Biomechanical analysis of an upper limb rehabilitation process using optoelectronic cameras in patients with Parkinson's disease
Montoya Arteaga, Daniela | 2022
Parkinson’s disease (PD) is the second most common neurodegenerative disease in North America and Europe. PD is a degenerative disease that affects these systems: central, periph- eral, and enteric nervous, and has a significant impact on society, families and the quality of life of the patients. Patients with PD have a variety of motor symptoms such as resting tremors, rigidity, akinesia or bradykinesia and postural instability. Therefore, patients with PD need to have a rehabilitation program to preserve current function, improve range of motion (RoM), posture, strength and endurance, prevent disabling complications, and family training. This work presents a biomechanical assessment of 12 patients with PD evaluated with the Hoehn and Yahr scale before and after rehabilitation therapy for two months with robotic therapy (Armeo®Spring exoskeleton). Patients performed three tests (Maximum Forward Reach, Apley Scratching and Box and Block) where maximum angles, range of motion, angular velocities, and execution times were measured. Nexus software (Oxford Metrics, Oxford, UK) was used to track the trial data, and Polygon software (Oxford Metrics, Oxford, UK) provided the kinematic outcomes of each user. Also, game scores are calculated with the Armeo therapy report because it performs a quantitative analysis regarding the patient’s score in performing the therapeutic games. A Wilcoxon test (p = 0.05) was performed to compare the variables before and after the therapy for the more and less affected upper limbs. Also, averages and standard deviations of game scores are calculated to compare the more and less affected upper limbs before and after rehabilitation therapy. Significant differences were found in the shoulder, elbow and wrist joints. The increase found was 15.89% for adduction-abduction of the shoulder, 6.8% for flexion-extension of the elbow, and 26.82% for flexion-extension of the wrist joint in the more affected upper limb before and after rehabilitation therapy in the maximum forward reach test.
Regarding the minor affected upper limb, the increase found was 9.57% for flexion-extension of the shoulder. On the other hand, in the Apley Scratching Test, the increase found was 12.65% for flexion-extension of the elbow joint in the more affected upper limb before and after rehabilitation therapy. Concerning the less affected upper limb, the increase found was 14.79% for flexion-extension of the elbow joint. Finally, concerning the Box and Block Test, the increase found was 9.13% for the flexion-extension of the elbow joint in the more affected upper limb before and after rehabilitation therapy. In the less affected upper limb, the increase found was 17.13% for the flexion-extension of the elbow joint. In conclusion, the Armeo therapy has been shown to improve motor skills reacquisition in upper limbs through the performance of high intensity, high dose, and is repeatable, reliable and flexible.