The present invention generally relates to methods and devices for patient functional ability determination, and more particularly relates to methods and systems for quantitatively determining a patient's significant, latent and manifested functional abilities.
In today's world, brain injuries, including brain injuries resulting from cardiovascular disease, are a leading cause of death and a leading increase in a patients' post-injury disability. The ability to live independently after a brain injury depends largely on the patient's recovery of motor function and functional abilities after the brain injury. Therefore, accurate assessment of functional abilities provides substantial assistance for rehabilitation planning and support realistic goal-setting by clinicians, therapists and patients.
In addition, it is important to understand a patient's current functional condition in order to provide suitable treatment strategies. To understand the current stage of a patient's functional abilities, quantitative determination of motor function is a strong clinically relevant indicator of treatment effectiveness. However, current rehabilitation processes are based on subjective scoring of a functional assessment of selected patient movements by a trained clinical therapist. For example, a typical finger extension assessment by a clinical therapist requires a patient to extend their fingers against gravity while the therapist presses down on the fingers using some resistance. The therapist then scores the patient based on their maintenance of the finger extension. In addition to the subjectivity of manual muscle test (MMT) muscle strength scoring, such assessment of motor function and quantification of functional abilities is also flawed because current objective/subjective scoring of muscle strength is based on an ordinal measure of the clinical MMT score and, while four is twice two, it cannot be concluded that a patient with a MMT score of four has twice the muscle strength of a patient with a MMT score of two.
Using motion-sensing to objectively assess motor function and quantify the functional abilities has also been attempted, yet the motion-sensing and subjective/objective scores rarely capture the actual functional performance of a patient. In addition, use of a combination of inertial measurement units (IMUs) and acoustic sensors (for example, bioacoustics sensors such as mechanomyography (MMG) sensors) has been used for sensing muscle activity or monitoring fetal movement but also lack the ability to objectively reflect the actual functional performance of a patient. If only IMU scoring is done, important information on muscle activity is not captured and the IMU score is not patient-relevant. Similarly, if only MMG or electromyography (EMG) scoring of muscle activity is used, important information on the patient's range of motion against gravity or resistance is missing. Some patients may have EMG contraction but limited or no movement and some patients may have movement but limited or weak EMG contractions.
Thus, what is needed is an objective assessment of motor function and quantification of functional abilities which reflects the individual patient's functional abilities. Furthermore, other desirable features and characteristics will become apparent from the subsequent detailed description and the appended claims, taken in conjunction with the accompanying drawings and this background of the disclosure.
According to at least one embodiment of the present invention, a method for monitoring and determining progress of a patient's rehabilitative treatment is provided. The method includes sensing physiological performance and body portion movement while moving a portion of the patient's body, generating a first signal in response to the sensed physiological performance of the portion of the patient's body, and generating a second signal in response to the sensed body portion movement of the portion of the patient's body. The method further includes determining a latent category in response to the first signal, determining a manifested category in response to the second signal, and determining a significant category in response to both the first signal and the second signal. Finally, the method includes determining the patient's rehabilitative treatment progress in response to all of the latent category, the manifested category and the significant category.
According to another embodiment of the present invention, a system for monitoring and determining progress of a patient's rehabilitative treatment is provided. The system includes two or more sensing devices and a predictive patient recovery potential module. The two or more sensing devices include a first device for sensing physiological performance by the patient while moving a portion of the patient's body and generating a first signal in response thereto and a second device for sensing body portion movement by the patient while moving the portion of the patient's body and generating a second signal in response thereto. The predictive patient recovery potential module is coupled to the two or more sensing devices and includes a categorization module and a functional performance recovery level module. The categorization module determines a latent category in response to the first signal, a manifested category in response to the second signal, and a significant category in response to both the first signal and the second signal. The functional performance recovery level module determines the patient's rehabilitative treatment progress in response to all of the latent category, the manifested category and the significant category.
According to another embodiment of the present invention, a non-transitory computer readable medium containing program instructions for causing a computer to perform a method for monitoring and determining progress of a patient's rehabilitative treatment is provided. The method includes determining a latent category in response to a segmented portion of a sensed physiological performance signal of a movement of a portion of a patient's body and determining a manifested category in response to a corresponding segmented portion of a sensed body portion movement signal of the movement of the portion of the patient's body. The method also includes determining a significant category in response to a dynamic functional connectivity measurement of the segmented portion of the sensed physiological performance signal of the movement of the portion of the patient's body and the corresponding segmented portion of the sensed body portion movement signal of the movement of the portion of the patient's body. Finally, the method includes determining the patient's rehabilitative treatment progress in response to all of the latent category, the manifested category and the significant category.
