Objective assessment of bradykinesia in Parkinson's disease using a serious game

Abstract

Abstract Background: Bradykinesia is the main motor symptom of Parkinson's disease (PD). Its clinical assessment is based on scales, such as the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS). However, this type of assessment has limitations, such as subjectivity and dependence on experienced assessors. Hence, this study aimed to objectively assess bradykinesia using a bee-themed serious game, so-called RehaBEElitation. Methods: The experimental and control groups (EG and CG) consisted of fifteen individuals with PD in the ON and OFF states of medication, as well as fifteen healthy people, respectively, with matched ages and sexes. Bradykinesia was evaluated by detecting the voluntary movement of the gyroscope signals using Singular Spectrum Analysis (SSA), a time series decomposition method. The response time (RT) and angular velocity (AV) of the participants while playing RehaBEElitationwere estimated. The Kruskal Wallis test and Wilcoxon test with Bonferroni correction were used to confirm the differences between groups. Results: The EG-OFF and CG participants who showed the worst results for RT also showed the worst results for AV, which reveals the consistency of the variables used to evaluate bradykinesia. Significant differences were found between groups for all comparisons (p<0.05). In most phases, CG participants obtained the best results for RT and AV, followed by EG-ON and then EG-OFF. Conclusion: The RehaBEElitationserious game is an alternative tool for assessing the main motor symptom of PD in an objective and entertaining way. In general, the EG participants in the OFF state showed increased bradykinesia compared to the ON state.