Feasibility of a Multimodal Telemedical Intervention for Patients with Parkinson’s Disease—A Pilot Study

Bendig, Jonas; Wolf, Anna-Sophie; Mark, Tony; Frank, Anika; Mathiebe, Josephine; Scheibe, Madlen; Müller, Gabriele; Stahr, Marcus; Schmitt, Jochen; Reichmann, Heinz; Loewenbrück, Kai F.; Falkenburger, Björn H.

doi:10.3390/jcm11041074

Cited by 17 publications

(14 citation statements)

References 42 publications

(47 reference statements)

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“…However, previous research assessing the feasibility of a DHTS in PwP found a completion rate between 62 and 68% over 6 and 13 weeks, respectively, in people mostly scoring II on the Hoehn & Yahr scale ( 43 ). Therefore, as previously done by others over longer time periods (12 weeks) in people with a median Hoehn & Yahr score of II, a completion rate of 68% was used as feasibility threshold in the present study ( 44 ). Here, this threshold was exceeded for all devices which was expected as the monitoring period was much shorter.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and usability of a digital health technology system to monitor mobility and assess medication adherence in mild-to-moderate Parkinson's disease

et al. 2023

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IntroductionParkinson's disease (PD) is a neurodegenerative disorder which requires complex medication regimens to mitigate motor symptoms. The use of digital health technology systems (DHTSs) to collect mobility and medication data provides an opportunity to objectively quantify the effect of medication on motor performance during day-to-day activities. This insight could inform clinical decision-making, personalise care, and aid self-management. This study investigates the feasibility and usability of a multi-component DHTS to remotely assess self-reported medication adherence and monitor mobility in people with Parkinson's (PwP).MethodsThirty participants with PD [Hoehn and Yahr stage I (n = 1) and II (n = 29)] were recruited for this cross-sectional study. Participants were required to wear, and where appropriate, interact with a DHTS (smartwatch, inertial measurement unit, and smartphone) for seven consecutive days to assess medication adherence and monitor digital mobility outcomes and contextual factors. Participants reported their daily motor complications [motor fluctuations and dyskinesias (i.e., involuntary movements)] in a diary. Following the monitoring period, participants completed a questionnaire to gauge the usability of the DHTS. Feasibility was assessed through the percentage of data collected, and usability through analysis of qualitative questionnaire feedback.ResultsAdherence to each device exceeded 70% and ranged from 73 to 97%. Overall, the DHTS was well tolerated with 17/30 participants giving a score > 75% [average score for these participants = 89%, from 0 (worst) to 100 (best)] for its usability. Usability of the DHTS was significantly associated with age (ρ = −0.560, BCa 95% CI [−0.791, −0.207]). This study identified means to improve usability of the DHTS by addressing technical and design issues of the smartwatch. Feasibility, usability and acceptability were identified as key themes from PwP qualitative feedback on the DHTS.ConclusionThis study highlighted the feasibility and usability of our integrated DHTS to remotely assess medication adherence and monitor mobility in people with mild-to-moderate Parkinson's disease. Further work is necessary to determine whether this DHTS can be implemented for clinical decision-making to optimise management of PwP.

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Section: Discussionmentioning

confidence: 99%

Feasibility and usability of a digital health technology system to monitor mobility and assess medication adherence in mild-to-moderate Parkinson's disease

et al. 2023

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“…During the COVID‐19 pandemic, in fact, the possibility of supporting patients with telerehabilitation protocols via mobile health, independent of their geographical location, could represent a positive opportunity, considering its accessibility and high motivational power based on the integration of playfulness and gamification 20–22 . Finally, mobile health is flexible, as its use is independent of time and place, and thus adaptable to the daily life of patients 23,24 . It should be considered that previous studies have reported that patients who consider therapy to be useful and motivating show greater therapeutic adherence and involvement in therapy, especially in distant rehabilitation 25,26 .…”

