iHandU Simulator - Towards a medical education tool for wrist rigidity assessment

Abstract

During Deep Brain Stimulation (DBS) surgery, electrodes are implanted in the patient's brain in order to alleviate motor symptoms of common disorders such as Essential Tremor (ET) and Parkinson's Disease (PD). Stimulation parameters and electrode position are adjusted during surgery, chosen in order to obtain the best improvement in the patient's symptoms. The most commonly assessed symptom is muscular rigidity, which is characterized by an increased resistance to movement marked by a permanently elevated muscle contraction in response to a passive stretch. The assessment typically results from a series of flexions and extensions of a chosen joint, and consists of a qualitative improvement given according to a subjective scale, which is susceptible to errors, and has a verified lack of consistency among different clinicians. Robotic simulation of this behavior is of interest not only as a way to develop an educational tool for a unified method of rigidity assessment, but also in the context of aiding the development of decision support systems such as the iHandU, a wearable device in development at INESC-TEC.