The aim of this graduation thesis was to find out the level of motor skills in younger school age children, namely in the group of 7-10 years, using the standardized test battery MABC-2 (Movement Assessment Battery for Children-2nd Edition) at our chosen primary school. 62 children participated in the testing, of which 34 were girls and 28 were boys. We tested three components - gross motor skills, fine motor skills and balance. After evaluating all three components, we compared both sexes with each other. The results showed that all 62 children (100%) did not show any motor difficulties and ranked in the 1st zone. However, in a more detailed examination of the sub-components, we encountered problems with aiming & catching (coarse motoring). There were six children who were diagnosed with the risk of developing motor problems with recommendations for further monitoring (2nd band). In the same component, there were even 9 children who had significant motor difficulties with recommendation for specialized examinations (3rd band).

Although upper limb motor impairments are common, the primary tools for assessing and tracking these impairments in a clinical setting are subjective, qualitative rating scales that lack resolution and repeatability. Markerless motion capture technology has the potential to greatly improve clinical assessment by providing quick, low-cost, and accurate tools to objectively quantify motor deficits. Here we lay some of the groundwork necessary to enable markerless motion capture systems to be used in clinical settings. First, we adapted five motor tests common in clinical assessments so they can be administered via markerless motion capture. We implemented these modified tests using a particular motion capture sensor (Leap MotionTM Controller, hereafter referred to as the Leap Motion sensor) and administered the tests to 100 healthy subjects to evaluate the feasibility of administrating these tests via markerless motion capture. Second, to determine the ability of the Leap Motion sensor to accurately measure tremor, we characterized the frequency response of the Leap Motion sensor. During the administration of the five modified motor tests on 100 healthy subjects, the subjects had little trouble interfacing with the Leap Motion sensor and graphical user interface, performing the tasks with ease. The Leap Motion sensor maintained an average sampling rate above 106 Hz across all subjects during each of the five tests. The rate of adverse events caused by the Leap Motion sensor (mainly jumps in time or space) was generally below 1%. In characterizing the frequency response of the Leap Motion sensor, we found its bandwidth to vary between 1.7 and 5.5 Hz for actual tremor amplitudes above 1.5 mm, with larger bandwidth for larger amplitudes. To improve the accuracy of tremor measurements, we provide the magnitude ratios that can be used to estimate the actual amplitude of the oscillations from the measurements by the Leap Motion sensor. These results suggest that markerless motion capture systems are on the verge of becoming suitable for routine clinical use, but more work is necessary to further improve the motor tests before they can be administered via markerless motion capture with sufficient robustness for clinical settings.

Tyrimo objektas: pacientų, patyrusių galvos smegenų insultą funkcinis mobilumas. Tyrimo problema. Insultas yra trečioji pagal dažnį mirties priežastis išsivysčiusiose šalyse (Dias et al., 2007). Įvykus insultui sutrinka motorinės, sensorinės ir pažintinės funkcijos. Gali būti labai pažeista ėjimo funkcija. Eisenos atgavimas yra svarbiausias reabilitacijos tikslas (Dias et al., 2007). Tyrimo tikslas – nustatyti grupinių ir individualių kineziterapijos procedūrų poveikį pacientų, patyrusių galvos smegenų insultą, mobilumui. Tyrimo uždaviniai. 1) Įvertinti tiriamųjų pusiausvyrą pagal Berg skalę prieš ir po grupinių ir individualių kineziterapijos procedūrų taikymo; 2) Įvertinti tiriamųjų pusiausvyrą sėdint, atsistojimą iš sėdimos padėties bei ėjimą pagal judesių įvertinimo skalę prieš ir po grupinių ir individualių kineziterapijos procedūrų taikymo; 3) Įvertinti tiriamųjų ėjimą pagal testą „Stotis ir eiti“ prieš ir po grupinių ir individualių procedūrų taikymo; 4) Nustatyti koreliacinius ryšius tarp tirtų rodiklių. Tyrimo metodika. Taikant grupinius ir individualius užsiėmimus buvo vertinama 30-ties tiriamųjų (amžius 74,4±4,3 m.) patyrusių insultą ne mažiau kaip prie 36 mėn. pusiausvyra ir ėjimas pagal Berg pusiausvyros skalę, modifikuotą judesių įvertinimo skalę bei „Stotis ir