QUANTITATIVE METHODS FOR THE EVALUATION OF PATIENTS WITH CEREBRAL PALSY
Cerebral Palsy is a condition characterized by paralysis, weakness, incoordination, or any other aberration of motor function due to pathology of motor control centers of the brain. Quantification of the various motor syndromes is a valuable aid to both the researcher interested in disease physiology, and to the clinician concerned with efficacy of treatment and evaluation of functional ability. The objective of this work is the development of 3 quantitative techniques which are useful for evaluation of the Cerebral Palsied. The first concerns a means to quantify passive resistance to motion. Specifically, 2 distinct devices are discussed. One is used to quantify passive resistance of the forearm, while the other is used to measure leg passive resistance. The method of data analysis selected in both cases allows assignment of a single energy related numerical value to each limb test. The second measurement technique involves a means for the analysis of postural sway. Several methods of data treatment are developed in this section. Some of these provide 3-dimensional displays of summary sway information, while the others provide more quantitative output. The final measurement technique concerns the quantification of gait through the use of electrogoniometry in conjunction with a data compression, pulse width modulation unit. Both quantitative and qualitative information, including 3-dimensional displays is output from this system. Analytical mechanical models of the forearm, leg and whole body are proposed in order to describe the effects of inertia upon the respective measurement systems. Finite element analysis techniques are used to determine the effects of subject position on balance platform measurements. The use of signal analysis techniques for the description of postural sway is also reviewed. Experimental procedures for subject testing are concurrently developed for application with each system. The results from several clinical tests are presented. A group of normal volunteers and subjects with Cerebral Palsy are tested for arm and leg passive resistance. The Cerebral Palsied group is also studied before and after Cerebellar implant; as well as post-operatively. Decreases in arm and leg passive resistance following implantation with the stimulator on are statistically significant (p < 0.05). Subjects tested post-operatively with stimulator off for 48 hours, and then on for 1 hour do not show significant decreases. Smaller populations of normals and ambulatory Cerebral Palsy subjects are evaluated for postural sway and gait. Results from these studies indicate that both measurement systems are effective in quantifying the various parameters, and in providing clear distinctions between groups. Conclusions drawn as a result of the study are that the systems are accurate and reliable in quantifying passive resistance to motion, postural sway and gait. The parameters chosen for data representation are quantitative, yet are also sound from an intuitive standpoint. Thus, the devices are appropriate for use in both research and clinical environments.
GERALD FRANCIS HARRIS,
"QUANTITATIVE METHODS FOR THE EVALUATION OF PATIENTS WITH CEREBRAL PALSY"
(January 1, 1981).
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