It has been shown that patients with Parkinson's disease (PD) have impaired kinaesthesia and haptic perception of the upper limbs. In PD patients, these impairments might be involved in the development of hypometria or bradykinesia and may play a role in postural deficits, thereby significantly contributing to the overall disability level. Dedicated conventional or robot-assisted training might improve sensory-motor function in PD patients. In order to provide efficient robot-assisted therapy, robotic devices have to be able to tailor the therapy difficulty to the individual impairment profile of each patient. For difficulty adaptation in robot-assisted therapy, it is important to assess the impairment profiles with the same robotic platform that would be used for therapy, therefore minimizing costs or potential errors coming from the use of different devices. However, up to now, little emphasis has been placed on providing sensory-motor robot-assisted therapy for the upper limbs to persons with PD based on their individual level of impairment. The aim of this study is therefore to evaluate if the assessments of sensory-motor hand function implemented on a robotic device for hand rehabilitation, i.e. the ReHapticKnob, are suitable to measure the impairments of kinaesthesia and haptic perception observed in subjects with Parkinson's disease. If the assessments implemented in the ReHapticKnob are sensitive enough to detect a difference between the sensory-motor function of PD patients and healthy subjects, the device might in the future be used to assess improvements before and after sensory-motor therapy. This is a necessary step before the investigators can use these assessments to tailor the difficulty level of the therapy performed with the ReHapticKnob and to investigate the benefits and impact of such a therapy on the kinaesthetic and haptic impairments of persons with PD.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
OTHER
Masking
NONE
Enrollment
20
During the assessment sessions with the ReHapticKnob, subjects sit comfortably on a chair in front of a screen and place the fingers of the hand on the handles of the device. The different assessments consist of moving the hand or forearm of the subjects to two different positions and asking the subject to discriminate between them (discrimination thresholds for the amplitude of grasping and forearm pronosupination positions), of passively moving the hand or forearm of the subject at low velocities and asking the subject to say when he/she detects the movement (detection thresholds for passive movements), or of rendering two objects with different stiffness and asking the subject to discriminate between them (discrimination thresholds for the stiffness of objects pinched with the hand).
Clinica Hildebrand, Centro di Rehabilitazione Brissago
Brissago, Switzerland
Detection threshold resulting from the assessment of detection of passive grasping movements - Right hand
Outcome of the assessment for the detection of passive grasping movements performed with the right hand. This threshold is expressed in time until movement detection.
Time frame: Through study completion, an average of 2 weeks
Detection threshold resulting from the assessment of detection of passive grasping movements - Left hand
Outcome of the assessment for the detection of passive grasping movements performed with the left hand. This threshold is expressed in time until movement detection.
Time frame: Through study completion, an average of 2 weeks
Detection threshold resulting from the assessment of detection of passive forearm pronosupination movements - Right forearm
Outcome of the assessment for the detection of passive forearm pronosupination movements performed with the right forearm. This threshold is expressed in time until movement detection.
Time frame: Through study completion, an average of 2 weeks
Detection threshold resulting from the assessment of detection of passive forearm pronosupination movements - Left forearm
Outcome of the assessment for the detection of passive forearm pronosupination movements performed with the left forearm. This threshold is expressed in time until movement detection.
Time frame: Through study completion, an average of 2 weeks
Discrimination threshold resulting from the assessment of just noticeable difference for grasping positions - Right hand
Outcome of the assessment for the discrimination of grasping positions performed with the right hand. This threshold is expressed in millimeters and represents the minimum difference that the subject can perceive.
Time frame: Through study completion, an average of 2 weeks
Discrimination threshold resulting from the assessment of just noticeable difference for grasping positions - Left hand
Outcome of the assessment for the discrimination of grasping positions performed with the left hand. This threshold is expressed in millimeters and represents the minimum difference that the subject can perceive.
Time frame: Through study completion, an average of 2 weeks
Discrimination threshold resulting from the assessment of just noticeable difference for pronosupination positions - Right forearm
Outcome of the assessment for the discrimination of pronosupination positions performed with the right forearm. This threshold is expressed in degrees and represents the minimum difference that the subject can perceive.
