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Evaluation of upper Limb Kinematic Synergies in Parkinson's Patients in Medication States and before and after Rehabilitation

Kashefi, Erfan | 2024

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  1. Type of Document: M.Sc. Thesis
  2. Language: Farsi
  3. Document No: 56963 (08)
  4. University: Sharif University of Technology
  5. Department: Mechanical Engineering
  6. Advisor(s): Behzadipour, Saeed
  7. Abstract:
  8. Parkinson's disease is a destructive and long-term disease of the central nervous system. This disease especially affects the motor system. Parkinson's patients can be studied under dopaminergic and non-dopaminergic conditions. The non-dopaminergic state means not taking the drug, for at least 12 hours, and the dopaminergic state, from one hour to less than 12 hours after taking the usual dose of the dopaminergic drug. The aim of this study is to examine and compare the statistics and characteristics of Parkinson's patients in dopaminergic and non-dopaminergic states, focusing on reaching and tracking activities. It also aims to analyze the differences before and after rehabilitation in these activities for all patients, considering both the more affected and less affected hand in Parkinson's. In recent years, the concept of kinematic synergies, an extension of muscle synergies, has been utilized to characterize movement patterns. In this study, data from 33 Parkinson's patients in two medication states (dopaminergic and non-dopaminergic) was analyzed as the initial phase, followed by the examination of remote rehabilitation data from 21 Parkinson's patients post-medication intake. Data was collected using the Kinect camera for predefined activities consistent with prior research, employing the Sana system exclusively for data acquisition in this study. In both parts of the study aim, 4 joint angles were computed for each hand and kinematic synergies were identified through non-negative matrix decomposition. The quantity of synergies in each task was determined by the highest occurrence of that synergy across all patients, followed by clustering analysis on the weighted structure input. Based on clinical findings, categorization of the more affected hand in patients was carried out using the weighted structures of all patients, with synergy analysis performed separately for patients with the right hand dominance and those with the predominantly affected left hand. The initial findings of the study revealed no change in the number of synergies, with slight modifications in weight structures and activation patterns under the two medication states across all patients. The reaching activity of both hands played a crucial role in categorizing patients based on the more affected hand. Further analysis of the more affected hand and synergy in the left hand activities of the affected group indicated a change in the number of synergies only in the diagonal reaching activity of the right hand, under two medication conditions. Evaluation of synergy in the activities of the more affected right hand group also showed no alteration in the number of synergy activities for the two medication conditions. The subsequent phase of the research demonstrated a variation in the number of synergies in the left hand diagonal tracking activity. Categorization of patients by the most involved hand and studying the related group's synergy revealed changes in the number of synergies for patients with a more affected left hand in right hand reaching activities and left hand diagonal reaching. Patients with a more affected right hand exhibited changes in the number of synergies in reaching activities of both out-of-phase hands and diagonally reaching of both in-phase hands and the right hand. Despite no disparity in the number of synergies pre- and post-rehabilitation, the non-in-phase circular two-hand tracking activity displayed a significant difference in degrees of freedom during the investigation. These results underscore the significance of two-handed reaching activity in identifying the more affected hand and the reaching activity in rehabilitating patients with the more affected right hand, with a p-value ≤0.05 for various degrees of freedom. Further exploration involving a group of healthy individuals in this research continuation could aid in developing treatment strategies and enhancing our understanding of skeletal-neuromuscular abnormalities in Parkinson's disease patients
  9. Keywords:
  10. Parkinson Disease ; Tele-rehabilitation ; Kinect Sensor ; Kinematic Synergy ; Dopaminergic Treatment ; Non-Dopaminergic Treatment ; Rehabilitation

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