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Balance Assessment in Parkinson Disease based on a Combination of Posturographic Indices

Zahedi, Amir | 2020

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  1. Type of Document: M.Sc. Thesis
  2. Language: Farsi
  3. Document No: 53281 (08)
  4. University: Sharif University of Technology
  5. Department: Mechanical Engineering
  6. Advisor(s): Behzadipour, Saeed; Taghizadeh, Ghorban
  7. Abstract:
  8. Parkinson's disease is a progressive neurodegenerative disease in which balance disorders are a common symptom. Clinical and non-clinical methods have been developed to evaluate the quality of maintaining balance. Clinical methods include questionnaires and tests that are scored by the therapist and therefore depend on the examiner's skill. On the other hand, there are biomechanical methods that do not depend on the therapist's skill. Posturography -based methods are among the biomechanical tests used today to assess balance. In these methods, some indicators are extracted from the patient's foot center of pressure that can measure the quality of balance. These studies usually examine the correlation of these indicators with clinical tests and the reliability of indicators by retest test and analysis of Intra Class Correlation (ICC). Although a combination of these indicators can have more potential to assess the quality of balance in Parkinson's patients, so far no research has been done in this field (finding a combined balance index using dynamic Posturography for Parkinson's patients).The present project aims to find a combination of indicators in the field of dynamic Posturography that its validity and reliability is higher than each of the indicators. We also want to evaluate the performance of this assessment method in a rehabilitation - remote sensing (Telerehab) and compare it with the measurement results in the clinical environment.For this purpose, during a therapeutic intervention of 21 Parkinson's patients who received training with the Sana rehabilitation system at home, we performed dynamic Posturography balance tests (LOS and RC) during 24 treatment sessions. Then, we calculated the indices in the literature for these two tests and compared the validity and reliability results of the indices with the study of the test-retest, which was previously performed in a clinical setting at the Movafaghian Center. A linear combination of baseline indicators based on multi-objective optimization was also presented; In such a way that the validity, reliability, and signal-to-noise ratio are maximized.The validity of the indicators in the remote rehabilitation study with the Berg clinical test increased compared to the retest test study. Also, despite the limitations when studying remote rehabilitation, the ICC of indicators in telerehabilitation increased compared to the retest test; However, the ICC indicators in these two studies are not very comparable due to the limitations of the remote rehabilitation study. Finally, it appears that the indicators in the RC test performed better than the indicators in the LOS test. Finally, by performing the optimization process on remote rehabilitation data, a composite index was introduced whose overall performance was better than single indices
  9. Keywords:
  10. Parkinson Disease ; Multiobjective Optimization ; Composite Index ; Dynamic Posturography ; Posture Control

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