The use of "EMG driven" nueromusculoskeletal modeling in the evaluation of the effects of rehabilitation in Parkinson's disease.

The aim of this thesis is to perform a comparison between an innovative exoskeleton based robotic therapy (Eksobionics) and other conventional therapies on Parkisnon’s disease subjects. To this end an innovative approach to assess the impact of the treatments is proposed which involves in terms of neuro-muscle-skeletal (NMS) models combined with surface electromyography (sEMG) (i.e. EMG-driven musculoskeletal models). The advantage of this methodology is the possibility to estimate internal variables such as muscle forces in dynamic conditions (i.e. gait) and to base subjects assessment on these parameters. In the current work, these internal variables are used to compare the neuromuscular profile of people with Parkinson's disease before and after a rehabilitation intervention with a wearable robotic device (Ekso). In particular a sample of Parkinsonian subjects were acquired at Villa Margherita Fresco Parkinson Foundation (Vicenza) in collaboration with BiomovLab (University of Padova) within the research project “Quantitative assessment of training effects using a wearable exoskeleton in Parkinson's disease patients”. To realize this target, data from several gait cycles acquired simultaneously through a stereophotogrammetric system, force plates and surface electromyographic devices must be processed. The data pre-processing has a predefined pipeline that includes several steps: it is necessary to obtain data in compatible formats with OpenSim via a Matlab toolbox (MOtoNMS); then, through Opensim scaling, muscle analysis, inverse kinematics and inverse dynamics are carried on. Finally, in CEINMS the model associated with the subject must be calibrated, and then muscle forces and activations through Matlab are computed. The final step will be to compare the pre-treatment and post-treatment data. In addition, data from people with Parkinson's will be compared with data from a population of normal subjects with the same age and body mass index to evaluate the overall effect of the therapy on restoring a more functional gait pattern.