基于层次聚类的上肢痉挛状态定量评定研究

Quantitative evaluation of the spasticity of upper limbs based on hierarchical clustering

痉挛状态等级的客观定量评定对于偏瘫康复治疗具有积极意义。针对改良Ashworth量表(modified Ashworth scale,MAS)临床评定痉挛状态等级主观性高、量表痉挛等级划分不精准的问题,文章提出一种基于层次聚类的上肢痉挛状态定量评定方法。根据痉挛状态发生过程中的动力学机理设计痉挛状态等级量化评定装置;利用临床实验采集患者上肢被动牵伸过程中加速度以及角度数据判定牵张反射阈值,计算牵张反射阈值与关节活动度比值作为痉挛状态等级量化评定指标;利用层次聚类算法对量化评定指标聚类划分,重新评估痉挛状态等级。实验结果表明,基于层次聚类的上肢痉挛状态定量评定方法可以有效消除MAS评定痉挛状态等级中的主观性因素,能更加精准评定和细化痉挛状态等级。

The objective and quantitative evaluation of spasticity level is of positive significance for the rehabilitation of hemiplegia.In view of the high subjectivity of clinical evaluation of spasticity level and the imprecise classification of spasticity level of the modified Ashworth scale(MAS),a quantitative evaluation method of spasticity level of upper extremity based on hierarchical clustering was proposed.According to the dynamic mechanism in the process of spasticity,a quantitative evaluation device for spasticity level was designed.In the clinical experiment,the acceleration and angle data during the passive stretch process of patients’upper limbs were collected to determine the stretch reflex threshold,and the ratio of stretch reflex threshold to joint activity was calculated as the quantitative evaluation index of spasticity level;hierarchical clustering algorithm was used to cluster the quantitative evaluation index and reevaluate the spasticity level.The experimental results show that the quantitative evaluation method based on hierarchical clustering can effectively eliminate the subjective factors in MAS evaluation of spasticity,and can more accurately evaluate and refine spasticity.