BackgroundMost studies of smartphone-based assessments of motor symptoms in Parkinson’s disease (PD) focused on gait, tremor or speech. Studies evaluating bradykinesia using wearable sensors are limited by a small cohort size and study design. We developed an application named smartphone tapper (SmT) to determine its applicability for clinical purposes and compared SmT parameters to current standard methods in a larger cohort.MethodsA total of 57 PD patients and 87 controls examined with motor UPDRS underwent timed tapping tests (TT) using SmT and mechanical tappers (MeT) according to CAPSIT-PD. Subjects were asked to alternately tap each side of two rectangles with an index finger at maximum speed for ten seconds. Kinematic measurements were compared between the two groups.ResultsThe mean number of correct tapping (MCoT), mean total distance of finger movement (T-Dist), mean inter-tap distance, and mean inter-tap dwelling time (IT-DwT) were significantly different between PD patients and controls. MCoT, as assessed using SmT, significantly correlated with motor UPDRS scores, bradykinesia subscores and MCoT using MeT. Multivariate analysis using the SmT parameters, such as T-Dist or IT-DwT, as predictive variables and age and gender as covariates demonstrated that PD patients were discriminated from controls. ROC curve analysis of a regression model demonstrated that the AUC for T-Dist was 0.92 (95% CI 0.88–0.96).ConclusionOur results suggest that a smartphone tapping application is comparable to conventional methods for the assessment of motor dysfunction in PD and may be useful in clinical practice.
A mobile application named HLTapper was designed for Android mobile phones to collect and assess real-time alternating finger tapping movement data such as mean tapping speeds, temporal variations of tapping intervals, horizontal tapping variances, and vertical tapping variances, from built-in sensors while a subject performs the finger tapping movement task according to directions given through the application interface. The results of a controlled experiment (40 subjects including nine subjects with Parkinson disease, 11 healthy age-matched subjects, and 20 healthy young subjects) and a discriminant analysis revealed sensitivity of 85.71% and specificity of 91.42%, on an average, which suggests that HLTapper would be useful for early diagnosis and personalised treatment plan adjustments of patients with Parkinson disease.
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