Section: Discussionmentioning

confidence: 99%

“… 20 , 21 , 22 Finally, mobile health is flexible, as its use is independent of time and place, and thus adaptable to the daily life of patients. 23 , 24 It should be considered that previous studies have reported that patients who consider therapy to be useful and motivating show greater therapeutic adherence and involvement in therapy, especially in distant rehabilitation. 25 , 26 Moreover, it has been demonstrated that the use of mobile health can improve functional outcomes, promoting the quality of life of patients, especially in PD.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and usability of a non‐immersive virtual reality tele‐cognitive app in cognitive rehabilitation of patients affected by Parkinson's disease

et al. 2022

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Background: Cognitive impairment is one of the most common non-motor features of Parkinson's disease (PD). The aim of the present study was to evaluate the feasibility and acceptability/usability of a protocol using a nonimmersive virtual reality tele-cognitive app, performed remotely in a sample of Italian patients with PD. Methods: Non-demented patients with mild PD were included in the study. Patients performed the cognitive rehabilitation in a remote way, at home (three training sessions lasting 20 min/week for 6 weeks) using the NeuroNation app, downloaded for free on the patients' smartphones. The usability and feasibility of the tele-cognitive rehabilitation program were assessed with the System Usability Scale (SUS) and the Goal Attainment Scaling (GAS). Results: Sixteen patients (9 men and 7 women; mean age 58.4 AE 8.3 years; mean disease duration 4.6 AE 2.1 years) were included in the study. At the end of the study, the mean SUS was 83.4 AE 11.5. The GAS score recorded at the end of the study (65.6 AE 4.2) was significantly higher than at baseline (38.5 AE 2.4; P-value <0.001). Conclusion:In our sample, good feasibility and usability were observed for a 6-week cognitive rehabilitation protocol based on the non-immersive virtual reality tele-cognitive app NeuroNation. Our data support the usefulness of cognitive rehabilitation performed in a remote way in PD patients.

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“…We assessed 3 eHealth solutions that use different paradigms: (1) guided measurements at specific time points by a camera system; (2) continuous, implicit monitoring of mobility by wearable sensors; and (3) a combination of guided and continuous measurements by a tablet app. The systems were described in detail previously [ 18 ].…”

Section: Methodsmentioning

confidence: 99%

Measuring the Usability of eHealth Solutions for Patients With Parkinson Disease: Observational Study

Bendig¹,

Spanz²,

Leidig³

et al. 2022

JMIR Form Res

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Background Parkinson disease (PD) is a neurodegenerative disorder with a variety of motor and nonmotor symptoms. Many of these symptoms can be monitored by eHealth solutions, including smartphone apps, wearable sensors, and camera systems. The usability of such systems is a key factor in long-term use, but not much is known about the predictors of successful use and preferable methods to assess usability in patients with PD. Objective This study tested methods to assess usability and determined prerequisites for successful use in patients with PD. Methods We performed comprehensive usability assessments with 18 patients with PD using a mixed methods usability battery containing the System Usability Scale, a rater-based evaluation of device-specific tasks, and qualitative interviews. Each patient performed the usability battery with 2 of 3 randomly assigned devices: a tablet app, wearable sensors, and a camera system. The usability battery was administered at the beginning and at the end of a 4-day testing period. Between usability batteries, the systems were used by the patients during 3 sessions of motor assessments (wearable sensors and camera system) and at the movement disorder ward (tablet app). Results In this study, the rater-based evaluation of tasks discriminated the best between the 3 eHealth solutions, whereas subjective modalities such as the System Usability Scale were not able to distinguish between the systems. Successful use was associated with different clinical characteristics for each system: eHealth literacy and cognitive function predicted successful use of the tablet app, and better motor function and lower age correlated with the independent use of the camera system. The successful use of the wearable sensors was independent of clinical characteristics. Unfortunately, patients who were not able to use the devices well provided few improvement suggestions in qualitative interviews. Conclusions eHealth solutions should be developed with a specific set of patients in mind and subsequently tested in this cohort. For a complete picture, usability assessments should include a rater-based evaluation of task performance, and there is a need to develop strategies to circumvent the underrepresentation of poorly performing patients in qualitative usability research.

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Feasibility of a Multimodal Telemedical Intervention for Patients with Parkinson’s Disease—A Pilot Study

Cited by 17 publications

References 42 publications

Feasibility and usability of a digital health technology system to monitor mobility and assess medication adherence in mild-to-moderate Parkinson's disease

Feasibility and usability of a digital health technology system to monitor mobility and assess medication adherence in mild-to-moderate Parkinson's disease

Feasibility and usability of a non‐immersive virtual reality tele‐cognitive app in cognitive rehabilitation of patients affected by Parkinson's disease

Measuring the Usability of eHealth Solutions for Patients With Parkinson Disease: Observational Study

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