Motion analysis device, method for evaluating motor function, and motion analysis program

Abstract

To provide a motion analysis device that can be used for evaluating a motor function or motion disorder.SOLUTION: A motion analysis device (20) includes elbow flexure ratio calculation means (222) for calculating an elbow flexure ratio of an upper limb in elevation exercise which is expressed by an expression (1) or an expression (2) from respective three-dimensional coordinate data of the shoulder, elbow, and hand of a person to be evaluated when the person to be evaluated is in upper limb elevation exercise. In the expression (2), SH represents a vector from the shoulder to the hand, SE represents a vector from the shoulder to the elbow, and EH represents a vector from the elbow to the hand.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] The present invention relates to a motion analysis device, a motor function evaluation method, and a motion analysis program. [Background technology]

[0002] Upper limb dysfunction affects approximately 70% of stroke patients and negatively impacts activities of daily living and health-related quality of life. Patients report that loss of upper limb function is one of the most distressing long-term consequences after stroke. Therefore, improving upper limb function is an important challenge for stroke survivors and caregivers.

[0003] Upper limb rehabilitation for stroke patients requires the use of the affected upper limb in training and daily activities, and the degree of functional improvement is known to depend on the amount of use. To use the affected upper limb, lifting the upper limb—that is, flexing the shoulder joint and raising the arm in space—is essential to positioning the hand relative to a target or the environment. However, stroke patients frequently exhibit disease-specific abnormal movements during upper limb lifting, such as abnormal synergy (i.e., difficulty in isolated joint movement, e.g., excessive movement of an adjacent joint when attempting voluntary movement of one joint), compensatory movements, and cocontraction, due to symptoms such as motor paralysis, muscle weakness, contracture, and spasticity. In particular, abnormal movements of the trunk, shoulder elevation, shoulder abduction, and elbow flexion are commonly observed during upper limb lifting. These abnormal movements not only limit improvement in motor function, but also may lead to problems such as limited range of motion and pain due to overuse. Abnormal movements during upper limb elevation are an impediment to upper limb rehabilitation, so it is important to evaluate abnormal movements before carrying out rehabilitation.

[0004] There have been a number of studies that have focused on abnormal movements such as abnormal synergy and compensatory movements during upper limb elevation. For example, the Fugl-Meyer Assessment (FMA), the gold standard for assessing motor paralysis, is also used to evaluate synergistic movements and abnormal synergistic movements (Non-Patent Document 1).

[0005] Furthermore, with the recent spread of robotic rehabilitation, the development and application of robotic devices to evaluate motor dysfunction has progressed. In fact, robots for evaluating abnormal movements are being developed, and other previous studies have attempted to quantify abnormal movements using electromyography and three-dimensional motion analysis devices.

[0006] For example, Patent Document 1 discloses a motor function evaluation device that acquires information about curvature from a plurality of pieces of position information about a part of a body and evaluates the function of the part of a body.

[0007] Patent Document 2 discloses a pathological condition analysis device that digitizes the pathological condition of the upper limbs of a hemiplegic patient, and that includes an upper arm drive arm, a forearm drive arm, and an upper limb control unit.

[0008] Patent document 3 is the development of a three-dimensional motion analysis device for evaluating motor function disorders in patients with neurological diseases, and discloses a motion analysis device equipped with a first evaluation value acquisition means that acquires a first evaluation value indicating the accuracy of a repetitive movement using positional information of a fixed point on a part of the subject's body during multiple repetitive movements of that part, and / or a second evaluation value acquisition means that acquires a second evaluation value that indicates the smoothness of the repetitive movement. [Prior art documents] [Patent documents]

[0009] [Patent Document 1] Patent Publication No. 2009-285273 [Patent Document 2] Patent Publication No. 2017-153706 [Patent Document 3] Patent Publication No. 2016-209212 [Non-patent literature]

[0010] [Non-Patent Document 1] Hadjiosif AM et al., J Neurophysiol. 2022 Apr 1;127(4):856-868. Summary of the Invention [Problem to be solved by the invention]

[0011] However, there is no gold standard for evaluating abnormal movements observed during arm elevation. Although there are a few studies that focus on abnormal movements such as abnormal synergies and compensatory movements during arm elevation, these have several issues.

[0012] The first problem is that commonly used assessments cannot perform quantitative assessments. For example, the FMA used in Non-Patent Document 1 is an assessment consisting of a three-point Likert scale, and it is impossible to quantitatively evaluate abnormal movements. Furthermore, none of Patent Documents 1 to 3 teaches how to provide quantitative data used to evaluate the motor function or motor impairment of a subject during upper limb lifting movements.

[0013] The second issue is the lack of simplicity in prior art technologies aimed at quantification. Evaluation of abnormal movements using robots not only requires specific equipment, but also takes time for preparation, measurement, and analysis, making them unsuitable for practical use in actual clinical settings. The motor function evaluation device in Patent Document 1 does not evaluate abnormal movements during shoulder elevation. The movement analysis device in Patent Document 2 analyzes the movement of the patient's upper limbs using a robot by attaching the patient's upper arm and forearm to the upper arm drive arm and forearm drive arm, respectively, of a pathological analysis device, and measuring the upper arm time series data and forearm time series data requires time and skill.

[0014] Finally, there is no technology that can translate the results of abnormal movement assessment into treatment. Clinical assessments are conducted not only to understand the current physical and mental state, but also to collect information to determine treatment and training based on the severity and changes of symptoms. However, to date, there is no technology that can translate the severity of abnormal movement into a specific treatment plan, such as calculating the range of movement. None of the devices in Patent Documents 1 to 3 have been developed for treatment.

[0015] There is a need for a motion analysis device or method that can be used to evaluate motor function or motor impairment from three-dimensional coordinate data of a subject performing an upper limb lifting movement, and there is also a need for an evaluation of motor function using such a motion analysis device or method. [Means for solving the problem]

[0016] The present invention encompasses the embodiments described below. Section 1. A motion analysis device equipped with an elbow flexion ratio calculation means for calculating the elbow flexion ratio during upper limb raising movement, expressed by the following formula (1) or (2), from the three-dimensional coordinate data of the shoulder, elbow, and hand of the subject when the subject raises the upper limb.

