Iranian Journal of Biomedical Engineering (IJBME)
نشریه علمی مهندسی پزشکی زیستی

Modeling Parkinsonian Gait and Investigating some Approaches to Increase the Gait Speed

Document Type : Full Research Paper

Authors

Seyede Fatemeh Ghoreishian Amiri 1
Mohammad Pooyan 2

1 M.Sc., Department of Biomedical Engineering, Faculty of Engineering, Shahed University, Tehran, Iran

2 Associate Professor, Department of Biomedical Engineering, Faculty of Engineering, Shahed University, Tehran, Iran

https://doi.org/10.22041/ijbme.2021.135873.1621
Abstract
Parkinson's disease (PD) is a neurological disorder that mainly affects dopamine-producing neurons and motor system. The most obvious symptoms of PD are tremor, slow movement, stiffness and difficulty with walking. Walking in PD is slower than normal walking. In this paper, the gait in patients with PD is modeled by a mathematical and computational method. This model includes structures which are involved in PD, such as basal ganglia, thalamus, cortex, supplementary motor area (SMA), muscle and joint-load dynamics. The output of the model is walking speed in PD. The output value is 0.83 m/s, which is in the range reported by clinical results (0.18-1.21 m/s). Some methods which increase the gait speed in PD are investigated too. These methods include deep brain stimulation, drug prescription and strengthening the muscles. The results show that each of these methods will improve the gait speed, in fact, by using these methods, the value of output increases and approaches the walking speed range in healthy individuals (1.36-1.30 m/s). Moreover, the effect of rigidity on gait speed is studied; it has been observed that the stiffness and speed of the gait are inversely related. Finally a control method is offered which improve the gait speed by increasing the magnitude response of the closed-loop system.

