Parkinson’s disease and rehabilitation

Parkinson’s disease (PD) is a neurodegenerative disorder of unknown cause that particularly affects areas of the brain which are involved in movement control. Because PD is a neurological disorder with progressive disability over time, the merits of rehabilitation have been questioned. In the past two decades, there was a shift due to evidence that the brain affected by PD may be capable of plasticity, and brain activity patterns may be altered with appropriate intensive training. Research studies confirm the value of motor learning in PD, as well as showing improvements as a result of training.  CuPiD will develop innovative rehabilitation based on new technology, the patient's needs, the principles of motor learning in PD. CuPiD will contribute to the challenge of engaging patients with a chronic neurodegenerative disease in intensive exercise for a considerable length of time.

CuPiD promotes patients’ independence by providing home-based training. For this to be effective, CuPiD will monitor and record remotely a patient’s activity in training and clinicians will be able to supervise their progression, change the training to fit an individual’s needs and assess problems that occur using a computer interface.

CuPiD’s three services:

  1. Exergaming which will provide audio, visual and tactile feedback while the patients train using different simulations. This training requires integration of cognitive (attention, decision making) and motor function in a motivating and engaging environment.
  2. Provision of external cues to avert freezing of gait (FOG) and training of its prevention. (Can include outdoor usage)
  3. Biofeedback device for training of daily activities; the device will be portable and able to provide audio, visual and tactile feedback for the training of motor / cognitive functions. (can be used outdoors)

CuPiD will develop and validate a personal health service with:

Exergaming. This is a powerful tool for repetitive practice of motor function, providing feedback about performance and motivation for patients.

Wearable components. These will be connected to a exergaming simulation whose feedback will enhance training.

CuPiD will provide targeted care to improve motor function, reduce disability and social isolation of a wide variety of users with PD.  

Freezing of gait is a gait disturbance which is seriously debilitating. During FOG episodes the subject often perceives complete inability to continue walking.  FOG episodes increase the risk for falls, and have a considerable negative impact on quality of life. CuPiD will offer a device which will realize freezing of gait rehabilitation by predicting onset of a freezing episode and provide feedback shortly before the freeze. This can be used by a trained patient to consciously balance his / her body weight, thus providing assistance in case of freeze. Through repeated occurrences, the patients will internalize this feedback process, learning to overcome and manage freezing episodes.

In the first half of the project, configurations of sensors will be tested to increase knowledge of their specific applications. Tests will include wearable sensors, motor-task identification, efficacy of feedback restitution, real-time biofeedback, interface development and exergaming based simulation.

The second half of the project consists of a large validation campaign to allow accurate evaluation of the services in terms of:i) feasibility; ii) integration with healthcare institutions; iii) efficacy of intervention; iv) satisfaction of all users.