本文選題：帕金森病 + 步態(tài)障礙　； 參考：《中國科學(xué)技術(shù)大學(xué)》2017年博士論文

【摘要】：帕金森病(Parkinson's disease, PD)是一種多發(fā)于中老年人群、以運(yùn)動(dòng)障礙為主要臨床癥狀的神經(jīng)退行性疾病,其臨床上以靜止性震顫、運(yùn)動(dòng)遲緩、肌僵直以及姿勢步態(tài)障礙為四大主要癥狀。目前,PD患者步態(tài)障礙的分析評(píng)估主要依靠臨床醫(yī)師的經(jīng)驗(yàn)觀察、檢測藥物反應(yīng)、國際通用量表以及調(diào)查問卷的方式。這種評(píng)估方法雖然簡單易用,但是其易受醫(yī)師臨床經(jīng)驗(yàn),或患者瞬間癥狀變化的影響,客觀定量性較差。近年來,基于信息傳感技術(shù)的客觀定量評(píng)價(jià)方法逐漸成為研究熱點(diǎn)。由于PD患者步態(tài)障礙癥狀的復(fù)雜性和多變性,盡管已經(jīng)存在多種分析方法與評(píng)估系統(tǒng),但其往往關(guān)注的是步態(tài)障礙的某個(gè)單一信號(hào)的分析,量化分析的全面性和準(zhǔn)確性得不到有效保障。此外,多數(shù)系統(tǒng)還停留在實(shí)驗(yàn)室使用,并沒有在PD患者步態(tài)障礙的定量分析中得到普遍性應(yīng)用。因此,針對(duì)PD患者所表現(xiàn)出的步態(tài)障礙,本文結(jié)合了步態(tài)運(yùn)動(dòng)生物力學(xué)特征分析和國內(nèi)外現(xiàn)有步態(tài)獲取裝置研究的基礎(chǔ)上,設(shè)計(jì)并實(shí)現(xiàn)了一種基于柔性力敏傳感技術(shù)和三維測力平臺(tái)的新型U型電子步道系統(tǒng),并在此基礎(chǔ)上探討了 PD患者步態(tài)障礙客觀定量評(píng)估及量化分級(jí)評(píng)估方法。本文主要圍繞新型U型電子步道系統(tǒng)設(shè)計(jì)與實(shí)現(xiàn)、PD患者步態(tài)信號(hào)特征綜合提取、PD患者步態(tài)障礙定量評(píng)估與量化分級(jí)評(píng)估以及PD患者步態(tài)識(shí)別與評(píng)估這幾個(gè)方面開展研究,具體工作內(nèi)容如下:(1)構(gòu)建了一種基于柔性力敏傳感技術(shù)和三維測力平臺(tái)的新型U型電子步道系統(tǒng),用以綜合獲取PD患者在靜態(tài)站立和動(dòng)態(tài)行走過程中的足底分區(qū)壓力、步態(tài)運(yùn)動(dòng)學(xué)參數(shù)、步態(tài)動(dòng)力學(xué)參數(shù)以及轉(zhuǎn)彎情形下的步態(tài)特征。(2)針對(duì)足底壓力圖像中的足印分割問題,提出了一種分階段的分割算法;利用足內(nèi)弓和足外弓的外輪廓曲線波動(dòng)性差異實(shí)現(xiàn)了步行足印的實(shí)時(shí)動(dòng)態(tài)識(shí)別。(3)從靜態(tài)和動(dòng)態(tài)足底分區(qū)壓力的對(duì)比分析、步態(tài)運(yùn)動(dòng)學(xué)和動(dòng)力學(xué)參數(shù)統(tǒng)計(jì)分析、步態(tài)對(duì)稱性與雙邊協(xié)調(diào)性評(píng)估以及步態(tài)的非線性特征分析這四個(gè)方面比較PD患者步態(tài)與正常對(duì)照組之間的差異性,并在此基礎(chǔ)上探討了 PD患者步態(tài)障礙客觀定量評(píng)估及量化分級(jí)評(píng)估方法。此外,針對(duì)PD患者與健康人群組成的非平衡數(shù)據(jù)特點(diǎn),提出了一種代價(jià)敏感支持向量機(jī)方法(CS-SVM)構(gòu)建了步態(tài)信號(hào)分類模型,驗(yàn)證了本文設(shè)計(jì)的U型電子步道用于識(shí)別帕金森病患者步態(tài)的有效性和可行性。本文構(gòu)建的新型U型電子步道系統(tǒng)雖然受空間上的限制,但是其采集獲取的步態(tài)信息較為豐富,能夠綜合獲取PD患者在靜態(tài)站立、直行以及轉(zhuǎn)彎情形下的步態(tài)特征。實(shí)驗(yàn)結(jié)果表明:本文提出的步態(tài)障礙客觀定量評(píng)估方法對(duì)臨床PD患者異常步態(tài)的診斷和治療具有積極地指導(dǎo)意義。在此基礎(chǔ)上構(gòu)建的多分類SVM模型取得了初步成功,錯(cuò)誤分類都集中在相鄰的兩個(gè)評(píng)分級(jí)別之間。此外,與k-近鄰算法(KNN)、支持向量機(jī)(SVM)以及樸素貝葉斯分類器(NBC)構(gòu)建的模型相比,本文提出的一種基于代價(jià)敏感支持向量機(jī)方法(CS-SVM)構(gòu)建的步態(tài)信號(hào)分類模型,其綜合性能最佳,不僅有效提高了本文PD患者的識(shí)別準(zhǔn)確率,同時(shí)有效降低了臨床醫(yī)師對(duì)PD患者誤診而帶來的誤判代價(jià)。目前本文的U型電子步態(tài)系統(tǒng)及PD患者客觀定量評(píng)估與量化分級(jí)評(píng)估方法已經(jīng)成功應(yīng)用于安徽中醫(yī)藥大學(xué)神研所附屬醫(yī)院的臨床實(shí)踐,效果顯著。
[Abstract]:Parkinson's disease (Parkinson's disease, PD) is a kind of neurodegenerative disease which mostly occurs in the middle aged and elderly people, with the main clinical symptoms of motor disorders. The four major symptoms are static tremor, motion retardation, muscular stiffness and postural gait disorder. At present, the analysis and evaluation of gait disorders in PD patients mainly rely on clinicians. This evaluation method is easy to use, but it is easily affected by clinical experience of doctors, or changes in transient symptoms of patients. In recent years, the objective quantitative evaluation method based on information sensing technique has gradually become a hot topic. Because of the complexity and variability of the symptoms of gait disorders in PD patients, although a variety of analytical methods and evaluation systems have existed, it is often concerned about the analysis of a single signal of a gait disorder. The overall and accuracy of quantitative analysis is not effectively guaranteed. In addition, most systems are still used in the laboratory and are not in the PD. The quantitative analysis of gait disorders is universally applied. Therefore, based on the analysis of the biomechanical characteristics of the gait movement and the existing gait acquisition devices at home and abroad, a new