[0017]

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[0018]

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[0019] Section 2. Item 2. The motion analysis device according to item 1, further comprising an output unit that outputs the elbow flexion ratio during the upper limb lifting motion calculated by the elbow flexion ratio calculation unit. Section 3. Item 1. The motion analysis device according to item 1, further comprising an area under the curve calculation means for calculating the area under the curve of the elbow flexion ratio during the upper limb lifting movement in the range from the start of the upper limb lifting movement of the subject to the maximum shoulder flexion. Section 4. Item 1. The motion analysis device according to item 1, further comprising a shoulder flexion angle calculation means for calculating shoulder flexion angles at three points, including one point with the minimum value and two points immediately before and after the minimum value where the differential value is zero, from the differential value of the elbow flexion ratio during the upper limb raising movement calculated by the elbow flexion ratio calculation means, in the range from the start of the upper limb raising movement of the subject to the time of maximum shoulder flexion. Section 5. 5. The movement analysis device according to any one of items 1 to 4, which is a device for evaluating motor function. Section 6. A method for evaluating motor function, comprising: An elbow flexion ratio calculation step in which an elbow flexion ratio calculation means calculates an elbow flexion ratio during upper limb elevation movement represented by the following formula (1) or (2) from three-dimensional coordinate data of the shoulder, elbow, and hand of the subject before and after treatment of the subject during the upper limb elevation movement of the subject; an area under the curve calculation step of calculating the area under the curve of the elbow flexion ratio during the upper limb lifting movement of the subject from the start of the upper limb lifting movement to the maximum shoulder flexion by the area under the curve calculation means; A method comprising: Section 7. Item 7. The method described in item 6, wherein if the area under the curve calculated from the elbow flexion ratio after the treatment is greater than the area under the curve calculated from the elbow flexion ratio before the treatment, the treatment is likely to be effective in improving the motor function of the subject. Section 8. A method for providing data indicating a range of motion for upper limb elevation exercise suitable for an individual to be evaluated, an elbow flexion ratio calculation step of calculating an elbow flexion ratio during the upper limb raising movement represented by the following formula (1) or (2) using three-dimensional coordinate data of the shoulder, elbow, and hand of the subject during the upper limb raising movement of the subject by an elbow flexion ratio calculation means; a step of calculating, by shoulder flexion angle calculation means, three shoulder flexion angles, including one minimum value point and two points where the differential values ​​immediately before and immediately after the minimum value are zero, from the calculated differential values ​​of the elbow flexion ratio during the upper limb lifting movement; A method comprising: Section 9. A program for causing a computer to perform a motion analysis of an assessee, A program for causing a computer to function as an elbow flexion ratio calculation means for calculating the elbow flexion ratio during upper limb raising exercise, expressed by the following formula (1) or (2), from the three-dimensional coordinate data of the shoulder, elbow, and hand of the subject during the upper limb raising exercise. [Effects of the Invention]

[0020] According to the present invention, there is provided a movement analysis device or method that can be used to evaluate movement function or movement disorders, and a method for evaluating movement function using such a movement analysis device or method. [Brief explanation of the drawings]

[0021] [Figure 1] Block diagram of a motion analysis system. [Figure 2] 4 is a flowchart illustrating the operation of the motion analysis device. [Figure 3] 10 is a flowchart illustrating another operation of the motion analysis device. [Figure 4] 10 is a flowchart illustrating another operation of the motion analysis device. [Figure 5] 10 is a flowchart illustrating another operation of the motion analysis device. [Figure 6] 10 is a flowchart illustrating another operation of the motion analysis device. [Figure 7] Graph showing elbow flexion ratio during shoulder flexion and elevation exercise up to maximum shoulder flexion angle. [Figure 8] Graph obtained by differentiating the elbow flexion ratio. DETAILED DESCRIPTION OF THE INVENTION

[0022] As used herein, the singular forms "a," "an," and "the" are intended to include both the singular and the plural unless otherwise expressly stated herein or clearly contradicted by context.

[0023] In this specification, the terms "having" and "comprising" are concepts that also encompass "consisting essentially only of" and "consisting only of."

[0024] As used herein, treatment includes rehabilitation, drug therapy, etc. Rehabilitation includes exercise therapy, occupational therapy, etc. Treatment may be administered by a doctor or other medical professional (such as a physical therapist or occupational therapist), or may be assisted by a robot.

[0025] Hereinafter, embodiments of the present invention will be described with reference to the drawings. Note that the embodiments described below are examples of typical embodiments of the present invention, and the scope of the present invention should not be construed as being narrow.

[0026] Fig. 1 is a block diagram showing the configuration of a motion analysis system 1 according to an embodiment of the present invention. The motion analysis system 1 includes a sensor 10 for detecting the motion of a subject, and a motion analysis device 20 for storing and processing data received from the sensor 10. The subject may be, for example, a patient with upper limb dysfunction. An example of a patient with upper limb dysfunction is a patient with upper limb dysfunction following a stroke.

[0027] Sensor 10 may be an optical, mechanical, or magnetic sensor, and is preferably a motion sensor. The motion sensor measures the movement of the subject's upper limbs during movement by motion capture. The motion sensor is not limited to any particular type as long as it can acquire time-series data of the three-dimensional coordinates of a point on the subject's upper limb. Examples of such sensors include markerless motion sensors using a dot pattern projection method, and inertial sensors attached to a predetermined position on the upper limb (e.g., 6-axis or 9-axis sensors including a 3-axis acceleration sensor, a 3-axis angular velocity sensor, and a magnetic sensor). To reduce the effort and time required to attach the sensor to the subject's upper limb, a markerless motion sensor is preferred for sensor 10. An example of such a motion sensor is the Kinect sensor sold by Microsoft.

[0028] The motion analysis device 20 is composed of a computer or the like, and is equipped with a control unit 22 that performs calculations or judgments based on various data including data received from the sensor 10, data stored inside the motion analysis device 20, and / or data generated inside the motion analysis device 20, a memory unit 24 that stores the data received from the sensor 10 and various data stored or generated inside the motion analysis device 20, and an output unit 26 that outputs data processed by the control unit 22 (e.g., calculation results).

