RU2743327C1 - Method for recording postural tremor in children aged 3-6 months - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to a method for postural tremor registration in children. Method is implemented by functional examination using a microelectromechanical sensor. Sensor is equipped with an accelerometer and a gyroscope. Sensor is placed on an area of the cervical spine to child aged 3–6 months. Child is in an anti-gravity posture lying on the abdomen with an elevated head resting on forearms or palms. Accelerometer detects tremor frequency and amplitude. Tremor parameter of 60 % power of the frequency spectrum is recorded.

EFFECT: possibility of detecting postural tremor in children aged 3–6 months, which enables to determine indications for in-depth examination of a child for early diagnosis of neurological disorders.

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Description

The invention relates to medicine, namely to pediatric neurology, and allows for the registration of postural tremor in children aged 3-6 months.

The relevance of the proposed method is determined by the high incidence of motor disorders in children. Most often they are a manifestation of the consequences of perinatal lesions of the central nervous system. Children with this pathology have a high risk of developing disabling disorders (infantile cerebral palsy). Therefore, it is necessary to search for new methods for predicting unfavorable outcomes of perinatal pathology of the central nervous system. In the first year of a child's life, a gradual transition to verticalization occurs through the sequential development of anti-gravity postures. During their maintenance, active muscle contraction occurs, in which postural tremor may occur (Likhachev S.A., Vashchilin V.V., Dick S.K. Tremor: phenomenology and methods of registration // Medical Journal. - 2010. - No. 2 - S. 133-137). In case of impaired motor development in children of the first year of life, the formation of the ability to maintain antigravity postures may be impaired, which can affect the characteristics of postural tremor. The possibility of its study in children aged 3-6 months will make it possible to judge the need for an in-depth examination of the child for early diagnosis of neurological disorders.

There is a known method of recording postural tremor by video visualization, based on the use of a computer program of the motion detector. The study is carried out with a patient in a standing position with an outstretched arm, located at a distance of 50 cm from the webcam, against a background in sharp contrast to the arm, for 1 minute. The method allows you to determine the frequency of tremor (Frolov S.V., Gorbunov F.V., Potlov A.Yu. Registration and analysis of tremor using a motion detector based on a web camera // Biomedicina. - 2012. - No. 2 - P. 80 -83). Disadvantages of the method:

1. Technical difficulties when performing this method.

2. The inability to use it in children aged 3-6 months.

According to the literature, there is a known method for recording postural tremor by performing computer digital tremorography. The study is carried out in patients from 17 to 40 years old in a standing position with arms outstretched in front of them with fingers spread apart. An accelerometric sensor connected to the measuring system is fixed on the index finger of the subjects and within 45 seconds the parameters of the tremor are determined: amplitude and frequency (Prokopenko S.V., Shanina E.G. Diagnostics of autonomic dysfunction conditions using the method of computer digital tremorography // Annals of Clinical and experimental neurology. - 2011. - T. 5, No. 2. - S. 14-17). However, this method cannot be applied to children aged 3-6 months.

A known method for recording postural tremor using accelerography. The study is carried out in patients 26-50 years old on an inductive tremorograph in a sitting position with the sensor located at the distal metacarpal joint, 2 cm proximal from the top of the middle finger, for 30 seconds with eyes open and closed, while assessing the frequency and amplitude of postural tremor ( Burdakov V.V., Kutnikova T.A. Postural tremor in patients with post-traumatic encephalopathy // Orenburg Medical Bulletin. - 2013. - T. 1, No. 1. - P. 56-60).

The disadvantage of this method is the lack of the possibility of using it in children 3-6 months.

The claimed technical result is the ability to register postural tremor in children aged 3-6 months. The technical result is achieved by the fact that children undergo a functional study using a microelectromechanical sensor equipped with an accelerometer and a gyroscope installed on the cervical spine in the patient's prone position with the head raised, resting on the forearm or palm, with the determination of the parameters: frequency of tremor, its amplitude and 60% of the power of the frequency spectrum.

