functional tests, the degree of participation of specific muscles in ensuring an upright position is estimated. The disadvantage of this method is that it evaluates only the displacement of the projection of the center of gravity of the body. In what direction and to what extent the body has shifted in space in three planes, this method cannot indicate exactly. In order to identify postural imbalance, a method based on optical topography was proposed (RF patent No. 2136209 of 1999, RF patent No. 2152166 of 2000) using registration of the moire pattern of the back surface, in which registration of the moire pattern is performed sequentially in six transfer periods body weights on each of the legs from the position of the two-bearing state on the scales, and then based on a series of topograms, graphs of these movements in three planes are constructed with the subsequent assessment of the degree of displacement of the body axis. Unfortunately, this method involves assessing not the entire locomotor system, but only its parts, and does not allow for simultaneous stabilographic research and the optical topography device is not intended to monitor the allocated structures of the musculoskeletal system. There is a complex (RF patent No. 94831 dated June 10, 2010, RF patent No. 2442533 dated February 20, 2012) that allows registration, analysis and modeling of the human structural-motor apparatus based on the use of machine stereo vision and a stabilographic platform, while the information processing unit of this complex analyzes the location of the marked structures of the musculoskeletal system of a person, together with the position of the general center of gravity. According to the above patents, the complex stabilographic platform is used only to determine the projection of the common center of gravity in order to increase the accuracy of determining the location of the structural-motor apparatus.

Thus, complexes and devices that increase the information content of the stabilometric study by registering the fluctuations of the marked body structures for the simultaneous assessment of the postural system, i.e. the nervous system and musculoskeletal does not exist. Classical stabilographic study does not allow assessing the nature of the oscillatory movement of individual points of the body of the test person, for example, if the pelvic and shoulder girdles of a person while moving pose are in antiphase, then the classical stabilogram will not reflect, or will reflect ambiguously. Analysis of the classical stabilogram in order to highlight the components due to the movement of individual parts of the body is not possible.

The technical result of the proposed application is to register and evaluate the human postural system by stabilographic research and stereophotogrammetric tracking of the spatial coordinates of the marks placed on the subject’s body, while tracking the spatial coordinates of the marks is carried out both during classical stabilometry using the platform and independently, due to adding a block of averaging spatial coordinates data of the total movement of marks (center of gravity), in ulation most cases can replace a classic stabilograms.

The essence of the proposed study is that at the same time indicators are recorded from the platform and cameras operating in the tracking mode, while the entire postural system is evaluated. The fluctuation of the center of pressure is assessed using one or two stabilometric platforms “Computer stabilizer“ Sabilan 01-02 ”, the location of points in space with the possibility of tracking - using digital video cameras and laser rangefinders, or devices that combine a camera and a laser rangefinder - (type contactless controller Microsoft Kinect sensor for Windows), which is a 3D camera. These sensors incorporate a digital camera and a kind of laser rangefinder, which provides structured infrared laser illumination with parallax disparity calculation, which makes it possible to determine the position in space of the entire array of points of the object under study (body surface), calculate the perimeter of the coverage of parts and body segments. The 3-D camera allows, for example, in contrast to the above complex (RF patent No. 2442533 dated February 20, 2012), to increase the system’s functionality by automatically calibrating the scene by using the data of the long-distance picture provided by the sensor instead of using a special calibration object, which simplifies the calibration process in mass studies; sharing of two-dimensional and three-dimensional sensor data to improve the accuracy of tracking markers and the reliability of their retention. In some cases, when high accuracy of measurement is not required, and mainly, if reference to markers is not required, only three-dimensional data can be used. However, to achieve high accuracy of coordinate measurement and more reliable retention of marked points, support by stereogrammetric methods using a non-3-D shooting mode is required. When using two or more sensors, simultaneously from several sides to obtain a complete picture of the object, it is possible to automatically combine parts of the image from different angles into a single three-dimensional model. The diagnostic value of the complex increases the ability to use the built-in system for recognizing segments of the human body, for example, to obtain intersegment angles in real time to assess the dynamic stereotype and also the ability to track a surface three-dimensional model of an object in addition to tracking markers or independently. In addition, the researcher may optionally select a specific structure or group of markers for tracking.