[0029] The control unit 22 is composed of a CPU, a microprocessor, or the like. The control unit 22 may also be referred to as a processing unit. Processing by the control unit 22 is performed automatically. The memory unit 24 may be composed of a storage medium such as a ROM, a RAM, or a hard disk. Programs executed by the control unit 22 may be stored in the memory unit 24. Output from the output unit 26 may include display on a display, projection using a projector, printing on a printer, audio output, transmission to an external device, storage on a recording medium, and delivery of processing results to other processing devices, other programs, etc. The output unit 14 may or may not include an output device such as a display or a speaker. The output unit 26 may be composed of driver software for an output device, or a combination of driver software for an output device and the output device, etc.

[0030] The control unit 22 further includes a three-dimensional coordinate data acquisition means 221 , an elbow flexion ratio calculation means 222 , an area under the curve calculation means 223 , a shoulder flexion angle calculation means 224 , and a motor function evaluation means 225 .

[0031] The three-dimensional coordinate data acquisition means 221 interpolates and smooths, as necessary, the data of the subject's upper limb lifting movement detected by the sensor 10, and acquires or generates three-dimensional coordinate data. The three-dimensional coordinate data includes three-dimensional coordinate data of the subject's shoulder, elbow, and hand.

[0032] The elbow flexion ratio calculation means 222 calculates the elbow flexion ratio during the upper limb raising movement, expressed by the following formula (1) or formula (2), from the three-dimensional coordinate data of the shoulder, elbow, and hand of the person being evaluated during the upper limb raising movement, obtained from the three-dimensional coordinate data acquisition means 221.

[0033]

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[0034]

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[0035] Instead of equation (1), the elbow flexion ratio during upper limb elevation can also be expressed by the following equation (1').

[0036]

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[0037] The method for measuring the elbow flexion ratio during upper limb elevation is to first obtain three-dimensional coordinate data from the patient using sensor 10. Specifically, the subject begins the upper limb elevation movement by sitting with their elbows extended downward. With their elbows extended, they then raise their upper limbs forward until their shoulders are maximally flexed (hereinafter referred to as "maximum shoulder flexion"). Three-dimensional coordinate data of the shoulders, elbows, and hands during this movement are obtained. The three-dimensional coordinate data acquisition means 221 interpolates and smooths the data of the subject's upper limb elevation movement detected by sensor 10 as necessary to obtain or generate three-dimensional coordinate data. Next, the elbow flexion ratio calculation means 222, which has obtained the three-dimensional coordinate data of the subject's shoulders, elbows, and hands from the three-dimensional coordinate data acquisition means 221, calculates the elbow flexion ratio during upper limb elevation movement using the above formula (1) or (2). The elbow flexion ratio during upper limb elevation movement is typically calculated from the start of the movement until the shoulders are maximally flexed.

[0038] The elbow flexion ratio during upper limb elevation, expressed by equation (1) or (2), has a denominator corresponding to the arm length and a numerator corresponding to the length from the shoulder to the hand, so the value decreases when the elbow is bent. When the elbow is fully extended, the denominator and numerator values ​​are equal, so the elbow flexion ratio is 100%.

[0039] Therefore, the elbow flexion ratio during upper limb elevation exercise expressed by Equation (1) or Equation (2) can be an index for evaluating motor function or motor disorders. "Evaluation of motor function or motor disorders" includes one or more of the following: detection of abnormal synergy during upper limb elevation exercise, evaluation of the presence or absence of motor disorders, evaluation of the worsening or improvement of motor disorders, and evaluation of the improvement or decline of motor function. Furthermore, when the index for evaluating motor function or motor disorders is a function, it can be one of its parameters.

[0040] The area under the curve calculation means 223 further calculates the area under the curve of the elbow flexion ratio during upper limb elevation calculated by the elbow flexion ratio calculation means 222, from the start of the subject's upper limb elevation to maximum shoulder flexion. The area under the curve is an index for quantitatively evaluating motor function or motor impairment, and if the subject can lift their upper limb with their elbow extended, the area under the curve will be close to 100%. The closer the area under the curve is to 100%, the less abnormal movement there is during upper limb elevation, and the lower the area under the curve, the more abnormal movement there is during upper limb elevation. Furthermore, for the same subject, an increase in the area under the curve indicates a reduction in abnormal movement during upper limb elevation, while a decrease in the area under the curve indicates an exacerbation of abnormal movement during upper limb elevation.

[0041] To the best of our knowledge, no method has been reported to quantitatively and simply evaluate abnormal movements during arm elevation. The area under the curve of the elbow flexion ratio during arm elevation can provide data for quantitatively and simply evaluating abnormal movements during arm elevation.

[0042] The shoulder flexion angle calculation means 224 calculates a total of three shoulder flexion angles, including one minimum value and two points just before and just after the minimum value where the differential value is zero, from the differential value of the elbow flexion ratio during the upper limb elevation movement calculated by the elbow flexion ratio calculation means 222 from the start of the upper limb elevation movement of the person being evaluated to the maximum shoulder flexion. The minimum value is the point where the abnormal movement is strongest, the point where the differential value just before the minimum value is zero is the point where the maximum abnormal movement started, and the point where the differential value just after the minimum value is zero is the point where the maximum abnormal movement ended.

[0043] By calculating the shoulder flexion angle at these three points and providing the subject with treatment or therapy such as rehabilitation that includes upper limb elevation exercises within that range, the treatment effect can be made more effective.

[0044] The motor function evaluation means 225 evaluates the motor function using at least one of the elbow flexion ratio calculated by the elbow flexion ratio calculation means 222, the area under the curve calculated by the area under the curve calculation means 223, and the shoulder flexion angle calculated by the shoulder flexion angle calculation means 224.

[0045] In one embodiment, the motor function evaluation means 225 can quantitatively indicate the rate of elbow flexion during upper limb elevation movement by the area under the curve calculated by the area under the curve calculation means 223 for a certain subject.