type of U type based on flexible force sensing technology and three dimensional force platform is designed and realized in view of the gait disturbance shown by PD patients. On the basis of the electronic footpath system, the objective quantitative assessment and quantitative evaluation method of gait disorder in PD patients are discussed. This paper mainly focuses on the design and implementation of the new U type electronic footpath system, the comprehensive extraction of the gait signal characteristics of the PD patients, the quantitative assessment and quantitative assessment of the gait disorder of the patients with PD, and the gait recognition and evaluation of the patients with PD. The main contents are as follows: (1) a new U type electronic footpath system based on flexible force sensing technology and three dimensional force platform is constructed, which can be used to synthetically obtain the foot subarea pressure, gait kinematics parameters, gait dynamics parameters and turn of PD patients during static and dynamic walking. In the case of the gait characteristics. (2) a phased segmentation algorithm is proposed for the foot print segmentation in the foot pressure image. The real-time dynamic recognition of foot prints is realized by using the fluctuation of the outer profile curve of the foot bow and the foot arch. (3) the comparison and analysis of the static and dynamic foot subarea pressure, the gait kinematics and dynamics. The statistical analysis of parameters, gait symmetry and bilateral coordination evaluation and the analysis of the nonlinear characteristics of gait are the four aspects to compare the differences between the PD patients' gait and the normal control group, and on this basis, the objective quantitative assessment and quantitative evaluation method of the gait disorder in PD patients are discussed. In addition, the PD patients and the healthy population are compared. A cost sensitive support vector machine (CS-SVM) method (CS-SVM) is proposed to construct a gait signal classification model, which validates the validity and feasibility of the U electronic gait design in this paper to identify the gait of patients with Parkinson's disease. The gait information obtained by collection is abundant, and it can synthesize the gait characteristics of PD patients under static standing, straight line and turning. The experimental results show that the objective quantitative assessment method proposed in this paper has positive guiding significance for the diagnosis and treatment of abnormal gait in clinical PD patients. The multi classification SVM model has achieved preliminary success, and the error classification is concentrated between two adjacent grades. In addition, compared with the k- nearest neighbor algorithm (KNN), support vector machine (SVM) and the simple Bias classifier (NBC) model, a gait signal based on the generation price sensitive support vector machine (CS-SVM) method is proposed. The class model has the best comprehensive performance. It not only effectively improves the recognition accuracy of the PD patients in this paper, but also effectively reduces the misdiagnosis cost of the clinician for the misdiagnosis of PD patients. At present, the objective quantitative assessment and quantitative evaluation method of the U type electronic gait system and the PD patients have been successfully applied to the Anhui University of traditional Chinese medicine. The clinical practice of the Affiliated Hospital of the Institute is very effective.
【學(xué)位授予單位】：中國科學(xué)技術(shù)大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2017
【分類號(hào)】：R742.5;TP274

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本文編號(hào)：1900253