Objective: To evaluate the capacity of upper limb kinematic measures, collected using wearable technology, in (a) capturing clinical rigidity in Parkinson’s disease (PD) and (b) assessing the effect of dopaminergic medication.

Background: Upper limb rigidity is a hallmark of PD, impacting manual dexterity and daily activities. Currently, rigidity is clinically evaluated using the Movement Disorder Society–Unified Parkinson’s Disease Rating Scale III (MDS-UPDRS III) in clinic. Wearable technology offers a potential to objectively and unobtrusively monitor upper limb rigidity during walking.

Method: 48 PD participants from the OxQUIP Study completed a two-minute walking task while wearing sensors on both wrists and the trunk. The task was performed in both off- and on-dopaminergic medication states. Clinical rigidity was assessed using MDS-UPDRS III prior to the task. Arm swing velocity and arm range of motion (ROM) of the most and the least affected arm (ipsilateral and contralateral respectively), were analysed to explore correlations with clinical rigidity scores and assess the effects of levodopa. Spearman’s rank correlation was used to assess associations between kinematic measures and rigidity scores, and Friedman tests with post-hoc Wilcoxon signed-rank tests were applied to evaluate medication effects.

Results: Both arm swing velocity (p<0.05) and ROM (p<0.001) were significantly lower in the ipsilateral arm compared to the contralateral arm. In the contralateral arm, greater clinical rigidity correlated with lower arm swing velocity (p<0.01) and lower arm ROM (p<0.05), whilst no such correlation was observed in the ipsilateral arm. Following levodopa challenge, arm ROM improved in both the ipsilateral (p<0.001) and contralateral arm (p<0.05), whilst arm velocity improved in only the contralateral arm (p<0.01).

Conclusion: Wearable sensor-derived kinematic measures successfully distinguished between the more and less affected arms in PD. The contralateral arm showed a significant relationship between kinematic metrics and clinical rigidity scores, and both arms demonstrated responsiveness to medication. These findings support the feasibility of using wearable technology for objective rigidity assessment and medication response monitoring in PD, providing proof-of-concept for its potential clinical application.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/identification-of-rigidity-in-parkinsons-disease-using-wearable-technology/