[0046] In another embodiment, the motor function evaluation means 225 compares the area under the curve calculated by the area under the curve calculation means 223 for a given subject with the same maximum shoulder flexion angle, with the area under the curve of other subjects with upper limb functional impairment, or with the median or average of the areas under the curve of a group of subjects with upper limb functional impairment other than the given subject, and determines that if the area under the curve of a given subject is lower than the area under the curve of other subjects with upper limb functional impairment other than the given subject or the median or average of the areas under the curve of the group, the given subject is more likely to have abnormal movements during upper limb elevation movements than other subjects with upper limb functional impairment other than the given subject or the group. Standardizing the maximum shoulder flexion angle means making the maximum shoulder flexion angle the same value between subjects.

[0047] In another embodiment, the motor function evaluation means 225 compares the area under the curve calculated by the area under the curve calculation means 223 for a certain person to be evaluated with the value of the area under the curve for a person with upper limb functional disorder, or the median or average value of the area under the curve for a group of multiple people with upper limb functional disorder other than the person to be evaluated, after standardizing the maximum shoulder flexion angle, and if the area under the curve for a certain person to be evaluated is higher than the value of the area under the curve for people with upper limb functional disorder other than the person to be evaluated or the median or average value of the area under the curve for the group, it determines that the person to be evaluated is likely to have less abnormal movement during upper limb elevation exercises than people with upper limb functional disorder other than the person to be evaluated or the group.

[0048] In another embodiment, the motor function evaluation means 225 compares the area under the curve before treatment calculated by the area under the curve calculation means 223 for a certain subject with the area under the curve after treatment, after standardizing the maximum shoulder flexion angle, and determines that the treatment is likely to be effective in improving upper limb functional disorder if the area under the curve after treatment for the subject is higher than the area under the curve before treatment.

[0049] In another embodiment, the motor function evaluation means 225 compares the area under the curve before treatment calculated by the area under the curve calculation means 223 for a certain subject with the area under the curve after treatment, after standardizing the maximum shoulder flexion angle, and determines that the treatment is unlikely to be effective in improving upper limb functional disorder if the area under the curve after treatment for the subject is no different from or lower than the area under the curve before treatment.

[0050] In another embodiment, the motor function evaluation means 225 compares the value calculated by the elbow flexion ratio calculation means 222 at an arbitrary shoulder flexion angle for a certain subject with the value of the elbow flexion ratio for the same shoulder flexion angle for persons with upper limb functional disorders other than the subject, or the median or average value of the elbow flexion ratio for the same shoulder flexion angle for a group of multiple persons with upper limb functional disorders other than the subject, and determines that if the elbow flexion ratio for a certain subject is lower than the value of the elbow flexion ratio for persons with upper limb functional disorders other than the subject, or the median or average value of the same shoulder flexion angle for the group, the subject is likely to have greater abnormal movement during upper limb elevation movement at that angle compared to persons with upper limb functional disorders other than the subject or the group.

[0051] In another embodiment, the motor function evaluation means 225 compares the value calculated by the elbow flexion ratio calculation means 222 at an arbitrary shoulder flexion angle for a certain person being evaluated with the value of the elbow flexion ratio for the same shoulder flexion angle for persons with upper limb functional disorders other than the person being evaluated, or the median or average value of the elbow flexion ratio for the same shoulder flexion angle for a group of multiple persons with upper limb functional disorders other than the person being evaluated, and determines that if the elbow flexion ratio for a certain person being evaluated is higher than the value of the elbow flexion ratio for persons with upper limb functional disorders other than the person being evaluated or the median or average value of the elbow flexion ratio for the group, the person being evaluated is likely to have less abnormal movement during upper limb elevation movement at that angle compared to persons or groups with upper limb functional disorders other than the person being evaluated.

[0052] In another embodiment, the motor function evaluation means 225 compares the pre-treatment elbow flexion ratio calculated by the elbow flexion ratio calculation means 222 at any shoulder flexion angle of a certain subject with the post-treatment elbow flexion ratio at the same shoulder flexion angle, and determines that the treatment is likely to be effective in improving upper limb functional disorder if the post-treatment elbow flexion ratio of the subject is higher than the pre-treatment elbow flexion ratio.

[0053] In another embodiment, the motor function evaluation means 225 compares the area under the curve before treatment calculated by the area under the curve calculation means 223 for a certain subject with the area under the curve after treatment, after standardizing the maximum shoulder flexion angle, and determines that the treatment is unlikely to be effective in improving upper limb functional disorder if the area under the curve after treatment for the subject is the same as or lower than the area under the curve before treatment. Examples of treatment include rehabilitation and drug therapy. Examples of rehabilitation include exercise therapy and occupational therapy.

[0054] In another embodiment, the motor function evaluation means 225 compares the value of the shoulder flexion angle calculated by the shoulder flexion angle calculation means 224 for a certain person to be evaluated with the shoulder flexion angle of a person other than the person to be evaluated who has upper limb functional impairment, or the median or average value of the shoulder flexion angle of a group of multiple people other than the person to be evaluated who have upper limb functional impairment, and if the shoulder flexion angle of a certain person to be evaluated is lower than the value of the shoulder flexion angle of a person other than the person to be evaluated who has upper limb functional impairment, or the median or average value of the shoulder flexion angle of the above group, it determines that the person to be evaluated is likely to exhibit abnormal movements during upper limb elevation movements earlier (abnormal movements appear at a lower shoulder flexion angle) than other people with upper limb functional impairment or the above group.

[0055] In another embodiment, the motor function evaluation means 225 compares the value of the shoulder flexion angle calculated by the shoulder flexion angle calculation means 224 for a certain person to be evaluated with the shoulder flexion angle of a person other than the person to be evaluated who has upper limb functional impairment, or the median or average value of the shoulder flexion angle of a group of multiple people other than the person to be evaluated who have upper limb functional impairment, and if the shoulder flexion angle of a certain person to be evaluated is higher than the value of the shoulder flexion angle of a person other than the person to be evaluated who has upper limb functional impairment, or the median or average value of the shoulder flexion angle of the above group, it determines that the person to be evaluated is likely to have a later timing of the appearance of abnormal movement during upper limb elevation movement (abnormal movement appears at a higher shoulder flexion angle) compared to people other than the person to be evaluated who has upper limb functional impairment, or the above group.

