Clinical Validation Testing Of An Upper Limb Robotic Medical Education Training Simulator For Rigidity Assessment

Abstract

An upper limb robotic training simulator was developed to replicate the haptic feeling of lead-pipe rigidity of the biceps. Rigidity is the increased muscle tone observed during passive movement of a joint. To validate the realism of our training simulator, a clinical validation study was conducted with 11 experienced clinicians. Testing involved two parts: Blinded Assessment followed by Disclosed Assessment. There were 12 randomized trials (4 levels of rigidity with 3 repetitions each) in the Blind Assessment. The participants were asked to rate the rigidity level using the Unified Parkinson’s Disease Rating Scale (UPDRS) in each trial without knowing the selected UPDRS level. During the Disclosed Assessment, participants were informed about the selected level and were asked to closely evaluate the fidelity of each UPDRS level. Participants completed a post-test evaluation questionnaire to rate the simulator’s accuracy in replicating rigidity and its potential as a medical education tool for healthcare students. Results from the first six participants indicated that the simulated muscle resistance magnitude was too high compared to their clinical experience. Therefore, the resistance magnitude was reduced for all 4 UPDRS levels. The second set of five participants reported that the training simulator closely replicated the UPDRS levels of rigidity compared to their clinical experience.