A palm-worn device to quantify rigidity in Parkinson’s disease

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dc.contributor.authorPerera, Thushara
dc.contributor.authorLee, Wee-Lih
dc.contributor.authorJones, Mary
dc.contributor.authorTan, Joy
dc.contributor.authorProud, Elizabeth
dc.contributor.authorBegg, Angus
dc.contributor.authorSinclair, Nicholas
dc.contributor.authorPeppard, Richard
dc.contributor.authorMcDermott, Hugh
dc.date.accessioned2020-08-04T05:41:31Z
dc.date.available2020-08-04T05:41:31Z
dc.date.issued2019-02
dc.description.abstractBACKGROUND: 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.en_US
dc.description.sponsorshipThis work was supported by the Colonial Foundation, St Vincent’s Hospital Research Endowment Fund, and the National Health and Medical Research Council [project grant #1103238]. N.C.S. is supported through an Australian Government Research Training Program Scholarship. We would like to thank Dr. Wesley Thevathasan, Dr. San San Xu, Dr. Simon Little, and Prof. Peter Brown who provided expertise that greatly assisted the research. The Bionics Institute acknowledges the support it receives from the Victorian Government through its operational infrastructure program.en_US
dc.identifier.citationPerera, 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. 317: 113-120.en_US
dc.identifier.issn0165-0270
dc.identifier.urihttp://repository.bionicsinstitute.org:8080/handle/123456789/400
dc.language.isoenen_US
dc.publisherElsevier B.V.en_US
dc.subjectRigidityen_US
dc.subjectStiffnessen_US
dc.subjectParkinson's diseaseen_US
dc.subjectObjective monitoringen_US
dc.subjectMovement disordersen_US
dc.titleA palm-worn device to quantify rigidity in Parkinson’s diseaseen_US
dc.typeArticleen_US
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