[0056] In another embodiment, the motor function evaluation means 225 compares the shoulder flexion angle before treatment calculated by the shoulder flexion angle calculation means 224 of a certain person to be evaluated with the shoulder flexion angle after treatment, and if the elbow flexion ratio after treatment of the person to be evaluated is higher than the elbow flexion ratio before treatment, it determines that the treatment is likely to be effective in improving upper limb functional disorder.

[0057] In another embodiment, the motor function evaluation means 225 compares the shoulder flexion angle before treatment calculated by the shoulder flexion angle calculation means 224 of a certain person to be evaluated with the shoulder flexion angle after treatment, and if the elbow flexion ratio after treatment of the person to be evaluated is the same as or lower than the elbow flexion ratio before treatment, it determines that the treatment is unlikely to be effective in improving upper limb functional disorder.

[0058] The output unit 26 serving as output means outputs some or all of the elbow flexion ratio calculated by the elbow flexion ratio calculation means 222, the area under the curve calculated by the area under the curve calculation means 223, the shoulder flexion angle calculated by the shoulder flexion angle calculation means 224, and the evaluation results generated by the motor function evaluation means 225. For example, by displaying some or all of the elbow flexion ratio, the area under the curve, the shoulder flexion angle, and the motor function evaluation means on a display (not shown) by the output unit 26, a user of the motion analysis device 20 (for example, a doctor or other medical professional (such as a physical therapist or occupational therapist)) can use the displayed data to detect or evaluate one or more of abnormal synergy during upper limb elevation movement, the presence or absence of a motor disorder, worsening or improvement of the motor disorder, and improvement or decline of motor function.

[0059] In this way, the movement analysis device 20 can provide data that can be used as an index for evaluating the motor function or motor disorder of the person being evaluated. Furthermore, the movement analysis device 20 can be used as an evaluation device for the motor function of the person being evaluated using such data.

[0060] Next, the operation of the motion analysis device 20 will be described with reference to the flowcharts of FIGS.

[0061] In the embodiment of Figure 2, in step S1, the three-dimensional coordinate data acquisition means 221 acquires or generates three-dimensional coordinate data of the shoulders, elbows, and hands of the person being evaluated from data of the person's upper limbs detected by the sensor 10 during the upper limb lifting movement.

[0062] In step S2, the elbow flexion ratio calculation means 222 calculates the elbow flexion ratio during the upper limb raising movement using the above formula (1) or formula (2) from the three-dimensional coordinate data of the shoulder, elbow, and hand of the person being evaluated acquired or generated by the three-dimensional coordinate data acquisition means 221.

[0063] In step S3, the output unit 226 outputs the elbow flexion ratio calculated by the elbow flexion ratio calculation means 222.

[0064] A user of the motion analysis device 20 can use the output elbow flexion ratio data to evaluate motor function or motor disorders.

[0065] In the embodiment of Figure 3, in step S1, the three-dimensional coordinate data acquisition means 221 acquires or generates three-dimensional coordinate data of the shoulders, elbows, and hands of the person being evaluated from data of the person's upper limbs detected by the sensor 10 during the upper limb lifting movement.

[0066] In step S2, the elbow flexion ratio calculation means 222 calculates the elbow flexion ratio during the upper limb raising movement using the above formula (1) or formula (2) from the three-dimensional coordinate data of the shoulder, elbow, and hand of the person being evaluated acquired or generated by the three-dimensional coordinate data acquisition means 221.

[0067] In step S4, the area under the curve calculation means 223 calculates the area under the curve of the elbow flexion ratio during the upper limb lifting movement calculated by the elbow flexion ratio calculation means 222, from the start of the upper limb lifting movement of the person being evaluated to the maximum shoulder flexion.

[0068] In step S5, the output unit 226 outputs the area under the curve calculated by the area under the curve calculation means 223.

[0069] A user of the movement analysis device 20 can use the output area under the curve data to quantitatively assess movement function or movement disorders.

[0070] In the embodiment of Figure 4, in step S1, the three-dimensional coordinate data acquisition means 221 acquires or generates three-dimensional coordinate data of the shoulders, elbows, and hands of the person being evaluated from data of the person's upper limbs detected by the sensor 10 during the upper limb lifting movement.

[0071] In step S2, the elbow flexion ratio calculation means 222 calculates the elbow flexion ratio during the upper limb raising movement using the above formula (1) or formula (2) from the three-dimensional coordinate data of the shoulder, elbow, and hand of the person being evaluated acquired or generated by the three-dimensional coordinate data acquisition means 221.

[0072] In step S4, the area under the curve calculation means 223 calculates the area under the curve of the elbow flexion ratio during the upper limb lifting movement calculated by the elbow flexion ratio calculation means 222, from the start of the upper limb lifting movement of the person being evaluated to the maximum shoulder flexion.

[0073] In step S5, the motor function evaluation means 225 evaluates the motor function using the area under the curve calculated by the area under the curve calculation means 223. For example, it is possible to compare the area under the curve before and after a treatment is performed on the subject, and determine whether the treatment is effective in improving the motor function. The processing by the area under the curve calculation means 225 is as described above.

[0074] In step S6, the output unit 226 outputs the evaluation result evaluated by the area under the curve calculation means 225.

[0075] A user of the movement analysis device 20 can use the output evaluation results to quantitatively evaluate motor function or movement disorders.

[0076] The motion analysis method using the motion analysis device 20 shown in Figures 3 and 4 can quantitatively evaluate the degree of motor function or motor impairment, making it possible to understand symptoms and capture changes. Furthermore, because measurements can be completed in approximately five minutes, the barrier to introduction into clinical settings, such as those performing rehabilitation for upper limb functional impairment, is low, making it possible for the method to be widely adopted. Therefore, the area under the curve of the elbow flexion ratio during upper limb elevation and the motion analysis method using this area under the curve can serve as the gold standard for evaluating motor impairments during upper limb elevation, particularly abnormal movements during upper limb elevation in patients with brain disease.

[0077] In the embodiment of Figure 5, in step S1, the three-dimensional coordinate data acquisition means 221 acquires or generates three-dimensional coordinate data of the shoulders, elbows, and hands of the person being evaluated from data of the person's upper limbs detected by the sensor 10 during the upper limb lifting movement.

