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Filius SJ, Papa K, Harlaar J. Review of upper extremity passive joint impedance identification in people with Duchenne Muscular Dystrophy. J Neuroeng Rehabil 2025; 22:13. [PMID: 39863905 PMCID: PMC11763138 DOI: 10.1186/s12984-024-01537-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2024] [Accepted: 12/19/2024] [Indexed: 01/27/2025] Open
Abstract
Duchenne Muscular Dystrophy (DMD) progressively leads to loss of limb function due to muscle weakness. The incurable nature of the disease shifts the focus to improving quality of life, including assistive supports to improve arm function. Over time, the passive joint impedance (Jimp) of people with DMD increases. Force-based controlled motorised arm supports require a clear distinction between the user's movement intention and passive forces, such as passive Jimp. Therefore, Jimp identification is essential. This review aims to define Jimp, identify factors influencing it, and outline experimental methods used for quantification, with a focus on the upper extremities in DMD. A literature review was performed in May 2021 and updated in March 2024 using SCOPUS, PubMed, IEEEXplore, and WebOfScience. The results reveal confusion in definitions and show various Jimp measuring practices for both DMD and individuals without muscle weakness. This study presents an overview and lists important parameters affecting passive Jimp, such as the joint's position, velocity and the multi-articular nature of the upper arm muscles. For personalised passive Jimp compensation in arm supports, ramp-type perturbations with constant velocity across the full joint range appear most optimal for identifying the elevated and non-linear nature of the passive Jimp in DMD.
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Affiliation(s)
- Suzanne J Filius
- Department of BioMechanical Engineering, Delft University of Technology, Mekelweg 2, Delft, 2628 CD, South-Holland, The Netherlands.
| | - Kyriacos Papa
- Department of BioMechanical Engineering, Delft University of Technology, Mekelweg 2, Delft, 2628 CD, South-Holland, The Netherlands
| | - Jaap Harlaar
- Department of BioMechanical Engineering, Delft University of Technology, Mekelweg 2, Delft, 2628 CD, South-Holland, The Netherlands
- Department of Orthopedics and Sports Medicine, Erasmus MC University Medical Center, Dr. Molewaterplein 40, Rotterdam, 3015 GD, South-Holland, The Netherlands
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Tanikawa H, Mukaino M, Itoh S, Kondoh H, Fujimura K, Teranishi T, Ohtsuka K, Hirano S, Kagaya H, Saitoh E, Otaka Y. Development of a simple mechanical measurement method to measure spasticity based on an analysis of a clinical maneuver and its concurrent validity with the modified Ashworth scale. Front Bioeng Biotechnol 2022; 10:911249. [PMID: 36046668 PMCID: PMC9420860 DOI: 10.3389/fbioe.2022.911249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 07/18/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Despite recent developments in the methodology for measuring spasticity, the discriminative capacity of clinically diagnosed spasticity has not been well established. This study aimed to develop a simple device for measuring velocity-dependent spasticity with improved discriminative capacity based on an analysis of clinical maneuver and to examine its reliability and validity. Methods: This study consisted of three experiments. First, to determine the appropriate motion of a mechanical device for the measurement of velocity-dependent spasticity, the movement pattern and the angular velocity used by clinicians to evaluate velocity-dependent spasticity were investigated. Analysis of the procedures performed by six physical therapists to evaluate spasticity were conducted using an electrogoniometer. Second, a device for measuring the resistance force against ankle dorsiflexion was developed based on the results of the first experiment. Additionally, preliminary testing of validity, as compared to that of the Modified Ashworth Scale (MAS), was conducted on 17 healthy participants and 10 patients who had stroke with spasticity. Third, the reliability of the measurement and the concurrent validity of mechanical measurement in the best ankle velocity setting were further tested in a larger sample comprising 24 healthy participants and 32 patients with stroke. Results: The average angular velocity used by physical therapists to assess spasticity was 268 ± 77°/s. A device that enabled the measurement of resistance force at velocities of 300°/s, 150°/s, 100°/s, and 5°/s was developed. In the measurement, an angular velocity of 300°/s was found to best distinguish patients with spasticity (MAS of 1+ and 2) from healthy individuals. A measurement of 300°/s in the larger sample differentiated the control group from the MAS 1, 1+, and 2 subgroups (p < 0.01), as well as the MAS 1 and 2 subgroups (p < 0.05). No fixed or proportional bias was observed in repeated measurements. Conclusion: A simple mechanical measurement methodology was developed based on the analysis of the clinical maneuver for measuring spasticity and was shown to be valid in differentiating the existence and extent of spasticity. This study suggest possible requirements to improve the quality of the mechanical measurement of spasticity.
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Affiliation(s)
- Hiroki Tanikawa
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
- *Correspondence: Masahiko Mukaino,
| | - Shota Itoh
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Hikaru Kondoh
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Kenta Fujimura
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Toshio Teranishi
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Kei Ohtsuka
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Satoshi Hirano
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Hitoshi Kagaya
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
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