Keywords

Parkinson’s Disease
Modeling
Gait Speed
Improving

Subjects

  1. Morris, R. Iansek, T. Matyas, and J. Summers, ”Abnormalities in the stride length-cadence relation in Parkinsonian gait,” Mov Disord., Vol. 13(1), pp. 61–69, 1998. 
  2. F. Aita, “Why patients with Parkinson's disease fall,” JAMA., Vol. 247 (4), pp. 515–516, 1982. doi:10.1001/jama.247.4.515.
  3. C. Koller, S. Glatt, B. Vetere-Overfield, and R. Hassanein, “Falls and Parkinson's disease,”. Clin Neuropharmacol., Vol. 12 (2), pp. 98–105, 1989. 
  4. Sarbaz, F. Towhidkhah, M. Banaie, M. Pooyan, and Sh. Gharibzadeh, “Modeling the gait of normal and Parkinsonian persons for improving the diagnosis,” Neuroscience Letters., 2011.
  5. J. De Goede, SH. Keus, G. Kwakkel, et al, “The effects of physical therapy in Parkinson's disease: a research synthesis,” Arch Phys Med Rehabil., Vol. 82 (4), pp. 509–515, 2001. 
  6. Sarbaz, Sh. Gharibzadeh, F. Towhidkhah, M. Banaie, and A. Jafari, “A Gray-Box Neural Network Model of Parkinson's Disease Using Gait Signal,” Basic and Clinical Neuro Science., Vol.2, No. 3, 2011.
  7. M. Koop, S. J. Ozinga, A. B. Rosenfeldt, and J. L. Alberts, “Quantifying turning behavior and gait in Parkinson’s disease using mobile technology,” IBRO Reports., Vol.5, pp. 10–16, 2018.
  8. Paker, D. Bugdayci, G. Goksenoglu, D. Tekdöş Demircioğlu, N. Kesiktas, and N. Ince, “Gait speed and related factors in Parkinson’s disease,” Physical Therapy Science., Vol. 27(12), pp. 3675–3679, 2015.
  9. Towhidkhah, R. E. Gander, and H. C. Wood, “Model Predictive Impedance Control: A Model for Joint Movement,” Journal of Motor Behavior., Vol. 29, No. 3, pp. 209-222, 1997.
  10. A. Roper, N. Kang, J. Ben, J. H. Cauraugh, M. S. Okun, and C. J. Hass, “Deep brain stimulation improves gait velocity in Parkinson’s disease: a systematic review and meta-analysis,” J Neural., Vol. 263, pp. 1195–1203, 2016.
  11. Collomb-Clerca, and M. L.Welter, “Effects of deep brain stimulation on balance and gait in patients with Parkinson’s disease: A systematic neurophy siological review,” Clinical Neurophysiology., Vol. 45, pp. 371-388, 2015.
  12. S. Peterson, M. Mancini, P. C. Fino, F. Horak, K. Smulders, “Speeding Up Gait in Parkinson's Disease,” Journal of Parkinson's Disease., Vol. 10, pp. 245-253, 2020.
  13. Haeri, Y. Sarbaz, and Sh. Gharibzadeh, “Modeling the Parkinson’s tremor and its treatments,” Theoretical Biology., Vol. 236, pp. 311–322 , 2005.
  14. J. Van Albada, and P. A. Robinson, “Mean-field modeling modeling of the basal ganglia-thalamocortical system. I Firing rates in healthy and parkinsonian states,” Theoretic. Biol., Vol. 257, pp. 642-663, 2009.
  15. E. Mains, and J. F. Soechting, “A model for the neuromuscular response to sudden disturbances,” Dynamic Systems, Measurement and Control., vol. 93(4), pp. 247-251, 1971.
  16. MashhadiMalek, F. Towhidkhah, Sh. Gharibzadeh, V. Daeichin, and M. A. Ahmadi-Pajouh, “Are rigidity and tremor two sides of the same coin in Parkinson’s disease?,” Computers in Biology and Medicine., vol. 38, pp. 1133–1139, 2008.
  17. Brown, P. Mazzone, A. Oliviero, MG. Altibrandi, F. Pilato, PA. Tonali, et al, “Effects of stimulation of the subthalamic area on oscillatory pallidal activity in Parkinson’s disease,” Exp Neurol., pp.480-490, 2004.
  18. Brown, PL. Dowsey, P. Brown, M. Jahanshahi, P. Pollak, AL. Ben- abid, et al, “Impact of deep brain stimulation on upper limb akinesia in Parkinson’s disease,” Ann Neurol., Vol. 45, 473-488, 1999.
  19. Smulders, M. L. Dale, P. Carlson-Kuhta, J. G. Nutt, F. B. Horak, “Pharmacological treatment in Parkinson's disease: Effects on gait,” Parkinsonism and Related Disorders., Vol. 31, 3-13, 2016.
  20. Stuart, R. Morris, A. Giritharan, J. Quinn, J. G. Nutt, M. Mancini, “Prefrontal Cortex Activity and Gait in Parkinson’s Disease With Cholinergic and Dopaminergic Therapy,” Wiley Online Library., DOI. 10.1002/mds.28214, 2020.
  21. Van Blercom, A. Lasa, K. Verger, X. Masramón, V. M. Sastre , and G. Linazasoro, “Effects of gabapentin on the motor response to levodopa: a double-blind, placebo-controlled, crossover study in patients with complicated Parkinson disease,” Clin Neuro pharmacol, Vol. 27 (3), pp. 124-128, 2004.
  22. Ashrostaghi, H. Sadeghi, E. Shirzad, “Review of the Concept of Stiffness in the Research on Mechanical   Properties and Behavior of Human Body and Its Measurement Methods in Lower Extremity,” Rehabitilation Medicine, Neurosurgery, and Psychiatry., Vol. 6(2), pp. 258–270, 2017.
  23. Jankovic, “Parkinson's disease: clinical features and diagnosis,”Journal of Neurology, Neurosurgery, and Psychiatry., Vol. 79, No. 4, pp. 368–76, 2008.
  24. Pledgie, K. Barner, and S. Agrawal, “Tremor Suppression Through Impedance Control,” IEEE Transactions on Rehabilitation Engineering., vol. 8, no. 1, pp. 53–59, 2000.
  25. Suppa, A. Kita, G. Leodori, A. Zampogna, E. Nicolini, P. Lorenzi, R. Rao, and F. Irrera, “l-DOPa and Freezing of gait in Parkinson’s Disease: Objective assessment through a Wearable Wireless system,” Frontiers in Neurology., Vol. 8, 2017.
Iranian Journal of Biomedical Engineering (IJBME)
Volume 14, Issue 4
Winter 2021
Pages 321-331

  • Receive Date 04 September 2020
  • Revise Date 30 December 2020
  • Accept Date 12 January 2021

Home

Contact Us