[0078] In step S2, the elbow flexion ratio calculation means 222 calculates the elbow flexion ratio during the upper limb raising movement using the above formula (1) or formula (2) from the three-dimensional coordinate data of the shoulder, elbow, and hand of the person being evaluated acquired or generated by the three-dimensional coordinate data acquisition means 221.

[0079] In step S7, the shoulder flexion angle calculation means 224 calculates shoulder flexion angles at three points in total, including one point with the minimum value and two points immediately before and after the minimum value where the differential value is zero, from the differential value of the elbow flexion ratio during the upper limb raising movement calculated by the elbow flexion ratio calculation means 222.

[0080] In step S8, the output unit 226 outputs the shoulder flexion angle calculated by the shoulder flexion angle calculation means 224.

[0081] Optionally, in step S7, the shoulder flexion angle calculation means 224 may calculate a minimum value from the differential value of the elbow flexion ratio during the upper limb lifting movement calculated by the elbow flexion ratio calculation means 222, and in step S8, the output unit 226 may output the minimum value.

[0082] The minimum value of the differential value of the elbow flexion ratio during arm elevation is the point at which motor impairment is most pronounced, and therefore can be an indicator for determining the range in which treatment such as rehabilitation is most effective. In addition, the two points of shoulder flexion angle where the differential value is zero just before and just after the minimum value are the points at which abnormal movement appears and ends, and therefore can be the optimal range of movement to implement for the subject.

[0083] The user of the motion analysis device 20 can use the output shoulder flexion angle data to determine the range of motion to be performed on the subject.

[0084] In the embodiment of Figure 6, in step S1, the three-dimensional coordinate data acquisition means 221 acquires or generates three-dimensional coordinate data of the shoulders, elbows, and hands of the person being evaluated from data of the person's upper limbs detected by the sensor 10 during the upper limb lifting movement.

[0085] In step S2, the elbow flexion ratio calculation means 222 calculates the elbow flexion ratio during the upper limb raising movement using the above formula (1) or formula (2) from the three-dimensional coordinate data of the shoulder, elbow, and hand of the person being evaluated acquired or generated by the three-dimensional coordinate data acquisition means 221.

[0086] In step S4, the area under the curve calculation means 223 calculates the area under the curve of the elbow flexion ratio during the upper limb lifting movement calculated by the elbow flexion ratio calculation means 222, from the start of the upper limb lifting movement of the person being evaluated to the maximum shoulder flexion.

[0087] In step S7, the shoulder flexion angle calculation means 224 calculates the shoulder flexion angle at two points where the differential values ​​just before and just after the minimum value are zero, from the differential value of the elbow flexion ratio during the upper limb lifting movement calculated by the elbow flexion ratio calculation means 222.

[0088] In step S9, the motor function evaluation means 225 evaluates the motor function using the shoulder flexion angle calculated by the shoulder flexion angle calculation means 224. For example, it is possible to compare the elbow flexion ratio or the area under the curve before and after performing a treatment on the person to be evaluated at the shoulder flexion angle calculated by the shoulder flexion angle calculation means 224, and to determine whether the treatment is effective in improving the motor function. The processing by the area under the curve calculation means 225 is as described above.

[0089] In step S10, the output unit 226 outputs the evaluation result by the motor function evaluation means 225.

[0090] The order of steps S4 and S7 may be reversed.

[0091] Optionally, in step S7, the shoulder flexion angle calculation means 224 may calculate a minimum value from the differential value of the elbow flexion ratio during the upper limb elevation movement calculated by the elbow flexion ratio calculation means 222, and in step S10, the output unit 226 may output the minimum value. For example, the output unit 226 may output the minimum value before and after the treatment is performed on the subject.

[0092] The user of the motion analysis device 20 can use the output evaluation results to evaluate the effectiveness of treatment.

[0093] The motion analysis method using the motion analysis device 20 shown in Figures 5 and 6 can calculate the appropriate range of motion or training difficulty for the subject. For example, if training is performed at a position (e.g., a very low position) where no motor impairment (especially abnormal movements such as spasticity or compensatory movements) is observed, there will be little improvement in ability, while if training is performed at a position (e.g., a very high position) where motor impairment is excessively observed, there is a possibility of adverse events such as exacerbation of abnormal movements and pain. In other words, this technical means makes it possible to optimize the difficulty of treatment. As a result, it is possible to prevent the occurrence of pain and erroneous learning of abnormal movements that have previously been caused by rehabilitation performed without consideration of motor impairment, and to provide safe and optimal rehabilitation.

[0094] In the above embodiment, the motion analysis device 20 has been described, but the present invention is not limited to this and also includes a program for causing a computer to function as the motion analysis device 20, and a computer-readable recording medium on which the program is recorded.

[0095] The present invention further provides a method for evaluating motor function, comprising: an elbow flexion ratio calculation step of calculating an elbow flexion ratio during upper limb elevation exercise represented by the following formula (1) or (2) using elbow flexion ratio calculation means from three-dimensional coordinate data of the shoulder, elbow, and hand of the subject during the upper limb elevation exercise before and after the rehabilitation of the subject; and an area under the curve calculation step of calculating the area under the curve of the elbow flexion ratio during the upper limb lifting movement of the subject from the start of the upper limb lifting movement to the maximum shoulder flexion using an area under the curve calculation means.

[0096] If the area under the curve calculated from the elbow flexion ratio after the treatment is greater than the area under the curve calculated from the elbow flexion ratio before the treatment, this indicates that the treatment is likely to be effective in improving the subject's motor function.

[0097] The above-mentioned method for evaluating motor function may further include a step of outputting, by an output unit, the area under the curve calculated from the elbow flexion ratio before the treatment and the area under the curve calculated from the elbow flexion ratio after the treatment, both calculated by the area under the curve calculation means.

