New methodology for personalized rehabilitation in brain injury patients
Researchers from Universidad Politécnica de Madrid and Hospital Instituto Guttman have developed a new methodology of motor assessment of patients with acquired brain injury that improves the current neurorehabilitation models.
Due to the lack of objective assessment tools for patients with acquired brain injury, a team of researchers from Universidad Politécnica de Madrid (UPM) in collaboration with the Hospital Instituto Guttman have designed a new methodology of motor assessment of the upper extremity of this type of patients.
This tool is based on knowledge modeling methods to carry out an accurate analysis of movement, this improves not only the sensitivity of the diagnosis but the time needed to perform the assessment. Researchers have verified this method by comparing the results with the diagnosis of specialized therapists.
The motor assessment of upper extremity in acquired brain injury patients is usually conducted with subjective clinical tests. These tests are highly dependent on the criteria and experience of the examiner and, besides, there are other environmental factors that can alter the results.
According to Mailin A. Villán Villán, a female researcher from the Bioengineering and Telemedicine Group from School of Telecommunications Engineering at UPM, “the increasing number of patients with acquired brain damage and the lack of standardized objective assessment tools, it makes necessary the development of new methods to model, quantify and assess the detailed and precise movement of the upper extremity”.
This study has been carried out by UPM researchers with a background in neurorehabilitation engineering in collaboration with the Hospital Institut Guttmann, a reference hospital in comprehensive rehabilitation for people with disabilities of neurological origin.
To develop this tool, researchers used knowledge modeling methods associated with the performing of movements of the Fugl-Meyer upper extremity Assessment. The Fugl-Meyer Assessment provides a numerical scale to assess the motor impairment of people who have had a stroke.
Screenshot of the Fugl-Meyer Assessment. Credit: Mailin Villán Villán
Thus, researchers have developed cinematic models of reference to be used as a baseline in the analysis of pathological motion. Likewise, they estimated the metrics to obtain parameters characterizing the motion in order to see the differences between the movements in healthy individuals and in individuals with acquired brain injury.
The new methodology of motor assessment allows us to automatically estimate a value for each movement of the Fugl-Meyer Assessment and a global value for all. This tool provides a greater number of variations at a small scale of the upper extremity movement and the automatic identification of the specific alters of the patient movements.
In addition, this tool also provides a significant amount of objective data, which are not usually available in the assessment carried out by specialists, allowing personalized treatments.
Mailin A. Villán states, “the large volume of data produced by the assessment tool is the great potential of this research because allows us to understand the state of the motor function of each patient with higher detail than only using subjective tests”.
She continues, “Besides, this enables the development of new applications of analysis and data exploitation, therapeutic planning, progress monitoring of the motor function in patients and, what it is more, it also reduces the assessment time of patients with acquired brain damage”.
The research results and the developed tool help improve the current model of motor neurorehabilitation. The proposed methods can increase the accuracy and sensitivity of the diagnosis and achieve a more personalized physical rehabilitation.
This research has been funded by the TP-2012-1063-300000 Sensing Toys y TIN2012-38450-COGNITIO projects, led by Prof. Enrique J. Gómez Aguilera from UPM.
Villan-Villan, MA; Perez-Rodriguez, R; Martin, C; Sanchez-Gozalez, P; Soriano, I; Opisso, E; Hernando, ME; Tormos, JM; Medina, J; Gomez, EJ. Objective motor assessment for personalized rehabilitation of upper extremity in brain injury patients. NEUROREHABILITATION, 42 (4):429-439 2018