When researching using the proposed complex, the complex is first deployed (Fig. 1). The complex includes:

1 - Stabilizer analyzer "Stabilan - 01-2";

2 - Devices that combine the camera and the laser rangefinder;

3 - Tripods;

4 - Calibration device;

5 - Notebook

Before the study, a video capture system is being prepared. Devices 2 are mounted on tripods 3 so that the optical axes of the recording devices intersect in the study area, i.e. in the vertical zone, restored from the center of the stabilometric platform, a preliminary calibration of the complex is carried out, for which a calibration device is installed on stabilizer 1, then the subject is instructed and labeled, markers are placed on his body in projection onto the skin of certain bone structures and the subject becomes comfortable in the platform (main) rack, depending on the tasks, either with your back or facing the video capture system. Simultaneous registration of the oscillations of the pressure center and stereogrammetric registration of the marked points are made, a study protocol is formed, which reflects both the fluctuations of the pressure center and the marked points, as well as a preliminary assessment of these fluctuations. These protocols reflect the assessment of the postural system according to the standards of the international society of posturologists, or according to the program proposed by V.I. Usachev and Mokhov (2004), or at the request of the researcher. (Fig. 2, Fig. 3, Fig. 8). Then, protocols are presented to evaluate the fluctuation of points on the patient's body. Typically, the marker is installed on the area of the medial sacral ridge in the projection of the spinous process S1 or S2, which is as close as possible to the location of the common center of gravity of the person, the projection of the spinous process C7 and on the subject’s head, in the area between the large occipital tubercles. The type of processing of the obtained coordinates is selected either in the variant of standard stabilometric techniques, but with the possibility of tracking the vibrations of each registered point in three planes, and not only in the horizontal, or the vibrations of each registered point in three-dimensional space along with the vibrations of the center of pressure, or in the form of an assessment of vibrations an averaged point, where the location parameters of all marked points are connected, averaged and processed as a regular stabilographic signal. (Fig. 4, 9-11) The third protocol reflects the state of the musculoskeletal system, primarily the spinal column, the degree of compensation and direction of scoliosis, as well as the lengths of the limbs and their segments, focuses the doctor's attention on the search for shortened muscles. (Fig. 5, Fig. 6, Fig. 7.).

Thus, the presented complex with the survey algorithm can significantly increase the information content of the stabilographic study for recording and evaluating the body's postural system.

Examples of the operation of the complex illustrate the above.

Example 1. Using the complex to search for optimal orthopedic means of compensation

Patient B., 23 years old, student, childhood invalid, cerebral palsy, late residual stage, hemiparetic form. The clinical picture is determined by right-sided hemiparesis, expressed mainly in the right hand, as well as pronounced asymmetry of the limbs - underdeveloped right, the right leg 2 cm shorter than the left.

The stabilographic study conducted — the stable test — established the support shift to the healthy side, but when putting the braid under the right heel, vector analysis showed a sharp decrease in the quality of the equilibrium function (Fig. 3), although the braid under the right heel with a thickness of 15 mm improves static compensation of scoliosis (plumb from SP deviates by 1.92 from the intergluteal folds instead of 2.52 without a braid, Figs. 5, 6, 7). Using insoles under the entire sole is more appropriate. In-depth analysis requires long-term observation of points in tracking mode, a fragment of the observation protocol in tab. Excel is shown in FIG. four.

Example 2. The use of the complex for scientific purposes.

Subject B, 54 years old. At the time of the examination, it is almost healthy, with a history of circulatory failure in the vertebro-basilar pool, cervical osteochondrosis, lumbar osteochondrosis, paramedian hernia of the L4-5 disc, thoracic osteochondrosis, costal transverse arthrosis DVIII.

Vector analysis of the stability test (Fig. 8) and oscillations of the spinous process DVIII in the horizontal (Fig. 9), frontal (Fig. 10), sagittal planes (Fig. 11). The quality of the equilibrium function in the zone of limitation of mobility DVIII is higher than when performing the stability test in a conventional study (87.3%), especially in the frontal plane 98.93% and the sagittal plane - 97.39%. In the horizontal plane, 94.46% is noted, which is possibly associated with rigidity of the spine in the main stance.

Claims (2)

1. A way to increase the information content of the stabilometric study by simultaneously stereophotogrammetric tracking of the spatial coordinates of the marks placed on the subject’s body, in order to assess their relative position in space and determine the statodynamic characteristics of the structures of the musculoskeletal system based on these data, and by adding an averaging unit spatial coordinates of marks an accurate estimate of the center of gravity is possible. 2. A hardware system for recording and analyzing the main parameters of a person’s motor stereotype in space and time, characterized in that it integrates one or more stabilizers and a computer vision system that works on the principle of stereophotogrammetry using two calibration methods - with a calibration object and direct measurement of depth for better reference to the markers applied to the body of the subject and detailing the movements of the subject by optical methods.

Images