用可穿戴设备+形状分析，客观评估儿童运动功能，适合长期跟踪治疗效果。
A Shape-Based Functional Index for Objective Assessment of Pediatric Motor Function
- 通过形状主成分分析对齐运动轨迹，捕捉速度和不对称性等运动模式。
- 构建的运动功能指数与肌肉脂肪浸润等指标相关性达0.78，显著相关。
- 适用于家庭环境，适合需长期监测神经肌肉疾病患儿的临床研究。
针对脊髓性肌萎缩症（SMA）和杜氏肌营养不良症（DMD）等神经肌肉疾病的临床评估仍依赖主观判断。本研究利用可穿戴传感器，在19名DMD患者、9名SMA患者及13名年龄匹配健康对照中，客观评估日常活动中的运动功能。由于儿童生长过程中肢体长度差异和运动速度变化带来的复杂性，本文提出基于形状的主成分分析（Shape-based PCA），用于对齐运动轨迹并识别运动模式，包括速度变化与运动不对称性。结果显示，部分DMD与SMA患者运动功能与健康对照相当；但SMA患者表现出更强的运动不对称性激活。进一步结合偏最小二乘法（PLS），提取出一个协变模式，其典型相关系数r = 0.78（95%置信区间：[0.34, 0.94]），与肌肉脂肪浸润、Brooke评分及年龄相关退行性改变显著相关，提出了新型运动功能指数。该数据驱动方法可部署于家庭场景，实现对儿童神经肌肉疾病治疗效果的更优纵向追踪。
原文摘要 · Abstract (English)
Clinical assessments for neuromuscular disorders, such as Spinal Muscular Atrophy (SMA) and Duchenne Muscular Dystrophy (DMD), continue to rely on subjective measures to monitor treatment response and disease progression. We introduce a novel method using wearable sensors to objectively assess motor function during daily activities in 19 patients with DMD, 9 with SMA, and 13 age-matched controls. Pediatric movement data is complex due to confounding factors such as limb length variations in growing children and variability in movement speed. Our approach uses Shape-based Principal Component Analysis to align movement trajectories and identify distinct kinematic patterns, including variations in motion speed and asymmetry. Both DMD and SMA cohorts have individuals with motor function on par with healthy controls. Notably, patients with SMA showed greater activation of the motion asymmetry pattern. We further combined projections on these principal components with partial least squares (PLS) to identify a covariation mode with a canonical correlation of r = 0.78 (95% CI: [0.34, 0.94]) with muscle fat infiltration, the Brooke score (a motor function score), and age-related degenerative changes, proposing a novel motor function index. This data-driven method can be deployed in home settings, enabling better longitudinal tracking of treatment efficacy for children with neuromuscular disorders.
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