The objective assessment of motor impairment resulting from neurological disorders forms the basis for effective rehabilitation and therapeutic programs. Such assessments conducted through the engagement of suitable daily activities can serve as an effective surrogate measure for the assessment of independent living. This study considers an instrumented spoon in the assessment of upper-limb functionality through the self-feeding activity of a group of individuals clinically diagnosed with the debilitating condition, Friedreich ataxia (FRDA). Thirty-five subjects with FRDA (34 ± 14 years old) and 14 age-matched healthy subjects performed three cycles of self-feeding consisting of grasping, scooping, transferring food to mouth and returning the spoon. Parameters relating to the feeding rate, trajectory of the rotation, range of motion and movement variability with specific attention to each segment were considered for the capture of ataxia pertaining to the disability. Movement variability measured by Dynamic Time Warping (DTW) resulted in an average accuracy of 96% in the diagnosis of ataxia (separation of the two cohorts). The severity of ataxia estimated using a combination of features from Random Forest (RF) increased the correlation with the clinical estimates of ataxia by 13% and achieved higher coefficient (0.72 in patient scale) than the currently used tests (Box & Block, Pegboard). While the overall results provided an objective, daily activity based means of capturing intrinsic abnormalities, the different segments of the task demonstrated the presence of ataxia in a spatial context concurring with relevant clinical observations.

中文翻译：

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通过自给活动评估腓特烈共济失调上肢功能

由神经系统疾病引起的运动障碍的客观评估是有效康复和治疗计划的基础。通过开展适当的日常活动进行的评估可以作为评估独立生活的有效替代措施。这项研究考虑了一种工具勺，通过一组临床上被诊断患有虚弱状况的人Friedreich共济失调（FRDA）的自我进食活动来评估上肢功能。35名FRDA（34±14岁）的受试者和14名年龄相匹配的健康受试者进行了三个自进食周期，包括抓握，sc起，将食物转移到嘴中以及归还汤匙。与进给速度，旋转轨迹，考虑到运动和运动变异性的范围，特别注意每个部分，以捕获与残疾有关的共济失调。通过动态时间规整（DTW）测量的运动变异性在共济失调（两个队列的分离）的诊断中平均准确率为96％。使用随机森林（RF）的功能组合估算出的共济失调的严重程度使与共济失调的临床估计的相关性增加了13％，并且比当前使用的测试（Box＆Block，Pegboard）获得了更高的系数（患者规模为0.72） 。尽管总体结果提供了一种客观的，基于日常活动的捕获内在异常的方法，但该任务的不同部分都在空间上共济失调的存在，并与相关的临床观察结果相吻合。