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Title: A Palm-Worn Device to Quantify Rigidity in Parkinson’s Disease
Authors: Perera, Thushara
Lee, Wee-Lih
Jones, Mary
Tan, Joy
Proud, Elizabeth
Begg, Angus
Sinclair, Nicholas
Peppard, Richard
McDermott, Hugh
Keywords: Rigidity
Stiffness
Parkinson's disease
Objective monitoring
Movement disorders
Issue Date: Feb-2019
Publisher: Elsevier B.V.
Citation: Perera, T., W. L. Lee, M. Jones, J. L. Tan, E. L. Proud, A. Begg, N. C. Sinclair, R. Peppard, and H. J. McDermott. 2019. A Palm-Worn Device to Quantify Rigidity in Parkinson's Disease. Journal of Neuroscience Methods: pii: S0165-0270(0119)30053-30056 [epub ahead of print].
Abstract: BACKGROUND: Parkinsonian rigidity is identified on clinical examination as resistance to passive movement. Measurement of rigidity commonly relies on ordinal rating scales (MDS-UPDRS), however instrumented objective measures may provide greater mechanistic insight. NEW METHOD: We present a palm-worn instrument to objectively quantify rigidity on a continuous scale. The device employs a miniature motor to flex the third digit of the hand about the metacarpophalangeal joint whilst transducers record flexion/extension forces. We aim to determine congruence with the MDS-UPDRS, investigate sensitivity to the impact of deep brain stimulation (DBS) and contralateral movement, and make comparisons with healthy individuals. Eight participants with Parkinson's disease underwent evaluation during conditions: on and off DBS, and with and without contralateral limb movement to activate rigidity. During each DBS condition, wash-in/out effects were tracked using both our instrument and two blinded clinical raters. Sixteen healthy volunteers (age-matched/young) served as controls. RESULTS: Rigidity measured using our instrument had moderate agreement with the MDS-UPDRS and showed differences between therapeutic state, activation conditions, and disease/healthy cohorts. Rigidity gradually worsened over a one-hour period after DBS cessation, but improved more rapidly with DBS resumption. COMPARISON WITH EXISTING METHODS: Previous attempts to quantify rigidity include manual approaches where a clinician is required to manipulate limbs while sensors passively gather information, or large automated instruments to move the wrist or elbow. CONCLUSION: Given its ability to track changes in rigidity due to therapeutic intervention, our technique could have applications where continuous measurement is required or where a suitably qualified rater is absent.
URI: http://repository.bionicsinstitute.org:8080/handle/123456789/337
ISSN: 0165-0270
Appears in Collections:Neurobionics Research Publications

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