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I.
INTRODUCTION
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METHODS
Slow stretch
Position (degree)
150
100
50
0
20
30
40
50
Force (N)
10
0
-10
20
30
40
Time (sec)
50
Subject
#1
MAS score
of each
#2
examiner
#3
Scores used for
the modeling
#1
1
1
1+
#2
3
2
2
#3
1+
1+
1+
#4
2
2
1+
1+
Position (degree)
TABLE I.
Fast stretch
150
100
50
0
25
30
25
30
35
40
45
40
45
Force (N)
10
0
-10
35
Time (sec)
Position (degree)
Fast stretch
150
100
50
0
25
30
25
(i)
30
(ii) (iii)
35
Time (sec)
40
45
10
Force (N)
0
-10
35
(i)
40
45
(ii)(iii) (i)
Figure 3. Three phases in elbow spasticity: (i) pre-catch, (ii) catch, and (iii)
post-catch
W pre
mT bT kT .
(1)
There have been studies which applied the equation (1) for
representing non-spastic [15] or spastic elbows [10]. Moreover,
the clinical data collected under slow stretch also agrees with
this assumption. Since there was no catch under slow stretch,
the whole data set collected under slow stretch can be treated as
a pre-catch phase. For instance, the force (or torque) measured
during the assessment (Subject 3, slow stretch) and the
estimated force (or torque) obtained based on (1) had 11.4% of
average error (Fig. 4), which validates the assumption.
5
measured force
estimated force
the catch phase begins; and 'tc the time duration that the peak
torque maintains.
Along with the peak torque at the catch and its residual
torque, the time duration of catch phase needs to be determined
which automatically defines the end of catch phase and the
beginning of post-catch phase. From the clinical data collected,
we observed that the time duration of catch phase is inversely
proportional to the stretch velocity which is modeled as follows:
Force (N)
-5
-10
tc _ du
-15
0
20
40
Time (sec)
60
80
D
,
Tc
(4)
c _ du
T catch
Ti ,
T pre
(2)
W catch
hTc _ st G (t ) W pre _ en
with G (t )
if t tc _ st 'tc
q (q 1) if t tc _ st t 'tc
(3)
120
100
80
60
40
20
1
6 7
Trial
9 10 11 12
W post
(5)
III.
RESULTS
2000
1500
1000
1.5
2.0
2.5
0.15
0.5
0.55
= 15; T = 20;
60
50
40
th
Position (degree)
200
200
100
100
25
30
35
40
45
Force (N)
10
25
30
35
Time (sec)
40
45
Position (degree)
Force (N)
12
14
18
20
22
16
18
Time (sec)
20
22
16
200
200
100
100
20
25
30
35
40
0
22
10
10
-10
14
0
-10
10
12
10
0
-10
0
10
20
25
30
Time (sec)
35
40
24
26
28
30
32
34
APPENDIX
-10
22
24
26
28
30
Time (sec)
32
34
IV.
0 No increase in tone
1 Slight increase in muscle tone, manifested by a catch and
release or minimal resistance at the end of the ROM when the
affected part is moved in flexion or extension
1+ Slight increase in muscle tone, manifested by a catch,
followed by minimal resistance throughout the remainder (less
than half) of the ROM
2 More marked increase in muscle tone through most of the
ROM, but affected part easily moved
3 Considerable increase in muscle tone, passive movement
difficult
4 Affected part rigid in flexion or extension
ACKNOWLEDGMENT
The authors thank all subjects and clinicians volunteered
for the study. This research was supported by Intramural
Research Program of the NIH, Clinical Center (protocol
number 90-CC-0168) and Center for Neuroscience and
Regenerative Medicine (Grant number G192HF).
REFERENCES
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[5]
[6]
[7]
[8]
[9]
[10]
[11]
[12]
[13]
[14]
[15]
[16]
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[20]