BACKGROUND The use of integrated robotic technology to quantify the spectrum of motor symptoms of Parkinson's Disease (PD) has the potential to facilitate objective assessment that is independent of clinical ratings. The purpose of this study is to use the KINARM exoskeleton robot to (1) differentiate subjects with PD from controls and (2) quantify the motor effects of dopamine replacement therapies (DRTs). METHODS Twenty-six subjects (Hoehn and Yahr mean 2.2; disease duration 0.5 to 15 years) were evaluated OFF (after > 12 h of their last dose) and ON their DRTs with the Unified Parkinson's Disease Rating Scale (UPDRS) and the KINARM exoskeleton robot. Bilateral upper extremity bradykinesia, rigidity, and postural stability were quantified using a repetitive movement task to hit moving targets, a passive stretch task, and a torque unloading task, respectively. Performance was compared against healthy age-matched controls. RESULTS Mean hand speed was 41% slower and 25% fewer targets were hit in subjects with PD OFF medication than in controls. Receiver operating characteristic (ROC) area for hand speed was 0.94. The torque required to stop elbow movement during the passive stretch task was 34% lower in PD subjects versus controls and resulted in an ROC area of 0.91. The torque unloading task showed a maximum displacement that was 29% shorter than controls and had an ROC area of 0.71. Laterality indices for speed and end total torque were correlated to the most affected side. Hand speed laterality index had an ROC area of 0.80 against healthy controls. DRT administration resulted in a significant reduction in a cumulative score of parameter Z-scores (a measure of global performance compared to healthy controls) in subjects with clinically effective levodopa doses. The cumulative score was also correlated to UPDRS scores for the effect of DRT. CONCLUSIONS Robotic assessment is able to objectively quantify parkinsonian symptoms of bradykinesia, rigidity and postural stability similar to the UPDRS. This integrated testing platform has the potential to aid clinicians in the management of PD and help assess the effects of novel therapies.

中文翻译：

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具有触觉控制功能的集成机器人平台可将帕金森氏病患者与控制对象区分开，并量化左旋多巴的运动影响。

背景技术使用集成的机器人技术来量化帕金森氏病（PD）的运动症状的频谱具有促进客观评估的潜力，该客观评估独立于临床评级。这项研究的目的是使用KINARM外骨骼机器人来（1）区分具有PD的受试者和对照组，以及（2）量化多巴胺替代疗法（DRT）的运动效果。方法对26名受试者（Hoehn和Yahr平均为2.2；病程为0.5至15年）进行评估（最后一次剂量> 12小时后），并使用统一帕金森氏病评分量表（UPDRS）和KINARM外骨骼评估其DRT机器人。使用重复性运动任务击中运动目标，被动性拉伸任务，双侧上肢运动迟缓，僵硬和姿势稳定性进行量化 和扭矩卸载任务。将性能与年龄匹配的健康对照进行比较。结果与对照组相比，PD OFF药物治疗对象的平均手速慢了41％，命中的目标减少了25％。指针速度的接收器工作特征（ROC）面积为0.94。与对照组相比，PD受试者在被动拉伸任务中停止肘部运动所需的扭矩降低了34％，ROC面积为0.91。扭矩卸载任务显示最大排量比对照组短29％，ROC面积为0.71。速度和末端总扭矩的横向指数与受影响最严重的一侧相关。相对于健康对照组，手速侧向指数的ROC面积为0.80。在临床上有效的左旋多巴剂量的受试者中，DRT给药导致参数Z分数的累积得分（与健康对照相比是一项整体绩效的衡量指标）的显着降低。累积分数还与DRT效果的UPDRS分数相关。结论机器人评估能够客观地量化类似于UPDRS的运动迟缓，僵硬和姿势稳定性的帕金森症状。这个集成的测试平台有潜力帮助临床医生进行PD的管理，并帮助评估新疗法的效果。结论机器人评估能够客观地量化类似于UPDRS的运动迟缓，僵硬和姿势稳定性的帕金森症状。这个集成的测试平台有潜力帮助临床医生进行PD的管理，并帮助评估新疗法的效果。结论机器人评估能够客观地量化类似于UPDRS的运动迟缓，僵硬和姿势稳定性的帕金森症状。这个集成的测试平台有潜力帮助临床医生进行PD的管理，并帮助评估新疗法的效果。