The aim of this study is to develop a technique for quantitative evaluation of spastic upper limb in hemiplegic patients. The subjects were 19 hemiplegic patients. Each subject was seated or standing in a resting state, and his or her forearm was flexed 5 times and extended 5 times in each posture through a force-and-torque sensor placed on his or her wrist. The elbow joint angle, torque, and electromyograms of biceps brachii muscle, triceps brachii muscle, and brachioradialis muscle during flexion and extension were measured.
The quasi inertia of forearms and quasi visco-elastic coefficients were estimated with a mathematical model, which consisted of elastic components depending on elbow joint angle and muscle activities, by the least squares method. Then the elbow joint angle were estimated with the obtained quasi inertia and quasi visco-elastic coefficients and compared to the observed angle in order to evaluate the performance of the mathematical model. The elbow joint angle was closely estimated by the mathematical model.
Next, the maximum value of the quasi elastic coefficient during flexion/extension around the elbow joint (kmax) was calculated and compared with the modified Ashworth scale. Our results show that the kmax increased rapidly as the modified Ashworth scale increased. Moreover, logarithm of the kmax strongly correlated to the modified Ashworth scale. The kmax varied depending on patients' posture and mental strain. In conclusion, the mathematical model could represent the time course of the elbow joint angle during the manual muscle test. The kmax would be medically and clinically useful for quantitative evaluation of spasticity in hemiplegic patients.
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