arXiv:2508.12473cs.CVcs.AI2025-08被引 3

用视觉语言模型和推理大模型自动分析肌电反射波形,提升诊断标准化水平。

Standardization of Neuromuscular Reflex Analysis -- Role of Fine-Tuned Vision-Language Model Consortium and OpenAI gpt-oss Reasoning LLM Enabled Decision Support System

  • 构建多个微调的视觉语言模型,从肌电图像中提取神经肌肉特征。
  • 通过共识聚合与推理大模型,实现高精度、可解释的诊断输出。
  • 适合临床神经科、康复医学及运动员监测领域使用。

准确评估神经肌肉反射(如H反射)在运动科学、康复和临床神经学中至关重要。传统H反射肌电图波形分析存在临床医生与研究人员间变异性和主观解读偏差,影响可靠性与标准化。为此,本文提出一个微调的视觉语言模型(VLM)联盟与基于推理大语言模型(LLM)的决策支持系统,实现自动化H反射波形解读与诊断。该方法利用多个在标注的H反射肌电图图像数据集上微调的VLM,结合临床观察、恢复时间线和运动员元数据,直接从肌电图像和上下文信息中提取关键电生理特征,并预测疲劳、损伤与恢复等神经肌肉状态。VLM联盟的诊断结果通过共识机制聚合,并由专用推理LLM进一步优化,确保决策的鲁棒性、透明性与可解释性。端到端平台实现了VLM集合与推理LLM间的无缝通信,集成提示工程与自动化推理工作流。实验表明,该混合系统可提供高度准确、一致且可解释的H反射评估,显著推动神经肌肉诊断的自动化与标准化进程。据我们所知,这是首个将微调的VLM联盟与推理LLM结合用于基于图像的H反射分析的工作,为下一代AI辅助神经肌肉评估与运动员监测平台奠定基础。

原文摘要 · Abstract (English)

Accurate assessment of neuromuscular reflexes, such as the H-reflex, plays a critical role in sports science, rehabilitation, and clinical neurology. Traditional analysis of H-reflex EMG waveforms is subject to variability and interpretation bias among clinicians and researchers, limiting reliability and standardization. To address these challenges, we propose a Fine-Tuned Vision-Language Model (VLM) Consortium and a reasoning Large-Language Model (LLM)-enabled Decision Support System for automated H-reflex waveform interpretation and diagnosis. Our approach leverages multiple VLMs, each fine-tuned on curated datasets of H-reflex EMG waveform images annotated with clinical observations, recovery timelines, and athlete metadata. These models are capable of extracting key electrophysiological features and predicting neuromuscular states, including fatigue, injury, and recovery, directly from EMG images and contextual metadata. Diagnostic outputs from the VLM consortium are aggregated using a consensus-based method and refined by a specialized reasoning LLM, which ensures robust, transparent, and explainable decision support for clinicians and sports scientists. The end-to-end platform orchestrates seamless communication between the VLM ensemble and the reasoning LLM, integrating prompt engineering strategies and automated reasoning workflows using LLM Agents. Experimental results demonstrate that this hybrid system delivers highly accurate, consistent, and interpretable H-reflex assessments, significantly advancing the automation and standardization of neuromuscular diagnostics. To our knowledge, this work represents the first integration of a fine-tuned VLM consortium with a reasoning LLM for image-based H-reflex analysis, laying the foundation for next-generation AI-assisted neuromuscular assessment and athlete monitoring platforms.

神经肌肉多模态AI诊断肌电图

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