Time frame: Through study completion, an average of 2 weeks
Discrimination threshold resulting from the assessment of just noticeable difference for pronosupination positions - Left forearm
Outcome of the assessment for the discrimination of pronosupination positions performed with the left forearm. This threshold is expressed in degrees and represents the minimum difference that the subject can perceive.
Time frame: Through study completion, an average of 2 weeks
Discrimination threshold resulting from the assessment of haptic perception - Right hand
Outcome of the assessment for haptic perception performed with the right hand. This threshold is expressed as Weber Fraction and represents the minimum difference in stiffness that the subject can perceive.
Time frame: Through study completion, an average of 2 weeks
Discrimination threshold resulting from the assessment of haptic perception - Left hand
Outcome of the assessment for haptic perception performed with the left hand. This threshold is expressed as Weber Fraction and represents the minimum difference in stiffness that the subject can perceive.
Time frame: Through study completion, an average of 2 weeks
Demographic information
Gender, age, year of birth.
Time frame: This information is collected during the screening visit performed at the beginning of the study (day 0).
Edinburgh Handedness Inventory Score
Questionnaire to define handedness.
Time frame: This information is collected during the screening visit performed at the beginning of the study (day 0).This information is collected during the screening visit performed at the beginning of the study (day 0).
Montreal Cognitive Assessment
Assessment of cognitive function (max score = 30, high score = better).
Time frame: This information is collected during the screening visit performed at the beginning of the study (day 0).This information is collected during the screening visit performed at the beginning of the study (day 0).
Proprioception item of the Nottingham Sensory Assessment
Assessments used to characterize proprioception.
Time frame: The control group does this assessment during the screening visit (day 0). The group of patients with Parkinson's disease does this during the second examination visit (day 0 to day 0 + 2 days).
MDS-Unified Parkinson's Disease Rating Scale: items 3.15 to 3.18
Scale to characterize the state of the Parkinson's disease. This is done for the group of patients with Parkinson's disease only. These items are performed at the beginning as they are considered for the inclusion criteria.
Time frame: This information is collected during the screening visit performed at the beginning of the study (day 0).
MDS-Unified Parkinson's Disease Rating Scale III
Scale to characterize the state of the Parkinson's disease. This is done for the group of patients with Parkinson's disease only.
Time frame: This information is collected during the second examination visit (day 0 to day 0 + 2 days).
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Hoehn and Yahr stage
Scale to characterize the state of the Parkinson's disease. This is done for the group of patients with Parkinson's disease only.
Time frame: This information is collected during the screening visit performed at the beginning of the study (day 0).
Abnormal Involuntary Movement Scale
Scale to characterize the state of the Parkinson's disease. This is done for the group of patients with Parkinson's disease only.
Time frame: This information is collected during the screening visit performed at the beginning of the study (day 0).
Levodopa equivalent daily dose
Information used to characterize the state of the Parkinson's disease and the timespan when the patient is in the ON state. This is collected for the group of patients with Parkinson's disease only.
Time frame: This information is collected during the second examination visit (day 0 to day 0 + 2 days).
Disease onset
Information used to characterize the state of the Parkinson's disease. This is collected for the group of patients with Parkinson's disease only.
Time frame: This information is collected during the second examination visit (day 0 to day 0 + 2 days).
Most affected side
Information used to characterize the side of the body most affected by the Parkinson's disease. This is collected for the group of patients with Parkinson's disease only.
Time frame: This information is collected during the second examination visit (day 0 to day 0 + 2 days).
Frontal Assessment Battery
Assessment of cognitive function. This is collected for the group of patients with Parkinson's disease only.
Time frame: This assessment is performed once during the study (from day 0 to day 0 + 25 days).
Attentive matrices
Assessment of cognitive function. This is collected for the group of patients with Parkinson's disease only.
Time frame: This assessment is performed once during the study (from day 0 to day 0 + 25 days).
Digit span
Assessment of cognitive function. This is collected for the group of patients with Parkinson's disease only.
Time frame: This assessment is performed once during the study (from day 0 to day 0 + 25 days).
Fatigue scale for motor and cognitive functions
Assessment of cognitive function. This is collected for the group of patients with Parkinson's disease only.
Time frame: This assessment is performed once during the study (from day 0 to day 0 + 25 days).