Zesty Exercise System for Therapeutic Engagement (ZEST-E) Público

Abstract

Importance: Parkinson’s disease is a common neurodegenerative disease that causes various symptoms such as bradykinesia, a resting tremor, and postural reflex deficits (Jankovic, 2008).

Physical therapy can address many of the symptoms associated with Parkinson’s disease, but people with Parkinson’s disease frequently fail to achieve the full benefits of exercise sessions due to the limited time therapists can dedicate to individual patients (Clarke et al., 2016). Home robotics may be a potential solution to increase the time individuals with Parkinson’s disease are able to engage with therapeutic exercises, and a home robot programmed to deliver physical therapy activities could make frequent and consistent exercise more accessible.

Objective: To determine 1) if a robot-led exercise system can lead people with Parkinson's disease through a wide range of motion at different joints and 2) if people with Parkinson's disease are able to execute the exercises as instructed by the robot.

Design/Setting: Pilot interventional study.

Participants: 11 older adults (68.2 ± 5.9 years old), four males and seven females, with a Parkinson’s disease provided by a Movement Disorders specialist.

Main Outcome and Measure: Range of motion and physical therapist survey responses.

Results: Participants were able to move through a large range of motion that targeted hip flexion, knee extension, knee flexion, ankle plantarflexion, and torso twist. Participants had higher rates of adherence to ZEST-E’s verbal directions than to ZEST-E’s video instructions. The most common form errors were improper form between repetitions, and the most common hypothesized cause of form errors was misunderstanding instructions.

Conclusion and Relevance: Participants were able to achieve a maximum range of motion that is largely consistent with the literature’s comparative standard range of motion values. Instruction adherence was a challenge for users, but this finding may be due to the study design rather than the complexity of the exercises or the device.

Table of Contents

Hypothesis………………………………………………………………………………………….1

Introduction……………………………………………………………………….………….......1

        Parkinson’s Disease…………………………………………………………………………1

        Physical Therapy for People with Parkinson’s Disease……………………………..6

        Robotics for Physical Therapy…………………………………………………………….7

Materials and Methods……………………………………………………………………..…..11

        Participant Recruitment……………………………………………………………........12

        Robotic System for Physical therapy…………………………………………………...12

        ROM Measurement and Application in Exercise………………………………….....29

        Opals Motion Capture System.…………………………………………………………..14

        Experimental Protocol……………………………………………………………………..15

        Scoring and Rating……………………………………………………………………..…..18

        Statistical Analysis…………………………………………………………………..……..20

Results………………………………………………………………………………………….......21

        Subjects……………………………………………………………………….....…………...21

        Range of Motion………………………………………………………………………….....22

        Repetition Rate……………………………………………………………………..….…...23 

        Physical Therapist Rating……………………………………………………………..….24

Discussion………………………………………………………………………………………....29   

        ROM Measurement and Application in Exercise…………………………………....29

        Physical Therapy Ratings of Exercise Performance/Quality……………………....31 

Limitations………………………………………………………….........………………………33

Next Steps ………………………………………………………………………..........……......33

Conclusions……………………………………………………………………………………..…34

Figures and Graphs……………………………………………………………………………….35

        Figure 1………………………………………………………………………………...........35

        Figure 2………………………………………………………………………………...........36

        Figure 3………………………………………………………………………………...........37

        Figure 4…………………………………………………………………………….........…..38

        Figure 5…………………………………………………………………………….........…..39

        Figure 6…………………………………………………………………………….........…..40

        Table 1………………………………………………………………………………............41

        Table 2…………………………………………………………………………….........……42

        Figure 7………………………………………………………………………….........……..43

        Table 3…………………………………………………………………………….........…...43

        Figure 8………………………………………………………………………….........……..44

        Figure 9……………………………………………………….………………………..........45

        Figure 10…………………………………………………….…………………………….....46

        Table 4……………………………………………………….…......………………………..46

        Figure 11…………………………………………………….………......………………..…47

        Figure 12…………………………………………………….………......……………..……48

        Figure 13…………………………………………………….………………………........…48

        Figure 14…………………………………………………….………………………......…..49

        Figure 15……………………………………………………………………………............50

        Figure 16…………………………………………………………………………..........…..51

        Table 5………………………………………………………………………………….........52

Works Cited……………………………………………………………………………………......53

About this Honors Thesis

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School	Emory College
Department	Neuroscience and Behavioral Biology
Degree	B.S.
Submission	Honors Thesis
Language	English
Research Field	Engineering, Robotics Health Sciences, Rehabilitation and Therapy Health Sciences, Aging
Palavra-chave	Neurodegenerative disease Parkinson’s disease Robotics Physical therapy Range of motion Home robotics Physical therapist
Committee Chair / Thesis Advisor	Hackney, Madeleine, Emory University
Committee Members	Hue, Gillian, Emory University Nocera, Joe, Emory University

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