The accompanying figures, where like reference numerals refer to identical or functionally similar elements throughout the separate views and which together with the detailed description below are incorporated in and form part of the specification, serve to illustrate various embodiments and to explain various principles and advantages in accordance with a present embodiment.
Skilled artisans will appreciate that elements in the figures are illustrated for simplicity and clarity and have not necessarily been depicted to scale.
The following detailed description is merely exemplary in nature and is not intended to limit the invention or the application and uses of the invention. Furthermore, there is no intention to be bound by any theory presented in the preceding background of the invention or the following detailed description. It is the intent of the present embodiment to present a method and a system for monitoring and determining progress of a patient's rehabilitative treatment which uses a combination of electromyography (EMG) and inertial measurement unit (IMU) signals to quantify the performance of the patient's functional abilities. The latent and manifested categories for the patient's functional abilities are determined from the EMG and the IMU signals separately while a significant category is quantitatively determined using functional connectivity between the EMG and the IMU signals, where such functional connectivity is missing for some patients who have limited ability of movement. Functional connectivity refers to a functionally integrated relationship between physiological performance represented by the EMG signals and range of motion of a body portion as represented by the IMU signals.
Referring to
Then, a latent category is determined 108 in response to the first signal and a manifested category is determined 110 in response to the second signal. In accordance with the present embodiment, a significant category 112 is determined in response to both the first signal and the second signal by determining a dynamic functional connectivity measurement of corresponding portions of the first signal and the second signal as discussed herein below. Finally, the patient's rehabilitative treatment progress is determined 114 by calculating an objective score in response to all of the latent category, the manifested category and the significant category.
Referring to
Referring to
The functional abilities 310 correspond to manifested category scores 312 determined in response to the second signal from the IMU devices 206, 212, latent category 314 determined in response to the first signal from the EMG devices 210, 216, and significant category 316 determined in response to the first and second signals. In accordance with the present embodiment, a recovery stage 318 can advantageously be determined from the output 308, such as an objective score of motor function. Thus, a more clinically relevant and stronger parameter for the prediction of functional assessment can be provided in accordance with the present embodiment by quantitatively determining a significant category from corresponding portions of both the first and second signals which expresses a dynamic functional connectivity between the physiological performance captured by the multichannel EMG devices 210, 216 and the range of motion captured by the IMU devices 206, 212.
Referring to
Referring to
The deployed performance level clustering module 512 determines a plurality of classifiers from the latent category 518, the manifested category516 and the significant category 520. The scoring functional performance recovery level module 514 determines an objective score representing the patient's rehabilitative treatment progress in response to the plurality of classifiers of the latent category 518, the manifested category 516 and the significant category 520.
In accordance with the present embodiment, the EMG signal 402 can be pre-processed using baseline removal, band pass filtering and full wave rectification and smoothing. Most importantly, the EMG signal is normalized for example by using a maximum voluntary contraction normalization method. In addition, the IMU signal 406 is pre-processed. In accordance with the present embodiment, a complementary sensor fusion technology pre-processes the IMU signal 406 to accurately measure the elevation of movement of the patient or subject's limb.
The segmentation modules 404, 408 automatically segment the EMG signal 402 and the IMU signal 406 based on a windowing method without overlapping as described in greater detail in
In accordance with the present embodiment, the significant categories 414 are computed from integrating corresponding segmented portions of the EMG signal 402 and the IMU signal 406. Corresponding segmented portions means the segmented portions of the EMG signal 402 and the IMU signal 404 that fall within the same time window and therefore are EMG signals 402 and IMU signals 404 during the same motion of the limb or other body portion. A dynamic functional connectivity module 606 measures the functional correlation of corresponding segmented portions of the EMG signal 402 and the IMU signal 404 by defining a dynamic functional connectivity matrix between the EMG signals 402 and the IMU signals 404.
Referring to
When the threshold T is exceeded 706, a suspected activity is detected and the specific time point and the amplitude greater than T are collected 708. These are defined as TACT, and AmpACT 710. Then the difference between pairs of consecutive is determined 712 to find the change point among the collected time point vectors (TACT). Then, a minimum duration is defined 714 (e.g., two seconds) to find the activity/inactivity region in changed points. The time point among the changed points that are greater than the minimum duration 716 define when an activity starts and when an activity ends thereby defining the activity and inactivity regions 718. Thus, the EMG signal 402 and the IMU signal 406 are segmented 720 by the segmentation modules 404, 408 based on a windowing with overlapping method. Note that while two seconds is used as an example of a minimum duration, the minimum duration is not limited to this time period and can be changeable according to the characteristics of the signal.
