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Objective Assessment of Bradykinesia Estimated from the Wrist Extension in Older Adults and Patients with Parkinson’s Disease

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Abstract

Parkinson’s disease (PD) presents several motor signs, including tremor and bradykinesia. However, these signs can also be found in other motor disorders and in neurologically healthy older adults. The incidence of bradykinesia in PD is relatively high in all stages of the disorder, even when compared to tremor. Thus, this research proposes an objective assessment of bradykinesia in patients with PD (G PD: 15 older adults with Parkinson’s disease, 65.3 ± 9.1 years) and older adults (G HV: 12 healthy older adults, 60.1 ± 6.1 years). The severity of bradykinesia in the participants of G PD was assessed using the Unified Parkinson’s Disease Rating Scale. Movement and muscular activity were detected by means of inertial (accelerometer, gyroscope, magnetometer) and electromyographic sensors while the participants performed wrist extension against gravity with the forearm on pronation. Mean and standard error of inertial and electromyographic signal parameters could discriminate PD patients from healthy older adults (p value <0.05). In discriminating patients with PD from healthy older adults, the mean sensitivity and specificity were respectively 86.67 and 83.33%. The discrimination between the groups, based on the objective evaluation of bradykinesia, may contribute to the accurate diagnosis of PD and to the monitoring of therapies to control parkinsonian bradykinesia, and opens the possibility for further comparative studies considering individuals suffering from other motor disorders.

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Notes

  1. UPDRS Item 24 Hand Movements: patient opens and closes hands in rapid succession. UPDRS Item 25 Rapid Alternating Movements of Hands: pronation-supination movements of hands, vertically and horizontally, with as large an amplitude as possible, both hands simultaneously.

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Acknowledgments

The present work was carried out with the support the National Council for Scientific and Technological Development (CNPq), Coordination of Improvement of Higher Level Personnel (CAPES), Foundation for Research Support of the State of Minas Gerais (FAPEMIG) and Foundation for Research Support of the State of Goiás (FAPEG). A. O. Andrade is a Fellow of CNPq, Brazil (305223/2014-3). The authors are thankful to the patients of the Parkinson’s Disease Association of Triângulo (Associação Parkinson do Triângulo, Uberlândia, Brazil) for their participation in this study.

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Authors and Affiliations

  1. Centre for Innovation and Technology Assessment in Health, Postgraduate Program in Electrical and Biomedical Engineering, Faculty of Electrical Engineering, Federal University of Uberlândia, Uberlândia, Brazil

    Amanda Gomes Rabelo, Ana Paula S. Paixão, Fábio Henrique Monteiro Oliveira, Adriano A. Pereira & Adriano O. Andrade

  2. Institute of Physics, Federal University of Uberlândia, Uberlândia, Brazil

    Lucio Pereira Neves

  3. Postgraduate Program in Physiotherapy, Federal University of Triângulo Mineiro, Uberaba, Brazil

    Luciane Aparecida Pascucci Sande de Souza

  4. Bioengineering and Biomechanics Laboratory, Federal University of Goiás, Av. Esperança, s/n, Campus Samambaia, Goiania, GO, 74690-900, Brazil

    Marcus Fraga Vieira

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  1. Amanda Gomes Rabelo
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Correspondence to Marcus Fraga Vieira.

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Associate Editor Leonidas D. Iasemidis oversaw the review of this article.

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Rabelo, A.G., Neves, L.P., Paixão, A.P.S. et al. Objective Assessment of Bradykinesia Estimated from the Wrist Extension in Older Adults and Patients with Parkinson’s Disease. Ann Biomed Eng 45, 2614–2625 (2017). https://doi.org/10.1007/s10439-017-1908-3

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