BackgroundIn the last decades, several studies showed that wearable sensors, used for assessing Parkinson’s disease (PD) motor symptoms and recording their fluctuations, could provide a quantitative and reliable tool for patient’s motor performance monitoring.ObjectiveThe aim of this study is to make a step forward the capability of quantitatively describing PD motor symptoms. The specific aims are: identify the most sensible place where to locate sensors to monitor PD bradykinesia and rigidity, and identify objective indexes able to discriminate PD OFF/ON motor status, and PD patients from healthy subjects (HSs).MethodsFourteen PD patients (H&Y stage 1–2.5), and 13 age-matched HSs, were enrolled. Five magneto-inertial wearable sensors, placed on index finger, thumb, metacarpus, wrist, and arm, were used as motion tracking systems. Sensors were placed on the most affected arm of PD patients, and on dominant hand of HS. Three UPDRS part III tasks were evaluated: rigidity (task 22), finger tapping (task 23), and prono-supination movements of the hands (task 25). A movement disorders expert rated the three tasks according to the UPDRS part III scoring system. In order to describe each task, different kinematic indexes from sensors were extracted and analyzed.ResultsFour kinematic indexes were extracted: fatigability; total time; total power; smoothness. The last three well-described PD OFF/ON motor status, during finger-tapping task, with an index finger sensor. During prono-supination task, wrist sensor was able to differentiate PD OFF/ON motor condition. Smoothness index, used as a rigidity descriptor, provided a good discrimination of the PD OFF/ON motor status. Total power index, showed the best accuracy for PD vs healthy discrimination, with any sensor location among index finger, thumb, metacarpus, and wrist.ConclusionThe present study shows that, in order to better describe the kinematic features of Parkinsonian movements, wearable sensors should be placed on a distal location on upper limb, on index finger or wrist. The proposed indexes demonstrated a good correlation with clinical scores, thus providing a quantitative tool for research purposes in future studies in this field.
BackgroundLack of social skills and/or a reduced ability to determine when to use them are common symptoms of Autism Spectrum Disorder (ASD). Here we examine whether an integrated approach based on virtual environments and natural interfaces is effective in teaching safety skills in adults with ASD. We specifically focus on pedestrian skills, namely street crossing with or without traffic lights, and following road signs.MethodsSeven adults with ASD explored a virtual environment (VE) representing a city (buildings, sidewalks, streets, squares), which was continuously displayed on a wide screen. A markerless motion capture device recorded the subjects’ movements, which were translated into control commands for the VE according to a predefined vocabulary of gestures. The treatment protocol consisted of ten 45-minutes sessions (1 session/week). During a familiarization phase, the participants practiced the vocabulary of gestures. In a subsequent training phase, participants had to follow road signs (to either a police station or a pharmacy) and to cross streets with and without traffic lights. We assessed the performance in both street crossing (number and type of errors) and navigation (walking speed, path length and ability to turn without stopping).To assess their understanding of the practiced skill, before and after treatment subjects had to answer a test questionnaire. To assess transfer of the learned skill to real-life situations, another specific questionnaire was separately administered to both parents/legal guardians and the subjects’ personal caregivers.ResultsOne subject did not complete the familiarization phase because of problems with depth perception. The six subjects who completed the protocol easily learned the simple body gestures required to interact with the VE. Over sessions they significantly improved their navigation performance, but did not significantly reduce the errors made in street crossing. In the test questionnaire they exhibited no significant reduction in the number of errors.However, both parents and caregivers reported a significant improvement in the subjects’ street crossing performance. Their answers were also highly consistent, thus pointing at a significant transfer to real-life behaviors.ConclusionsRehabilitation of adults with ASD mainly focuses on educational interventions that have an impact in their quality of life, which includes safety skills. Our results confirm that interaction with VEs may be effective in facilitating the acquisition of these skills.Electronic supplementary materialThe online version of this article (doi:10.1186/s12984-015-0010-z) contains supplementary material, which is available to authorized users.
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