THE ROBOTIC THERAPY: THE ASSESSMENT OF AN ACTVE ORTHOSIS FOR THE REHABILITATION OF FLEXION AND EXENTION OF THE WRIST FOR PARKINSON'S DISEASE PATIENTS
Creators: name: MEKAOUI, Amel
Publisher: name: Zenodo
Year: 2020
Subjects: Parkinson's disease
Orthesis
Rehabiliation

description: The Parkinson disease is a neurodegenerative disease that affects the central<br> nervous system. It is a progressive, chronic movement disorder that affects the<br> control of muscle and balance. Parkinson [1] is a progressive disease because it<br> progresses with time, and it is a neurodegenerative disease because during the<br> disease there is a loss of neurons in the brain. There is a loss of particular kind of<br> neuron: the dopamine neurons. These neurons make a little chemical signal called<br> dopamine and allowed us to make normal movement. This dopamine neurons live<br> in the substantia nigra, an area of the brain. When the dopamine neurons are lost,<br> there is a reduction in the amount of dopamine in the brain and we can start to<br> see the main movement signs of Parkinson’s disease. The dopamine neurons are<br> used to make a lot of our dopamine and in the Parkinson’s disease case there are<br> not in the substantia nigra situated in the midbrain yet. And when there is a<br> reduction in dopamine, the main symptom of Parkinson’s disease start. Without dopamine, the synapse doesn’t work and the mains signs of Parkinson’s<br> disease start to appear.<br> The first sign is the shakiness, which can be a form of tremor focus in the hand<br> and the fingers. There are two types of tremor: the resting tremor and the action<br> tremor. The resting tremor is the most common in Parkinson’s disease. We can<br> see the combination of both of them in a patient. The character of the tremor can<br> change during the illness.<br> The second sign is the stiffness, or we can say rigidity. It is felt when the patient<br> bends part of their body. This sign concerns the arm, the wrist or the leg. When<br> this sign appears, the movement of the body become not smooth, not fluid<br> anymore it feels really rigid like there is a resistance in the body motion.<br> A third main sign is the bradykinesia. It is a kind of slowed-down movements. This<br> symptom takes the patient longer to complete a movement. It concerns the muscle<br> of the body, we can see a slowness of voluntary movement. The particularity of<br> this sign is that the patient can do the movement, is just that it takes a lot longer<br> for them to do it.<br> We can talk about the problems with balance for the fourth sign of Parkinson’s<br> disease. The patient feels unsteady or really unstable when he walks around or<br> stands. This postural instability occurred in the third stage of Parkinson’s disease,<br> it is a later consequence.<br> Furthermore, all the patient with the Parkinson’s disease have all of these signs.<br> The combination of the symptom depends of the sexes, age, stage of the patient.<br> The causes of Parkinson’s disease are not known for most of the case, these cases<br> are called idiopathic cases. It is mean that the cause is unknown yet.<br> Therapy:<br> There are different ways for dumping the Parkinson’s disease symptoms. We can<br> put forward three groups of treatment:<br> 7<br> - Drugs<br> - Surgery<br> - Rehabilitation<br> First of all, the obvious treatment of Parkinson’s disease must involve medication:<br> the way of many medications work is by replacing dopamine in the brain or<br> increasing it inside because the cell producer of dopamine has degenerated during<br> the disease. We can note some common drugs for this treatment: dopaminergic,<br> antiglutamatergic, anticholinergic.<br> When patients have this disease for several years, the medication doesn’t work<br> anymore. The next step of treatment is the surgery.<br> The aim of the surgery is to disable areas in the brain that are causing the problems<br> of movement, like the tremor. But the Parkinson’s disease is a progressive disease,<br> it mains that it will continue to develop with time. The most common kind of<br> surgery is the pallidotomy, or the deep brain stimulation (DBS). This procedure<br> consists by implanting electrical stimulators in the midbrain. The results are<br> excellent for some years.<br> The medication therapy and surgery therapy cannot stop the disease, these<br> methods can just be helpful for managing the symptoms and making the patient<br> has a better quality of life for as long as possible.<br> Then, in the aim to increase the movement habilitation of the patient, there are<br> some methods to help the patient to gain physicals abilities. We can note the<br> physical therapy, the speech therapy nor the robotic therapy.<br> This last method is a safe way to help patient with Parkinson’s disease and it allows<br> an intensive rehabilitation. The robotic therapy is used for individuals with light or<br> severe motor deficits.