Referring to
Referring to
Thus, it can be seen that the present embodiment provides significant categories for functional connectivity to identify an individual's functional reorganization of neurologic recovery from brain injuries such as stroke. Disrupted functional connectivity will affect the performance of functional abilities. In accordance with the present embodiment, a system and method is provided to quantitatively determine significant categories, manifested categories and latent categories of a patient's functional abilities. Tuning parameters are provided in a detection algorithm in accordance with the present amendment for activities of EMG physiological data and IMU motion data and automatic segmentation.
While exemplary embodiments have been presented in the foregoing detailed description of the invention, it should be appreciated that a vast number of variations exist. It should further be appreciated that the exemplary embodiments are only examples, and are not intended to limit the scope, applicability, operation, or configuration of the invention in any way. Rather, the foregoing detailed description will provide those skilled in the art with a convenient road map for implementing an exemplary embodiment of the invention, it being understood that various changes may be made in the function and arrangement of steps and method of operation described in the exemplary embodiment without departing from the scope of the invention as set forth in the appended claims.
The program can be stored and provided to the computer device using any type of non-transitory computer readable media. Non-transitory computer readable media include any type of tangible storage media. Examples of non-transitory computer readable media include magnetic storage media (such as floppy disks, magnetic tapes, hard disk drives, etc.), optical magnetic storage media (e.g. magneto-optical disks), CD-ROM (Read Only Memory), CD-R, CD-R/W, and semiconductor memories (such as mask ROM, PROM (Programmable ROM), EPROM (Erasable PROM), flash ROM, RAM (Random Access Memory), etc.). The program may be provided to the computer device using any type of transitory computer readable media. Examples of transitory computer readable media include electric signals, optical signals, and electromagnetic waves. Transitory computer readable media can provide the program to the computer device via a wired communication line, such as electric wires and optical fibers, or a wireless communication line.
For example, the whole or part of the exemplary embodiments disclosed above can be described as, but not limited to, the following supplementary notes.
(Supplementary Note 1)
A method for monitoring and determining progress of a patient's rehabilitative treatment, the method comprising:
sensing physiological performance and body portion movement while moving a portion of the patient's body;
generating a first signal in response to the sensed physiological performance of the portion of the patient's body;
generating a second signal in response to the sensed body portion movement of the portion of the patient's body;
determining a latent category in response to the first signal;
determining a manifested category in response to the second signal;
determining a significant category in response to both the first signal and the second signal; and
determining the patient's rehabilitative treatment progress in response to all of the manifested category, the latent category and the significant category.
(Supplementary Note 2)
The method in accordance with Supplementary note 1 wherein generating the first signal comprises:
generating a physiological performance signal in response to the sensed physiological performance of the portion of the patient's body; and
segmenting the physiological performance signal to generate the first signal.
(Supplementary Note 3)
The method in accordance with Supplementary note 1 or 2 wherein generating the second signal comprises:
generating a sensed movement signal in response to the sensed movement of the portion of the patient's body; and
segmenting the sensed movement signal to generate the second signal.
(Supplementary Note 4)
The method in accordance with Supplementary note 1 wherein generating the first signal comprises:
generating a physiological performance signal in response to the sensed physiological performance of the portion of the patient's body; and
segmenting the physiological performance signal to generate the first signal wherein the first signal comprises a plurality of segmented portions of the first signal, and wherein generating the second signal comprises:
generating a sensed movement signal in response to the sensed movement of the portion of the patient's body; and
segmenting the sensed movement signal to generate the second signal wherein the second signal comprises a plurality of segmented portions of the second signal, and
wherein determining the significant category comprises determining the significant category in response to a dynamic functional connectivity measurement of corresponding segmented portions of the first signal and the second signal.
(Supplementary Note 5)
The method in accordance with Supplementary note 1 wherein determining the latent category comprises:
extracting predetermined features [tuning parameters] from the first signal; and
determining the latent category in response to the predetermined features extracted from the first signal.
(Supplementary Note 6)
The method in accordance with Supplementary note 1 wherein determining the manifested category comprises:
extracting predetermined features from the second signal; and
determining the manifested category in response to the predetermined features extracted from the second signal.
(Supplementary Note 7)
The method in accordance with Supplementary note 1 wherein generating the first signal comprises generating the first signal in response to an electromyography (EMG) of the sensed physiological performance of the portion of the patient's body.
(Supplementary Note 8)
The method in accordance with Supplementary note 1 wherein generating the second signal comprises generating the second signal in response to inertial measurement units (IMU) of the sensed body portion movement of the portion of the patient's body.
