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首页> 外文期刊>Neural Systems and Rehabilitation Engineering, IEEE Transactions on >Development of a Haptic Elbow Spasticity Simulator (HESS) for Improving Accuracy and Reliability of Clinical Assessment of Spasticity
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Development of a Haptic Elbow Spasticity Simulator (HESS) for Improving Accuracy and Reliability of Clinical Assessment of Spasticity

机译：触觉肘部痉挛模拟器（HESS）的开发，以提高痉挛临床评估的准确性和可靠性

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摘要

This paper presents the framework for developing a robotic system to improve accuracy and reliability of clinical assessment. Clinical assessment of spasticity tends to have poor reliability because of the nature of the in-person assessment. To improve accuracy and reliability of spasticity assessment, a haptic device, named the HESS (Haptic Elbow Spasticity Simulator) has been designed and constructed to recreate the clinical “feel” of elbow spasticity based on quantitative measurements. A mathematical model representing the spastic elbow joint was proposed based on clinical assessment using the Modified Ashworth Scale (MAS) and quantitative data (position, velocity, and torque) collected on subjects with elbow spasticity. Four haptic models (HMs) were created to represent the haptic feel of MAS 1, $1{+}$, 2, and 3. The four HMs were assessed by experienced clinicians; three clinicians performed both in-person and haptic assessments, and had 100% agreement in MAS scores; and eight clinicians who were experienced with MAS assessed the four HMs without receiving any training prior to the test. Inter-rater reliability among the eight clinicians had substantial agreement $(kappa = 0.626)$. The eight clinicians also rated the level of realism ($7.63pm 0.92$ out of 10) as compared to their experience with real patients.
机译：本文提出了开发机器人系统以提高临床评估准确性和可靠性的框架。由于面对面评估的性质，痉挛的临床评估往往可靠性较差。为了提高痉挛评估的准确性和可靠性，已设计并构造了一种名为HESS（触觉肘部痉挛模拟器）的触觉设备，以基于定量测量来再现肘部痉挛的临床“感觉”。基于临床评估，使用改良的Ashworth量表（MAS）和在肘部痉挛患者身上收集的定量数据（位置，速度和扭矩），提出了代表痉挛性肘关节的数学模型。创建了四个触觉模型（HMs）来表示MAS 1，$ 1 {+} $，2和3的触觉感觉。三名临床医生同时进行了面对面和触觉评估，并在MAS评分中达成100％的一致性；八位具有MAS经验的临床医生在测试前未接受任何培训的情况下评估了四个HM。八名临床医生之间的评分者间信度具有实质性一致性（kappa = 0.626）$。与实际患者的经验相比，八名临床医生还对现实水平进行了评估（每10名患者中有7.63美元每0.92美元）。

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