Feasibility and Initial Effects of One Session of Robot-Assisted Therapeutic Exercises for People With Parkinson’s Disease: A Pilot Study

Research Objectives: To investigate if robot-assisted therapeutic exercise is safe, feasible and satisfactory by examining initial physiological and biomechanical effects in people with Parkinson’s disease (PD). To guide development of robotic exercise systems for people with PD to improve exercise efficacy.

Design: Observational one group cohort study.

Setting: Wesley Woods Health Center on the Emory University campus in a movement laboratory assessment room.

Participants: 10 people with mild-moderate PD (5 women; Hoehn & Yahr range: 1-2.5, age: 69±5.7 years) participated.

Interventions: In one visit, participants completed the forward standing reach (FSR) (pre and post), and a 1-hour session of six exercises that increased in difficulty, aimed at increasing motor control and range of motion, led by a custom programmed robot (Hello Robot Stretch, Inc.) and supervised by staff. Participants wore a heart rate (HR) monitor. They were checked for HR and asked their rate of perceived exertion (RPE) before exercise, and after the 3rd and 6th exercise.

Main Outcome Measures: Change in FSR distance, RPE, and HR pre to post.

Results: 7 of 10 participants increased their FSR distance at session end compared to the start (Average increase: 0.040±0.046m). Participants reported increased RPE from start to end (1.6 RPE at beginning; 3.7 at midpoint, and 6.6 at end). HR increased from pre-exercise (86±8 beats per minute (bpm)) to the midpoint (90±12 bpm) for 7 participants. All participants showed an increased HR at the end (108±13 bpm) compared to the start of the session.

Conclusions: A robot-assisted exercise program with staff support is safe and feasible for people with PD. Average exercise intensity (HR and RPE) was moderate (40-65% of HR max) for 8 of 10 participants and was vigorous (>65% HR max) for 2 participants. The increase in intensity is likely due to the more challenging exercises being in the second half. Participants increased their FSR reach distance indicating improved mobility. More development is warranted.

Author(s) Disclosures: Dr. Kemp is a cofounder, a board member, an equity holder, and the CTO of Hello Robot, Inc.