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We have developed a quantitative analysis system, which is constructed on a personal computer and a transparent digitizer attached to a crystal display, for estimating functions of voluntary movements in the upper limb. We tried to identify parameters for distinguishing the movement functions of normal subjects and patients with spinocerebellar degeneration (SCD), and normal ones and patients with Parkinson's disease (PD) using the visually guided tracking method in the system. The subject pursued a target moving on a circle at a fixed speed with a stylus pen, and the position of the pen was digitized and led to the computer. We decomposed the locus of pen into X and Y axes, and calculated the mean velocity (MV), the mean acceleration (MA), the sum of power spectrum of the acceleration waveform (SPS), coefficient of variation of the moving distance per each sampling time (CV), the distance and the delay from the target and the pen pressure. These parameters in normal subjects were statistically compared with those in SCD or PD patients. Parameters of MV, MA, SPS in both X and Y axes, CV and the distance from the target were significantly (p<0.001) larger in SCD patients than in normal subjects. While, PD patients were clearly distinguished from normal subjects by parameters of MA and SPS in the X axis, and CV. Also, we examined the recovery process in patients with normal pressure hydrocephalus (NPH) and patients with cerebral apoplexy (CA) as compared with a doctor' s estimation. In NPH patients, it was found that the distance and the delay from the target, and SPS were very effective parameters as quantitative estimation of the recovery process. While, in CA patients, parameters of the delay from the target and SPS in the pen pressure were presented the recovery process similar to doctor's estimation. Thus, it is suggested that the analysis system may be useful to quantify voluntary movement disorders in the upper limb.

Technical Approach for Rehabilitation Medicine: Development of a Quantitative Analysis System for Voluntary Movement Functions in the Upper Limb.