IEEE Trans Neural Syst Rehabil Eng. 2020 Jun;28(6):1325-1333. doi: 10.1109/TNSRE.2020.2987020. Epub 2020 Apr 13.
This work focuses on the design and the validation of a wearable mechatronic device for an at-home assessment of wrist stiffness in patients affected by Parkinson's Disease (PD). The device includes one actuated joint and four passive revolute joints with a high overall intrinsic backdriveability. In order to allow the user to freely move the wrist during activities of daily living, we implemented a transparent controller on the basis of the interaction force sensed by the embedded load cell. Conversely, in order to provide perturbations for estimating the wrist flexion-extension rigidity, we implemented a torque controller. Firstly, we report a pilot study that aimed at characterizing the device in terms of range of motion (ROM) allowed, transparency perceived and torque-tracking capability. Then, we present a case study in which we tested our device with seven PD patients in both drug-OFF and drug-ON conditions and we compared the measured stiffness with the one measured in fourteen healthy controls and with the outcome of the most used clinical scale (MDS-UPDRS). The device allowed to successfully estimate the stiffness as different depending on the movement direction. Indeed, extension stiffness was higher than the flexion one, accordingly to the literature. Moreover, the device allowed to discriminate both Healthy subjects from PD subjects, and PD subjects in OFF condition from PD subjects in ON condition. In conclusion, we demonstrate the feasibility of the device in measuring wrist rigidity, thus enabling the possibility to implement an at-home assessment of the PD rigidity.
这项工作专注于设计和验证一种可穿戴机电设备，用于在家中评估帕金森病（PD）患者的手腕僵硬程度。该设备包括一个驱动关节和四个被动转动关节，具有很高的整体固有背驱动力。为了允许用户在日常生活活动中自由移动手腕，我们在嵌入式测力传感器感知的相互作用力的基础上实现了一个透明控制器。相反，为了提供用于估计手腕屈伸刚度的扰动，我们实现了一个扭矩控制器。首先，我们报告了一项旨在从允许的运动范围（ROM）、感知的透明度和扭矩跟踪能力方面对设备进行特征描述的初步研究。然后，我们提出了一项案例研究，其中我们在药物停用和药物开启两种情况下对 7 名 PD 患者进行了测试，并将测量的刚度与 14 名健康对照者和最常用的临床量表（MDS-UPDRS）的结果进行了比较。该设备成功地估计了不同运动方向的刚度。事实上，根据文献，伸展刚度高于弯曲刚度。此外，该设备能够区分健康受试者和 PD 患者，以及药物停用状态的 PD 患者和药物开启状态的 PD 患者。总之，我们证明了该设备在测量手腕硬度方面的可行性，从而为实施 PD 硬度的家庭评估提供了可能性。