eiti“ testą prieš ir po kineziterapijos. Rezultatai. Berg pusiausvyros skalės rezultatai individualios kineziterapijos grupėje prieš kineziterapiją buvo 39,6±5,89, po kineziterapijos – 44,5±6,0 balo... [toliau žr. visą tekstą] / Problem. Stroke is the third common cause of mortality in developed countries (Dias et al., 2007). Several disabilities occur after stroke, including loss of motor, sensory and cognitive functions. Gait in stroke patients can be greatly disrupted. Restoration of gait is a major goal in the rehabilitation of stroke patients (Dias et al., 2007). Aim: to compare the effectiveness of group therapy and individual physiotherapy on the functional mobility in stroke patients. Objectives. 1) to assess balance in stroke patients according Berg Balance Scale before and after group and individual physiotherapy; 2) to assess sitting balance, standing and walking in stroke according Motor Assessment Scale before and after group and individual physiotherapy; 3) to evaluate walking in stroke patients according Up & Go test before and after group and individual physiotherapy; 4) to find correlation among assessed values. Methods. Balance and walking were assessed in 30 stroke patients (age 74.4±4.3 years) according to Berg Balance Scale, Motor Assessment Scale and Up & Go test applying group or individual physiotherapy. Time after stroke was no less than 36 months. All measures were done before and after physiotherapy. Results. Results of Berg Balance Scale before and after individual physiotherapy were: 39.6±5.89 and 44.5±6.0 score respectively; Results of Berg Balance Scale before and after group physiotherapy were: 39.0±6.21 and – 44.6±5.99 scores respectively. Results of Motor... [to full text]

Avec le vieillissement de la population, l’Accident Vasculaire Cérébrale (AVC) est l’un des principaux problèmes de santé et touche 15 millions de personnes par an à travers le monde. Après un AVC, de nombreux troubles moteurs et sensoriels, qui ont un impact direct sur les activités de la vie quotidienne (AVQ), peuvent apparaître comme le manque de coordination, la spasticité ou les tremblements. Afin de rétablir au maximum leurs capacités motrices et sensorielles, les patients doivent suivre un processus de rééducation long et coûteux. De plus, le suivi et l’évaluation des patients se fait à partir d’observations visuelles. Peu voire aucune information objective et quantifiable sur la réalisation des exercices n’est collectée pendant les séances de rééducation. Ainsi, des informations potentiellement cruciales sur les capacités motrices des patients ne sont pas mesurées. De nombreuses plates-formes de rééducation et de suivi ont été développées pour collecter des informations objectives à l’aide de la réalité virtuelle, augmentée, d’écrans interactifs ou de dispositifs portables. Cependant, ces plates-formes peuvent présenter des contraintes de coût, de portabilité et d’utilisabilité.L’objectif de cette thèse est de proposer des outils permettant d’améliorer l’accompagnement des patients durant la rééducation fonctionnelle en offrant aux professionnels de santé un suivi plus représentatif de l’état de santé de ces derniers séance après séance. Ce suivi s’effectue à l’aide d’informations objectives et quantifiables sur les fonctions motrices des membres supérieurs collectées par des objets instrumentés de capteurs. Sur la base de l’état de l’art et des résultats d’une étude observationnelle réalisée auprès de quatorze professionnels de santé, nous avons développé cinq objets de rééducation instrumentés pour le suivi des fonctions motrices de la main et du bras et des activités de la vie quotidienne qui se matérialisent par : (i) un osselet qui collecte des informations sur la dextérité manuelle (position et pression des doigts, orientation, mouvements irréguliers, tremblements), (ii) un cube qui collecte des informations sur la préhension globale de la main (pression globale des doigts, orientation, mouvements irréguliers et tremblements), (iii) un bracelet connecté du commerce qui collecte des informations sur les fonctions motrices du bras (mouvements du bras, mouvements irréguliers et tremblements), (iv) un vêtement instrumenté qui mesure l’angle de flexion du coude et (v) un verre qui collecte des informations sur les fonctions motrices du bras et de la main lors de séquences d’actions complexes (niveau de liquide, orientation, position sur une cible, pression des doigts et tremblements) et qui permet de reconnaître les activités de la vie quotidienne boire, s’asseoir, se lever, marcher, monter et descendre des