Objectively assessing the movement coordination of patients with cerebral palsy

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Dr. Jobbágy Ákos Andor
Department of Measurement and Information Systems

As the definition describes, cerebral palsy is a non-progressive group of movement disorders. The disease can be categorized by muscle movements, posture, affected limb, functionality, associated disorders and etiology. Early, non-specific and diagnostic symptoms can be distinguished. Medical history, physical examination, diagnostic tests and questionnaires (most importantly the GMFM) are keys to diagnose CP. Its therapy consists of conservative therapy including physiotherapy and medication, and surgical therapy.

Functionality of balancing and walking is affected by cerebral palsy, mainly by spastic diplegia and hemiplegia.

To assess the ability of balancing and walking I used two instruments: the PAM movement analyzer, which uses passive markers and x-IMU, a sensor fusion device, which consists of a three dimensional gyroscope, magnetometer and accelerometer. Amongst the data recorded by the x-IMU I assessed the Euler-angles.

Two types of tests were performed: a balance test and gait examination. During the assessment of balancing ability the subjects should remain motionless, 30 seconds with eyes open, then 30 seconds eyes closed. The gait examination consisted of a 4 meter walking without any help (for example walkers, crutch, etc.). During my research I examined two age groups: adults (healthy) and children (healthy and with cerebral palsy).

To characterize the ability of balance I depicted the frontal and horizontal movements recorded by the x-IMU in 2-D, then computed the area covered by the displacements using the MATLAB’s polyarea() and convhull() functions.

To characterize the periodicity of gait I examined the difference between the average and other step cycles. To assess the asymmetry of gait I used integral calculation using MATLAB’s trapz() function.

Based on the results of the test subjects’ abilities, an order could be made. The set up order based on the parameters and the therapist’s subjective opinion were identical. The defined parameters can characterize the balancing ability and gait pattern.


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