A novel method for systematic analysis of rigidity in Parkinson's disease

We propose a novel system that analyzes the components of rigidity in Parkinson's disease (PD) usually perceived by physicians, in a very simple and systematic way for routine clinical practice. Our system is composed of two compact force sensors, a gyroscope, and EMG surface electrodes. Muscle tone was assessed in 24 healthy elderly subjects and 27 PD patients by passive extension and flexion of the elbow joint with ramp-and-hold trajectory. Torque and angle data in the dynamic phase were used to calculate "elastic coefficients" in extension and flexion, and the mean value of torque in each dynamic phase at each joint angle (defined as "Bias") was also calculated. The muscle activity index in the static phase (EMG Index) was obtained for both biceps brachii (BB) and triceps brachii (TB) muscles. "Elastic coefficients," sum of the "difference of Bias" and "EMG Index" for BB all correlated well with UPDRS score. Based on our results, Parkinsonian rigidity consists of both an "elastic" component and a "difference of Bias" component, and neurologists may assess greater rigidity when either one or both components are high in value. The EMG index was useful for differentiating PD patients with slight rigidity from healthy elderly adults.