A novel indicator to assess upper limb usage in daily living and its preliminary evaluation during recovery from acute stroke

Background. Current upper limb motor rehabilitation approaches have a view of patient progress, which is limited to the evaluation in highly controlled environments for example in a clinic or into a hospital. There is need of an indicator of patient progress that it permits observing their closeness...

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Detalles Bibliográficos
Autor: Silvia Iliana Franco Pastrana
Tipo de recurso: tesis de maestría
Estado:Versión aceptada para publicación
Fecha de publicación:2019
País:México
Institución:Instituto Nacional de Astrofísica, Óptica y Electrónica
Repositorio:Repositorio Institucional del INAOE
Idioma:inglés
OAI Identifier:oai:inaoe.repositorioinstitucional.mx:1009/2017
Acceso en línea:http://inaoe.repositorioinstitucional.mx/jspui/handle/1009/2017
Access Level:acceso abierto
Palabra clave:info:eu-repo/classification/Inspec/Subacute stroke
info:eu-repo/classification/Inspec/Laterality
info:eu-repo/classification/Inspec/Dominance
info:eu-repo/classification/Inspec/Edinburgh inventory,
info:eu-repo/classification/Inspec/Continuous assessment
info:eu-repo/classification/Inspec/Uncontrolled environments
info:eu-repo/classification/Inspec/Virtual reality
info:eu-repo/classification/Inspec/Neurorehabilitation.
info:eu-repo/classification/cti/1
info:eu-repo/classification/cti/12
info:eu-repo/classification/cti/1203
info:eu-repo/classification/cti/120323
Descripción
Sumario:Background. Current upper limb motor rehabilitation approaches have a view of patient progress, which is limited to the evaluation in highly controlled environments for example in a clinic or into a hospital. There is need of an indicator of patient progress that it permits observing their closeness to patterns of movement in healthy people in uncontrolled environments to be closer to daily functional relevance, continuous and usable out of ward. This thesis proposes a potential indicator, the index of limb usage balance (ILUB), as well as an ubiquitous computing platform to operationalize it. Hypothesis. The ILUB reects changes in bilateral motor patterns capturing the progress of a patient undergoing rehabilitation transitioning from dissimilar to similar to healthy patterns of bilateral motricity as therapy progresses. Aim. Validate a novel index of upper limb functional motor ability as a tool to track progress of patient out-of-w ard.Method. A new metric of progress in the bilateral behavior of the upper limb, the ILUB, is proposed for patients who suffered a stroke. This has been operationalized through an ubiquitous computing platform based on smart devices. Three experiments were carried out for the verification and validation of said indicator. In the first experiment, the correct collection of data by means of the hardware and software platform was verified as well as estimation of the metric based on the veracity of the collected data. This experiment involved the controlled execution of 13 repetitive activities based on the Edinburgh inventory in 27 healthy volunteers. In the second experiment, feasibility of continuous monitoring in a naturalistic uncontrolled environment was tested. The storage capacity of the database and the steadiness of the platform for 5 days were verified. 13 volunteers were asked to wear the Smart devices between 8 to 12 hours a day during a week. This experiment also served as the basis to establish the parameters for healthy population that permits the subsequent comparative analysis of the tracking data of stroke patients. Finally, the third experiment accompanied 7 subacute stroke patients whilst attending a rehabilitation program based on virtual therapy. Face validity of the index was establish by comparing exhibited ILUB from therapy onset to therapy end as relative to healthy baseline.