escaliers. Nous avons conduit une étude expérimentale auprès de quatorze professionnels de santé afin d'explorer l'ensemble des fonctionnalités ainsi que le design des objets afin de récolter des retours sur de possibles améliorations. Les résultats de cette étude nous ont permis s’assurer de la validité des fonctionnalités et de développer des interfaces de visualisation visant à afficher les données de manière simple, rapide et facile à interpréter. Nous avons mené une étude auprès de six professionnels de santé afin de valider le développement de ces interfaces. Les résultats indiquent que les choix de conception de ces interfaces de visualisation sont pertinents. Enfin, nous avons mené une étude expérimentale d’utilisabilité et d’acceptabilité auprès de neuf patients victimes d’AVC. Les résultats indiquent que les critères d’efficacité et de satisfaction de l’utilisabilité sont respectés. De plus, les patients ont jugé les objets faciles à utiliser et sont volontaires pour les utiliser pendant les séances de rééducation et à domicile afin d’adapter leur programme de rééducation en fonction de leurs progrès. / As the population ages, stroke is one of the major health problems affecting 15 million people worldwide each year. After a stroke, many motor and sensory disorders, which have a direct impact on activities of daily living (ADL), can appear as lack of coordination, spasticity or tremors. In order to restore their motor and sensory abilities as much as possible, patients must undergo a long and costly rehabilitation process. In addition, patient monitoring and evaluation is based on visual observations. Little or no objective and quantifiable information on the execution of exercises is collected during rehabilitation sessions. Thus, potentially crucial information on patients' motor abilities is not measured. Many rehabilitation and monitoring platforms have been developed to collect objective information using virtual reality, augmented, interactive screens or portable devices. However, these platforms may have cost, portability and usability constraints.The objective of this thesis is to propose tools to improve the accompaniment of patients during the process of functional rehabilitation by offering health professionals a more representative follow-up of the state of health of these, session after session. This monitoring is carried out using objective and quantifiable information on the motor functions of the upper limbs collected by objects instrumented with sensor. On the basis of the state of the art and the results of an observational study conducted with fourteen health professionals, we developed five instrumented rehabilitation objects for monitoring the motor functions of the hand and arm and the activities of daily life that are materialized by: (i) a jack that collects information on manual dexterity (finger position and pressure, orientation, irregular movements, tremors), (ii) a cube that collects information on overall hand grip (overall finger pressure, orientation, irregular movements and tremors), (iii) a commercially available connected watch that collects information on arm motor functions (arm movements), (iv) an instrumented garment that measures the bending angle of the elbow and (v) a cup that collects information on the motor functions of the arm and hand during complex action sequences (fluid level, orientation, position on a target, finger pressure and tremors) and allows the recognition of activities of daily living such as drinking, sitting, standing, walking, climbing and descending stairs. We conducted an experimental study with fourteen healthcare professionals to explore the functionalities and the design of the objects in order to gather feedback on possible improvements. The results of this study allowed us to tighten the measurement perimeter and make the objects more functional. This study also allowed us to develop visualization interfaces to display data in a simple, fast and easy to interpret manner. We conducted a study with six healthcare professionals to validate the development of these interfaces. The results indicate that the design choices of these visualization interfaces are relevant. Finally, we conducted an experimental usability and acceptability study in nine stroke patients. The results indicate that the efficiency and usability satisfaction criteria are met. The results show that patients found the objects easy to use and are willing to use them during rehabilitation sessions and at home to adapt their rehabilitation program according to their progress.