Development of an electronic instrumentalized interface physician patient (IPSP)

Abstract

Muscle spasticity is a complex motor disorder attributed to alteration of the supra-spinal inhibition, resulting in hyper excitability of the stretch reflex. It is generally accepted that mechanical changes of muscle and synaptic reorganization also are involved in spasticity. The anti spastic therapeutics are numerous varied pharmacological targets, but the problem of the assessment of spasticity is not clearly resolved. In clinical studies, the scale of Ashworth, Tardieu and Penn spasm frequency score remains indeed the reference assessment means, in spite of serious limitations. This scale suffers from poor reproducibility, since it is subjectively evaluated semi-quantitatively by the clinician. Various instrumental techniques allow a more quantitative evaluation but their implementation difficulty generally limits their use in clinical routine. Our work in the Master project takes place in the laboratory of the University of Balamand, aimed to develop the electronic part on the signal conditioning of a medical interface dedicated to measure heel and toe pressure, ankle orientation and EMG signals of the gastrocnemius. The expected results will be used to fully realize an instrument capable of quantitatively measuring spasticity, as well as to monitor over time the state of spasticity patient monitoring. In our first chapter, we present a bibliographic review over the spasticity, its definition viewed by the medical field, its physiopathology and focusing particularly on the methods of evaluation of spastic patient. In the second chapter, we described in the first place the design of the instrument. The size is variable to suit any possible leg size. Weight was as light as possible. The force sensor was described in the second place, followed by the load cell, the orientation sensor and the EMG muscle kit. For each part of the signals capturing, a quick introduction explained the need of such signal to help spastic patient. At the end, a design of the computer interface that allows access to the doctor into his patient database to check the result of his exercises while sitting at his office. The patient has the possibility to exercise at home and save the signal where only his doctor will have access to this interface. Finally, a conclusion was written with perspectives that will be done in the future in order to concept a better and more developed instrument.