An EMG-based system for continuous monitoring of clinical efficacy of Parkinson's disease treatments

Abstract

Current methods for assessing the efficacy of treatments for Parkinson's disease (PD) rely on physician rated scores. These methods pose three major shortcomings: 1) the subjectivity of the assessments, 2) the lack of precision on the rating scale (6 discrete levels), and 3) the inability to assess symptoms except under very specific conditions and/or for very specific tasks. To address these shortcomings, a portable system was developed to continuously monitor Parkinsonian symptoms with quantitative measures based on electrical signals from muscle activity (EMG). Here, we present the system design and the implementation of methods for system validation. This system was designed to provide continuous measures of tremor, rigidity, and bradykinesia which are related to the neurophysiological source without the need for multiple bulky experimental apparatuses, thus allowing more precise, quantitative indicators of the symptoms which can be measured during practical daily living tasks. This measurement system has the potential to improve the diagnosis of PD as well as the evaluation of PD treatments, which is an important step in the path to improving PD treatments.

Physical Activity in Ankylosing Spondylitis: evaluation and analysis of an eHealth tool

“…The challenges include selfassessment, which is subjective by nature and can therefore lack precision and allows for a range of interpretation and therefore no standardised approach to comprehending or responding to questions or inputting data,32 even when standardised collection tools (e.g. IPAQ) are utilised.…”

The past, present, and future of telemedicine for Parkinson's disease

“…In addition to improving care, the published literature actually has many reports on novel remote monitoring devices, beginning with a published report from 2002 on computer exercises that support the diagnosis of PD. 33 Additional remote monitoring devices that have been evaluated include wearable step counter 34 and gait sensors, 35 computer-based assessments of motor tasks (e.g., rapid alternating movements), [36][37][38] continuous electromyography, 39 noninvasive speech assessments, 40 and, more recently, smart phone applications that measure tremor, 41 among other symptoms. These studies have primarily assessed the validity and performance of remote assessments and have only recently linked remote monitoring to changes in care or in assessments of therapeutics for PD.…”

Using a Smart Phone as a Standalone Platform for Detection and Monitoring of Pathological Tremors

“…Patients can manually complete a diary of the evolution of their tremor over several days; however, they may have a difficult time accurately and objectively evaluating their own symptom severity and the effect of medication. Some quantitative methods were developed, such as an electromagnetic tracking device (O’Suilleabhain and Dewey, 2001), a mechanical linkage device on the fingertip (Matsumoto et al, 1999), lasers (Beuter et al, 1994), electromyography (Askari et al, 2010), wearable sensors (Chen et al, 2011), miniature gyroscopes (Salarian et al, 2007), digitizing tablets (Aly et al, 2007), a tremor pen (Papapetropoulos et al, 2010), and accelerometers (Barroso Junior et al, 2011). However, such devices are not readily available to patients or clinicians, they require technical expertise when manipulating hardware and analyzing results, and there are substantial costs associated with their purchase.…”