[0098] The present invention further provides a method for providing data indicating a range of motion of an upper limb elevation exercise suitable for an individual to be evaluated, comprising: an elbow flexion ratio calculation step of calculating an elbow flexion ratio during the upper limb raising movement represented by the following formula (1) or (2) using three-dimensional coordinate data of the shoulder, elbow, and hand of the subject during the upper limb raising movement of the subject by an elbow flexion ratio calculation means; a step of calculating, by shoulder flexion angle calculation means, three shoulder flexion angles, including a minimum value and two points where the differential values ​​immediately before and immediately after the minimum value are zero, from the calculated differential values ​​of the elbow flexion ratio during the upper limb lifting movement; The present invention provides a method comprising:

[0099] The method for providing data indicating the range of motion of the upper limb elevation movement suitable for the subject may further include a step of outputting the shoulder flexion angles of the two points by an output unit.

[0100] The present invention further provides a rehabilitation method or a method for restoring motor function using the motion analysis device 20 described above.

[0101] In one embodiment, the rehabilitation method or motor function recovery method includes using the motion analysis device 20 to measure the area under the curve of a patient with upper limb dysfunction before treatment, and administering treatment to the patient so that the area under the curve of the patient is higher after treatment than before treatment.

[0102] In another embodiment, a rehabilitation method or a motor function recovery method includes using the motion analysis device 20 to calculate shoulder flexion angles at three points in total, including the minimum value of the derivative of the elbow flexion ratio during upper limb elevation movement of a patient with upper limb dysfunction and two points at which the derivative values ​​just before and just after the minimum value are zero, and having the patient exercise within the range of the shoulder flexion angles at the two points.

[0103] The technology disclosed herein can be combined with a tabletop display, virtual reality (VR), or mixed reality (MR) to provide an integrated assessment and treatment device that patients can use for self-training, allowing them to easily practice reaching within the optimal range of motion.

[0104] Although the embodiment of the present invention has been described above, the present invention is not limited to this and various modifications such as those described below are possible. The motor function evaluation means 225 may be omitted. That is, the control unit 22 does not need to include the motor function evaluation means 225. The output unit 26 does not have to output all of the elbow flexion ratio, the area under the curve, the shoulder flexion angle, and the evaluation result. It may output one or two of the elbow flexion ratio, the area under the curve, the shoulder flexion angle, and the evaluation result.

[0105] The disclosures of all patent applications and publications cited herein are hereby incorporated by reference in their entirety.

[0106] The following examples are intended for illustrative purposes only and are not intended to limit the scope of the present invention in any way. [Example]

[0107] 1. Method Study design and subjects The study design was a retrospective cohort study. The subjects were chronic stroke patients who were hospitalized or visited Keio University Hospital as outpatients between January 1, 2021, and January 31, 2024. Inclusion criteria were patients aged 18 years or older, stroke patients in the chronic phase (more than 90 days since onset), and patients who underwent kinematic evaluation of upper limb elevation movements. Exclusion criteria were missing data on upper limb function evaluation. This study was conducted in accordance with the Declaration of Helsinki and was reviewed and approved by the Keio University Ethics Committee.

[0108] Collected Data Basic information, including age, sex, time since stroke onset, stroke type, and paralyzed side, was collected from medical records. Furthermore, the Stroke Impairment Assessment Set-motor (SIAS-m) upper limb score, FMA upper limb score, and Modified Ashworth Scale (MAS) were collected as kinematic and upper limb function assessments. The SIAS-m upper limb score consists of two tests (knee-mouth test and hand function test) and is scored on a 6-point ordinal scale ranging from 0 (no movement) to 5 (normal). Higher scores indicate better motor function. The FMA upper limb score consists of 30 motor items and 3 reflex function items. Scores are scored on a 3-point ordinal scale (0 = unable, 1 = partial, 2 = complete), with higher scores indicating better motor function. The total score ranges from 0 to 66 points and is divided into four subcategories: A, shoulder, elbow, and forearm (0-36 points); B, wrist (0-10 points); C, fingers (0-14 points); and D, coordination (0-6 points). The MAS is an index for evaluating spasticity (muscle tone) of the agonist muscles that contribute to single-joint movement. The score is rated on a 6-point ordinal scale from "0 = no increased muscle tone" to "4 = stiffness, difficulty flexing and extending," with higher scores indicating greater spasticity.

[0109] kinematic evaluation Kinematic evaluation was performed using an Azure Kinect DK (Microsoft) and dedicated software (ICpro-K2; Hutec Co., Tokyo). Subjects performed maximum shoulder flexion tasks while seated, with their elbows extended as far as possible. Upper limb movement data was recorded using the Kinect. Data were preprocessed by spline interpolation of missing data points and smoothed using a second-order Butterworth filter with a cutoff frequency of 5 Hz. Analysis sections were extracted as three-dimensional coordinate data using dedicated software. From the extracted three-dimensional coordinate data, the maximum voluntary shoulder flexion angle and elbow flexion ratio during upper limb elevation were analyzed. The maximum shoulder flexion angle was calculated as the angle between a line perpendicular to the floor passing through the shoulder coordinate and a line from the shoulder to the elbow coordinate. The elbow flexion ratio during shoulder elevation was calculated from the path length ratio of the three-dimensional coordinates of the shoulder (S), elbow (E), and hand (H) as follows:

[0110]

number

[0111] Because the shoulder and hand are close together, this index decreases as the elbow flexes more during shoulder elevation (maximum value is 100). Abnormal movements during upper limb elevation were evaluated by calculating the area under the curve (AUC) of the values ​​calculated using a formula. The optimal range of movement was determined by differentiating the value calculated using the formula and calculating the point at which the differentiated value was minimum, as well as the point just before and just after the minimum where the differentiated value = 0. The validity of joint angle calculations using Kinect has been established (Schwarz A, et al., Stroke. 2019;50:718-27.).

[0112] statistical analysis Regarding validity, the correlation between the calculated AUC and the proximal score of each upper limb function assessment index was analyzed using Spearman's rank correlation coefficient. The proximal score of each upper limb function assessment index was the knee-mouth test (proximal score) for the SIAS-m upper limb score, item A: shoulder, elbow, and forearm for the FMA upper limb score, and elbow flexion for the MAS.

[0113] Regarding responsiveness, patients who underwent intervention for approximately three weeks were first classified into a "shoulder-focused intervention group" and a "fingers-focused intervention group" based on the primary intervention method. The AUC and standardized response mean (SRM) of the proximal scores of each upper limb function assessment index were then calculated for each group at admission and discharge. SRM is calculated by dividing the mean change in score by the standard deviation of the change in score.