(Supplementary Note 9)
The method in accordance with Supplementary note 1 wherein the portion of the patient's body moved comprises one of a patient's limb, a patient's hand, a patient's foot, a patient's fingers or a patient's toes.
(Supplementary Note 10)
A system for monitoring and determining progress of a patient's rehabilitative treatment, the system comprising:
two or more sensing devices comprising a first device for sensing physiological performance by the patient while moving a portion of the patient's body and generating a first signal in response thereto and a second device for sensing body portion movement by the patient while moving the portion of the patient's body and generating a second signal in response thereto; and
a predictive patient recovery potential module coupled to the two or more sensing devices and comprising:
a categorization module for determining a latent category in response to the first signal, determining a manifested category in response to the second signal, and determining a significant category in response to both the first signal and the second signal; and
a functional performance recovery level module for determining the patient's rehabilitative treatment progress in response to all of the latent category, the manifested category and the significant category.
(Supplementary Note 11)
The system in accordance with Supplementary note 10 wherein the categorization module comprises a first segmentation module for segmenting the first signal into a plurality of segmented portions of the first signal, the categorization module determining the latent category in response to each of the plurality of segmented portions of the first signal.
(Supplementary Note 12)
The system in accordance with Supplementary note 10 or Supplementary note 11 wherein the categorization module comprises a second segmentation module for segmenting the second signal into a plurality of segmented portions of the second signal, the categorization module determining the manifested category in response to each of the plurality of segmented portions of the second signal.
(Supplementary Note 13)
The system in accordance with Supplementary note 10 wherein the categorization module comprises a first segmentation module for segmenting the first signal into a plurality of segmented portions of the first signal and a second segmentation module for segmenting the second signal into a plurality of segmented portions of the second signal, and wherein the categorization module determines the latent category in response to each of the plurality of segmented portions of the first signal, determines the manifested category in response to each of the plurality of segmented portions of the second signal, and determines the significant category in response to a dynamic functional connectivity measurement of corresponding segmented portions of the first signal and the second signal.
(Supplementary Note 14)
The system in accordance with any of Supplementary note 10 to Supplementary note 13 wherein the categorization module comprises:
a first feature extraction module for extracting predetermined features from the first signal; and
a second feature extraction module for extracting predetermined features from the second signal, and
wherein the latent category is determined in response to the extracted predetermined features of the first signal, the manifested category is determined in response to extracted predetermined features of the second signal, and the significant category is determined in response to both the extracted predetermined features of the first signal and the extracted predetermined features of the second signal.
(Supplementary Note 15)
The system in accordance with any of Supplementary note 10 to Supplementary note 14 wherein the first device comprises an electromyography (EMG) device for sensing the physiological performance by the patient while moving the portion of the patient's body.
(Supplementary Note 16)
The system in accordance with any of Supplementary note 10 to Supplementary note 15 wherein the second device comprises an inertial measurement unit (IMU) device for sensing the body portion movement by the patient while moving the portion of the patient's body.
(Supplementary Note 17)
The system in accordance with any of Supplementary note 10 to Supplementary note 16 further comprising a deployed performance level clustering module coupled between the categorization module and the functional performance recovery level module for determining a plurality of classifiers from the latent category, the manifested category and the significant category, and wherein the functional performance recovery level module determines an objective score representing the patient's rehabilitative treatment progress in response to the plurality of classifiers.
(Supplementary Note 18)
The system in accordance with any of Supplementary note 10 to Supplementary note 17 wherein the portion of the patient's body moved comprises one of a patient's limb, a patient's hand, a patient's foot, a patient's fingers or a patient's toes.
(Supplementary Note 19)
A non-transitory computer readable medium containing program instructions for causing a computer to perform a method for monitoring and determining progress of a patient's rehabilitative treatment comprising:
determining a latent category in response to a segmented portion of a sensed physiological performance signal of a movement of a portion of a patient's body;
determining a manifested category in response to a corresponding segmented portion of a sensed body portion movement signal of the movement of the portion of the patient's body;
determining a significant category in response to a dynamic functional connectivity measurement of the segmented portion of the sensed physiological performance signal of the movement of the portion of the patient's body and the corresponding segmented portion of the sensed body portion movement signal of the movement of the portion of the patient's body; and
determining the patient's rehabilitative treatment progress in response to all of the latent category, the manifested category and the significant category.
This application is based upon and claims the benefit of priority from Singapore provisional patent application No. 10201800833T, filed on Jan. 31, 2018, the disclosure of which is incorporated herein in its entirety by reference.
Number | Date | Country | Kind |
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10201800833T | Jan 2018 | SG | national |
Filing Document | Filing Date | Country | Kind |
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PCT/JP2019/000497 | 1/10/2019 | WO | 00 |