Continuous in-home monitoring of essential tremor

Abstract

Background Essential tremor (ET) is typically measured in the clinic with subjective tremor rating scales which require the presence of a clinician for scoring and are not appropriate for measuring severity throughout the day. Motion sensors can accurately rate tremor severity during a set of predefined tasks in a laboratory. Methods We evaluated the ability of motion sensors to quantify tremor during unconstrained activities at home. 20 ET subjects wore a wireless sensor continuously for up to 10 hours daily on two days and completed hourly standardized tremor assessments involving pre-defined tasks. Mathematical models were used to predict tremor rating scores from the sensor data. Results At home tremor scores from hourly standardized assessments correlated with at home tremor scores estimated during unconstrained activities immediately following the standardized assessments. The hourly standardized assessments did not significantly fluctuate throughout the day, while fluctuations in the continuous assessments tended to follow changes in voluntary activity level. Both types of tremor ratings (standardized and continuous) showed high day-to-day test-retest reliability with intraclass correlation coefficients ranging from 0.67 to 0.90 for continuous ratings and 0.77 to 0.95 for standardized ratings. Conclusions Results demonstrate the feasibility of continuous monitoring of tremor severity at home, which should provide clinicians with a measure of the temporal pattern of tremor in the context of daily life and serve as a useful tool for the evaluation of novel anti-tremor medications in clinical trials.

Novel Methods and Technologies for 21st-Century Clinical Trials

“…Wearable sensors can now monitor tremor for as long as 10 hours daily. 34 Remote measurement of daily computer use can detect mild cognitive impairment, 35 and smartphones can map out the geographic area where individuals with Parkinson disease live. 36 Potentially more powerful applications are on the horizon.…”

More Time with Tremor: The Experience of Essential Tremor Versus Parkinson's Disease Patients

“…In both disorders, tremor has the potential to appear at various points during the day, emerging during a variety of daily activities. For patients with tremor, there is considerable variability from moment to moment as well as variability from one day to another …”

“…For patients with tremor, there is considerable variability from moment to moment as well as variability from one day to another. 7,8 Despite the common knowledge that a variety of tremors occur in both ET and PD, there is surprisingly little written about the experience of tremor from the perspective of the patient. There are numerous unanswered questions.…”

Blockchain-based Personal Health Data Sharing System Using Cloud Storage

“…To handle such large amount of data, advanced tools, like data-mining and machinelearning are necessary. The research about analyzing big data produced by wearable devices has been a hot topic for many years [16], [17], [18], [19], [20]. For example, the study of [21] used the acceleration data collected from a smart watch to evaluate the tremor level of patients with Essential Tremor.…”