Inertial sensor based quantitative assessment of upper limb range of motion and functionality before and after botulinum toxin: a pilot study

Lu Bai 1, *, Matthew G Pepper 2, 3, Yong Yan 2, Malcolm Phillips 4 and Mohamed Sakel

1 School of Computing, Ulster University, BT37 0QB, Belfast, UK.
2 School of Engineering and Digital Arts, University of Kent, CT2 7NT Canterbury, UK.
3 East Kent Hospitals University NHS Foundation Trust, Ethelbert Road, CT1 3NG, Canterbury, UK.
4 NHS Lothian, Medical Physics, Waverley Gate, EH1 3EG Edinburgh, UK.
 
Research Article
Global Journal of Engineering and Technology Advances, 2020, 02(03), 035-044.
Article DOI: 10.30574/gjeta.2020.2.3.0008
Publication history: 
Received on 04 February 2020; revised on 24 February 2020; accepted on 14 March 2020
 
Abstract: 
Botulinum toxin (BTX) treatment of upper limb is considered effective for upper limb spasticity following stroke and brain injury. Traditional method - Modified Ashworth Scale (MAS) is widely used for assessment of spasticity, however, it suffers from limitations including the lack of objective outcome measures and ignorance of the active movements. This pilot study is to develop a quantitative assessment utilizing inertial sensors tool for upper limb movement measurement and to investigate an objective measure of upper limb function for neurological patients before and after BTX treatment of spasticity. The system we proposed provides kinematic measurements of upper limb segment and joint motion data. In this study, four stroke patients were assessed by an inertial sensing system immediately before and one week after BTX injection. In addition, patients were assessed using clinical assessment scales e.g. MAS, Disability Assessment Scale (DAS) and Motor Assessment Scale. The results showed that elbow Active Range of Motion (AROM) increased by 19 degrees on average and MAS and Motor Assessment Scale scores did not show significant change. The changes of the kinematic measures for patients 1-3 e.g. AROM, Rate of change of elbow joint angle, NJS, MUN and S-ratio all show that the inertial system is able to identify improvement in performance. This inertial sensing system provides additional and novel dynamic motion data for a sensitive and quantitative assessment of response to treatment and the efficacy of post-injection physiotherapy. 
 
Keywords: 
Muscle Spasticity; Botulinum Toxin; Upper Limb; Inertial Sensing
 
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