[0114] 2.Results First, as shown in Figure 7, it was possible to show the elbow flexion ratio during shoulder elevation and calculate the area under the curve of the graph (area under the curve = 66.86%).

[0115] Validity analysis was performed on 85 subjects (Table 1). The mean age (standard deviation) was 58.2 (10.3) years, the total FMA upper limb score was 25.6 (12.7), and the area under the curve (AUC) for the calculated percentage of abnormal movements during upper limb elevation was 84.6 (7.6)%. Correlation analysis between the calculated AUC for the percentage of abnormal movements during upper limb elevation and the proximal scores of each upper limb function assessment revealed a correlation of 0.340 (p<0.01) with the SIAS-m proximal upper limb score, 0.578 (p<0.01) with the FMA upper limb score A, and -0.217 (p<0.05) with the MAS elbow flexion score. There was a mild to moderate correlation with the motor paralysis index and a weak correlation with the spasticity index (Table 2).

[0116] The responsiveness analysis included 42 patients (Table 3), 13 of whom received shoulder-focused intervention and 29 in the hand-focused intervention group. Table 4 shows a pre-post comparison and responsiveness analysis for the shoulder-focused intervention group. The SRM for the SIAS-m proximal upper limb score was 0.29, the SRM for the FMA upper limb score item A was 0.69, the SRM for the MAS elbow flexion score was 0.00, and the SRM for the calculated abnormal movement score was 0.83. In contrast, for the hand-focused intervention group, the SRM for the SIAS-m proximal upper limb score was 0.34, the SRM for the FMA upper limb score item A was 0.58, the SRM for the MAS elbow flexion score was -0.34, and the SRM for the calculated abnormal movement score was 0.04 (Table 5). In other words, the calculated abnormal movement rate indicated a high responsiveness in the shoulder-focused intervention group.

[0117] The optimal range of motion was calculated using data from one subject with typical abnormal movements (Figure 8). As a result, the shoulder joint flexion angle at the minimum (P1) was 37.2 degrees, the shoulder joint flexion angle at the start of the abnormal movement (the point just before the minimum where the derivative value = 0, P2) was 33.5 degrees, and the shoulder joint flexion angle at the end of the abnormal movement (the point just after the minimum where the derivative value = 0, P3) was 48.1 degrees.

[0118] From this, it was possible to calculate the optimal range of motion as a shoulder flexion angle of 37.2° (33.5-48.1°). Until now, setting the difficulty level of upper limb rehabilitation training has been left to the experience and intuition of doctors and therapists, and it has not been possible to give specific instructions, but by using this technology it is now possible to prescribe a specific range of motion, enabling the provision of optimal training.

[0119] [Table 1]

[0120] [Table 2]

[0121] [Table 3]

[0122] [Table 4]

[0123] [Table 5] [Explanation of symbols]

[0124] 20...Motion analysis device, 222...Elbow flexion ratio calculation means, 223...Area under the curve calculation means, 224...Shoulder flexion angle calculation means, 225...Motor function evaluation means, 26...Output unit.

Claims

1. A motion analysis device equipped with an elbow flexion ratio calculation means that calculates the elbow flexion ratio during upper limb raising movement, expressed by the following formula (1) or (2), from the three-dimensional coordinate data of the shoulder, elbow, and hand of the subject when the subject raises the upper limb. [Equation 1] [Equation 2]

2. The motion analysis device according to claim 1 , further comprising an output unit that outputs the elbow flexion ratio during the upper limb lifting movement calculated by the elbow flexion ratio calculation unit.

3. The motion analysis device according to claim 1, further comprising an area under the curve calculation means for calculating the area under the curve of the elbow flexion ratio during the upper limb lifting movement in the range from the start of the upper limb lifting movement of the subject to the time of maximum shoulder flexion.

4. 2. The motion analysis device according to claim 1, further comprising a shoulder flexion angle calculation means for calculating shoulder flexion angles at three points in total, including one minimum value and two points just before and just after the minimum value where the differential value is zero, from the differential value of the elbow flexion ratio during the upper limb raising movement calculated by the elbow flexion ratio calculation means, in the range from the start of the upper limb raising movement of the person being evaluated to the maximum shoulder flexion.

5. The movement analysis device according to any one of claims 1 to 4, which is a device for evaluating motor function.

6. A method for evaluating motor function, comprising: an elbow flexion ratio calculation step of calculating an elbow flexion ratio during upper limb elevation movement represented by the following formula (1) or (2) using elbow flexion ratio calculation means from three-dimensional coordinate data of the shoulder, elbow, and hand of the subject during the upper limb elevation movement of the subject before and after treatment; an area under the curve calculation step of calculating the area under the curve of the elbow flexion ratio during the upper limb lifting movement of the subject from the start of the upper limb lifting movement to the maximum shoulder flexion by the area under the curve calculation means; A method comprising:

7. The method of claim 6, wherein if the area under the curve calculated from the elbow flexion ratio after the treatment is greater than the area under the curve calculated from the elbow flexion ratio before the treatment, it indicates that the treatment is likely to be effective in improving the motor function of the subject.

8. A method for providing data indicating a range of motion for upper limb elevation exercise suitable for an individual to be evaluated, an elbow flexion ratio calculation step of calculating an elbow flexion ratio during the upper limb raising movement represented by the following formula (1) or (2) using elbow flexion ratio calculation means from three-dimensional coordinate data of the shoulder, elbow, and hand of the subject during the upper limb raising movement of the subject; a step of calculating, by a shoulder flexion angle calculation means, three shoulder flexion angles, including one minimum value point and two points immediately before and after the minimum value where the differential value is zero, from the calculated differential value of the elbow flexion ratio during the upper limb lifting movement; A method comprising:

9. A program for causing a computer to perform a motion analysis of an assessee, A program for causing a computer to function as an elbow flexion ratio calculation means for calculating the elbow flexion ratio during upper limb raising exercise, expressed by the following formula (1) or formula (2), from the three-dimensional coordinate data of the shoulder, elbow, and hand of the subject during the upper limb raising exercise.

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