GSO4SCHOOL Summer School 2020
Parkinson’s disease (PD) is one of the four most common neurodegenerative diseases of the elderly. The World Health Organization estimate that about 5 million people worldwide suffer from the disease. PD is a relentlessly progressive, incurable, neurological disorder in which the neurotransmitter ‘dopamine’ is depleted in certain regions of the brain.
The result is a progressive and insidious deterioration in many of the control loops and feed-back systems within the central nervous system, principally those connected with movement. This affects balance, gait, arm and facial movements. Motor blocks (freezing) most commonly affect an individual’s legs during walking and is generally referred to as freezing of gait.
Greater depression and lesser quality of life are also found among those who have a history of falls, gait disturbances, and akinesia and rigidity especially if they subsequently experience further decline in physical mobility, emotional reactions, pain, and social isolation.
People with akinesia due to PD often continue to experience gait impairment even with current medical treatments. Pharmacological management of PD is difficult and often ineffective at relieving the freezing of gait. The problem is even bigger given the fact that 80% of patients with occasional or frequent episodes of freezing also experienced falls, while these falls are the second more common cause of death among PD patients.
The answer to the problem
Strangely how, but when a visual “obstacle” appears on their way certain patients start to walk normally. This phenomenon is known as “kinesia paradoxa” that has been well documented in the literature. These visual “obstacles” often called “visual cues”, might be a line of line of ordinary playing cards, spaced at intervals equal to or slightly greater than the patient’s normal walking stride length, and positioned so as to align with his/her intended vector of gait.
Since the existing medications does not always effectively address the symptoms of gait disturbance, due to the fact that people with PD can also be prone to transient and unpredictable “ON/OFF” cycles, wherein medication becomes less effective at treating symptoms, giving periods of effectively controlled symptoms (ON) and periods of severe symptoms (OFF), non-pharmacological approaches are more necessary for akinesia, including the use of external sensory cues to help the patient to effectively deal with the mobility problems.
What we need is some kind of device (e.g. a pair of spectacles – glasses) that could provide visual cues and audio cues in a format that can be taken into many environments, including the community.
The technology
The technology is finally mature enough to support the development of a light wearable device which could generate visual cues in an augmented reality environment, supporting the proper motion of the patient in any real environment.
An important issue which is studied in depth concerns the size of such a device. So that it will not be heavy, technologically intimidating and socially isolating. For this reason, ways were sought to make the equipment more ergonomic and to remove the need of the user to wear a headset that covers most of their face. People with Parkinson are already coping with so much in order to avoid social isolation as a result of the motor symptoms and other behaviours such as drooling and tremor which they have no control over. The last thing they want is a system of cueing which is so obvious it adds to people’s overall embarrassment.
The technology is here! Smart glasses are expected to gain a lot of momentum as “wearable computing” takes root in the consumer market. Eyewear computers are claimed to be the next evolution beyond smartphones. Some of them work as smart phones, other as hands-free monitor. Wearable computing is still quite novel but as more people buy into the technology and start to wear it out and about for leisure then such systems offer us a real opportunity for the long-term treatment of progressive conditions.
The approach
The PAN ANTISTIXIS team, in collaboration with experts in PD, is developing a technologically advanced and low cost device to support the people with Parkinson’s disease in successful overcoming the phenomenon of freezing (kinesia paradoxa) without external aid. The device aims at reducing the number and length of their motorblocks, and thus, increases their safety while walking. It will include a virtual reality application and it will use smart glasses for the projection of the visual cues.
PAN ANTISTIXIS decided to develop our own device instead of creating just a software application for smart phones for the following reasons:
While the people with PD use mobile phones, they become deeply frustrated by an inability to manipulate them (e.g. touch screens) due to hand tremors.
The need to use specific sensors to detect freezing of gait events in order to provide support only during an actual event of “frozen gait”. The device acts as a context-aware wearable assistant that activates only when necessary and remains transparent in the other situations.
For this reason the device shall be able to include algorithms (such as power spectral density) to detect the events online and provide the assistance, while at the same consume low energy and be able to run on its battery for >8h.
The need to record a vast amount of real-time data for off-line analysis using data mining and signal processing algorithms in order to analyse real-world performance.
PAN ANTISTIXIS produces a device which includes all the aforementioned characteristics and above all it is totally discrete. The device meets all the requirements for improving the quality of life of people with Parkinson’s disease.
The device
PAN ANTISTIXIS developed a technologically advanced and low cost device to support the people with Parkinson’s disease in successful overcoming the phenomenon of freezing (kinesia paradoxa) without external aid. The device aims at reducing the number and length of their motorblocks, and thus, increases their safety while walking.
The device, which is using embedded 9-axes motion sensors, namely gyroscope, accelerometer, compass and 3D magnetometers in order to measure body motion. It also uses a powerful processor for implementing demanding motion analysis algorithms and for generating the visual cues. It is connected to smart transparent glasses using WIFI technology in order to display the visual cues. Furthermore, the software supports the continuous recording and analysis of patient’s motion so that the physician may have accurate information concerning the effect of the device. The device meets the following conditions:
- Low cost of purchase: 200 to 400 €
- Simplicity in construction: simple design and proven technology that is easy to maintenance and to expand
- Portability: really small and very light (similar to a smartphone)
- Ease of use: can be easily used by anyone without complicated and abstruse instructions
- Functionality: provides a wide range of settings that fit each patient
- Connectivity: uses open communication protocols (uIP/IwIP) as well as WIFI technology.
More information:
www.pan-antistixis.com
info@pan-antistixis.gr
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