Evaluation of Upper Limb Spasticity towards the Development of a High Fidelity Part-task Trainer

Abstract

Upper limb spasticity is commonly seen in conditions of upper motor neuron pathology, of which includes traumatic brain injury, stroke, high cervical spinal cord injury and Cerebral Palsy. Trained physicians, physiotherapists and occupational therapists are needed for the rehabilitation of such patients. To obtain skills in addressing spasticity, current practice in training of students utilizes patients as primary learning subjects. Novices without the required skills put the patient safety at stake. Further, physicians and therapists evaluate spasticity using the Tardieu, Ashworth, and Modified Ashworth Scale which can vary dependent on experience. Variability in rater scores suggest that training can be improved. To tackle this issue, an upper limb part-task trainer that is capable of consistently emulating spasticity symptoms is proposed for pre-clinical training of physicians, therapists and medical students. In order to obtain clinical data for the emulation of upper limb spasticity symptoms, a non-invasive evaluation procedure has been designed deploying a goniometer and a manual muscle tester. The goniometer measures the angle of elbow joint of the patient while the manual muscle tester measures the force applied by the rehabilitation physician on the patient's forearm. The elbow joint angle and its resistance force are recorded in real time via a data acquisition interface and NI LabVIEW software. The evaluation procedure was carried out by a rehabilitation physician during a routine rehabilitation session to the patients with symptoms of upper limb spasticity.