Functional improvement of patients with Parkinson syndromes using a rehabilitation training software

Marcus Barth; Robert Möbius; Peter Themann; Erdem Güresir; Cornelia Matzke; Dirk Winkler; Ronny Grunert

doi:10.3389/fneur.2023.1210926

Functional improvement of patients with Parkinson syndromes using a rehabilitation training software

Front Neurol. 2023 Aug 14:14:1210926. doi: 10.3389/fneur.2023.1210926. eCollection 2023.

Authors

Marcus Barth¹, Robert Möbius¹, Peter Themann², Erdem Güresir¹, Cornelia Matzke¹, Dirk Winkler¹, Ronny Grunert^{1

3}

Affiliations

¹ Department of Neurosurgery, Faculty of Medicine, Leipzig University, Leipzig, Germany.
² Clinic at Tharandter Forest, Department of Neurology and Parkinson, Halsbruecke, Germany.
³ Department of Medical Engineering, Fraunhofer-Institute for Machine Tools and Forming Technology, Dresden, Germany.

Abstract

Introduction: Individuals with Parkinsonian disorders often face limited access to specialized physiotherapy and movement training due to staff shortages and increasing disease incidence, resulting in a rapid decline in mobility and feelings of despair. Addressing these challenges requires allocating adequate resources and implementing specialized training programs to ensure comprehensive care and support. Regarding these problems, a computer software was invented that might serve as an additional home-based extension to conventional physiotherapy.

Methods: The trial took place in a rehabilitation center where every patient received equivalent treatment apart from the training program that was set up to be investigated over 3 weeks. Seventy four Patients were included and randomized between two intervention and one control group. Intervention group 1 (IG1) trained with the computer-based system two times a week while Intervention group 2 (IG2) received five training sessions a week. Using the markerless Microsoft Kinect® camera, participants controlled a digital avatar with their own body movements. UPDRS-III and Clinical measurements were performed before and after the three-week period.

Results: Patients in all groups improved in UPDRS-III pre and post intervention whereas reduction rates were higher for IG1 (-10.89%) and IG2 (-14.04%) than for CG (-7.74%). Differences between the groups were not significant (value of ps CG/IG1 0.225, CG/IG2 0.347). Growth rates for the arm abduction angle were significantly higher in IG1 (11.6%) and IG2 (9.97%) than in CG (1.87%) (value of ps CG/IG1 0.006 and CG/IG2 0.018), as was the 5-steps-distance (CG 10.86% vs. IG1 24.5% vs. UG2 26.22%, value of ps CG/IG1 0.011 and CG/IG2 0.031).

Discussion: The study shows the beneficial effects of computer-based training and substantiates the assumption of a similar impact in a home-based setting. The utilized software is feasible for such interventions and meets with the patient's approval. Group dynamics seem to have an additional supporting effect for the aspired objective of improving mobility and should be seen as an essential aspect of video games in therapy.

Keywords: Exergame; Kinect; Parkinson’s disease; home-based; markerless; movement training; physiotherapy; rehabilitation.