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Viability of robotic therapy with emphasis on ankle for individuals with Parkinson's Disease

Grant number: 19/27193-0
Support Opportunities:Scholarships in Brazil - Scientific Initiation
Effective date (Start): May 01, 2020
Effective date (End): December 31, 2020
Field of knowledge:Engineering - Mechanical Engineering
Principal Investigator:Adriano Almeida Gonçalves Siqueira
Grantee:Laryssa Debora Calegaro Maria
Host Institution: Escola de Engenharia de São Carlos (EESC). Universidade de São Paulo (USP). São Carlos , SP, Brazil


Parkinson's disease is a neurodegenerative disorder characterized by the progression of motor impairments and decreased quality of life. Robotic therapy has been recommended to complement conventional therapy with some advantages, such as controllable assistance during movements, good dynamics in therapy (repetitiveness of tasks), greater motivation duing training through the use of interactive games and the reduction of costs in health care. Studies with a robotic ankle device (Anklebot® exoskeleton) have been performed with the purpose of facilitating the ankle movements of patients with neurological disorders, thus facilitating lower limb motor function. Clinical trials have shown positive effects of robotic therapy (Anklebot) on patient gait, influencing gait performance. In this context, the objective of this study is to verify the feasibility of using robotic therapy with the exoskeleton Anklebot® in individuals with Parkinson's disease before and after a session of the training protocol will be measured the neuromuscular and functional performance and the motivation of these individuals. To this end, a pilot study will be developed that will include individuals with PD aged 40-75 years; stage 2.5 or 3 on the Hoehn-Yard scale. The dorsiflexor and plantar flexor performance will be evaluated and the robotic therapy sessions will be motivated by three virtual games. Game control will be performed by the Anklebot® exoskeleton. The sensory-motor performance will be evaluated functional tests, by electromyography and gait kinematics. The variables of muscle performance investigated will be concentric peak torque and submaximal target torque maintenance. The electromyographic variables will be: activation peak and median frequency of the anterior tibial and medial gastrocnemius muscles. All subjects will undergo motor function assessment with the Unified Parkinson's Disease Scale (UPDRS), dual-task TUG and Berg Scale for characterization of functional levels. For the statistic, the tests of normality and homogeneity will be applied. If the data is parametric, Anova-two-way will be applied followed by Tukey. To verify the relationship between the performance during TCA and the TCB, the Spearman Correlation Coefficient will be used. For the classification of this coefficient, the criterion used was that r> 0.7 would indicate that the instrument has validity. The significance level of 0.05 will be considered, with a 95% confidence interval (CI) for all statistical tests. The SPSS program (version 10.0) will be used.

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