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Journal of NeuroEngineering and Rehabilitation
Published in: Journal of NeuroEngineering and Rehabilitation 1/2015

Open Access 01-12-2015 | Research

Adaptive training with full-body movements to reduce bradykinesia in persons with Parkinson’s disease: a pilot study

Authors: Susanna Summa, Angelo Basteris, Enrico Betti, Vittorio Sanguineti

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2015

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Abstract

Background

Bradykinesia (slow movements) is a common symptom of Parkinson’s disease (PD) and results in reduced mobility and postural instability. The objective of this study is to develop and demonstrate a technology-assisted exercise protocol that is specifically aimed at reducing bradykinesia.

Methods

Seven persons with PD participated in this study. They were required to perform whole body reaching movements toward targets placed in different directions and at different elevations. Movements were recorded by a Microsoft Kinect movement sensor and used to control a human-like avatar, which was continuously displayed on a screen placed in front of the subjects. After completion of each movement, subjects received a 0-100 score that was inversely proportional to movement time. Target distance in the next movements was automatically adjusted in order to keep the score around a pre-specified target value. In this way, subjects always exercised with the largest movement amplitude they could sustain. The training protocol was organised into blocks of 45 movements toward targets placed in three different directions and at three different elevations (a total of nine targets). Each training session included a finite number of blocks, fitted within a fixed 40 minutes duration. The whole protocol included a total of 10 sessions (approximately two sessions/week).
As primary outcome measure we took the absolute average acceleration. Various aspects of movement performance were taken as secondary outcome measures, namely accuracy (undershoot error), path curvature, movement time, and average speed.

Results

Throughout sessions, we observed an increase of the absolute average acceleration and speed and decreased undershoot error and movement time. Exercise also significantly affected the relationship between target elevation and both speed and acceleration - the improvement was greater at higher elevations.

Conclusions

The device and the protocol were well accepted by subjects and appeared safe and easy to use. Our preliminary results point at a training-induced reduction of bradykinesia.
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Metadata
Title
Adaptive training with full-body movements to reduce bradykinesia in persons with Parkinson’s disease: a pilot study
Authors
Susanna Summa
Angelo Basteris
Enrico Betti
Vittorio Sanguineti
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Journal of NeuroEngineering and Rehabilitation / Issue 1/2015
Electronic ISSN: 1743-0003
DOI
https://doi.org/10.1186/s12984-015-0009-5

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