The novelty of the method lies in the possibility of registering postural tremor in children aged 3-6 months. For the first time, the installation of a microelectromechanical sensor on the cervical spine is used in a patient in an anti-gravity position lying on his stomach with his head elevated, resting on the forearm or palm, which allows to quantify the tremor.

Previously, for the registration of postural tremor in children of the first half of life, during clinical neurological examination, only a qualitative assessment was used, namely, its presence or absence (Badalyan L.O. Pediatric neurology: a textbook. - 4th ed. - M .: MED pressinform, 2016 .-- 608 s). The method of recording postural tremor using microelectromechanical sensors was used in patients in a standing or sitting position (Prokopenko S.V., Shanina E.G. Diagnostics of autonomic dysfunction conditions using the method of computer digital tremorography // Annals of Clinical and Experimental Neurology. - 2011. - T. 5, No. 2. - S. 14-17). However, in children of the first half of life, the maintenance of these postures is not formed. The proposed method allows you to register postural tremor using a microelectromechanical sensor while maintaining the first antigravity postures characteristic of a given age. The child should maintain a position lying on his stomach, raising his head, resting on his forearms or palms.

The method is carried out as follows: the study is carried out using a microelectromechanical sensor equipped with an accelerometer and a gyroscope, the information from which is fed to the computer using an analog-to-digital converter (Manual for the operation of the complex for diagnosis, treatment and rehabilitation of patients with motor pathology "TRUST-M") ... A child aged 3-6 months is placed in a prone position with support on the forearms or palms with a raised head and placed on the cervical spine

microelectromechanical sensor (LLC "Nevrokor", Moscow, Russia). Withstand the time interval until the child takes a stable position. Next, the write command is activated on the computer, and the registration time begins with a duration of 20 seconds. Record of involuntary rhythmic oscillatory movements arising from active muscle contraction while maintaining an anti-gravity posture. Then, automatic processing of the research results is carried out with the definition of indicators: the frequency of the tremor, its amplitude and 60% of the power of the frequency spectrum.

Features:

A microelectromechanical sensor equipped with a gyroscope is installed on the cervical spine of a child aged 3-6 months, who is in an anti-gravity position lying on his stomach with his head raised, resting on the forearms or palms, and the tremor parameter of 60% of the frequency spectrum power is recorded.

Example.

Child C, 3 months old, born from 2 pregnancies at 39 weeks with an Apgar score of 7/8 in satisfactory condition. Neurological status: head circumference 42.0 cm, hydrocephalic head shape with overhanging occiput, large fontanelle 2.5 × 2.5 cm, calm. Cranial nerves without pathology. Muscle tone is moderately diffusely increased in the flexors. Tendon reflexes are alive, D = S. With traction, it groups well, holds the head. The step reflex is negative. The grasping reflex is weak, the Moro reflex is phase 1. The straightening reaction from the trunk to the head is positive. Emotional tone is positive. To register a postural tremor, a microelectromechanical sensor was installed on the cervical spine in the prone position with the head elevated and supported on the forearms. After the child has taken a stable position, the oscillatory movements are recorded for 20 seconds. As a result of the study, indicators of frequency, amplitude and 60% of the power of the frequency spectrum of postural tremor were obtained, which make it possible to judge the need for an in-depth examination of the child.

The advantages of this method:

1. The method allows you to register postural tremor in children aged 3-6 months, which makes it possible to determine the indications for in-depth examination of the child for early diagnosis of neurological disorders.

2. The method can be used as a screening study.

3. Requires a small amount of time for its conduct (20 sec).

Claims (1)

A method for recording postural tremor in children by carrying out a functional study using a microelectromechanical sensor equipped with an accelerometer that records tremor parameters: frequency and amplitude, characterized in that the sensor, additionally equipped with a gyroscope, is installed on the cervical spine in a child aged 3-6 months, who is in an antigravitational position lying on his stomach with his head raised, with support on the forearms or palms, and additionally record the tremor parameter 60% of the power of the frequency spectrum.