Parkinson’s disease: current assessment methods and wearable devices for evaluation of movement disorder motor symptoms - a patient and healthcare professional perspective

Abstract

Background Parkinson’s disease is the second most common long-term chronic, progressive, neurodegenerative disease, affecting more than 10 million people worldwide. There has been a rising interest in wearable devices for evaluation of movement disorder diseases such as Parkinson’s disease due to the limitations in current clinic assessment methods such as Unified Parkinson’s Disease Rating Scale (UPDRS) and the Hoehn and Yahr (HY) scale. However, there are only a few commercial wearable devices available, which, in addition, have had very limited adoption and implementation. This inconsistency may be due to a lack of users’ perspectives in terms of device design and implementation. This study aims to identify the perspectives of healthcare professionals and patients linked to current assessment methods and to identify preferences, and requirements of wearable devices. Methods This was a qualitative study using semi-structured interviews followed by focus groups. Transcripts from sessions were analysed using an inductive thematic approach. Results It was noted that the well-known assessment process such as Unified Parkinson’s Disease Rating Scale (UPDRS) was not used routinely in clinics since it is time consuming, subjective, inaccurate, infrequent and dependent on patients’ memories. Participants suggested that objective assessment methods are needed to increase the chance of effective treatment. The participants’ perspectives were positive toward using wearable devices, particularly if they were involved in early design stages. Patients emphasized that the devices should be comfortable, but they did not have any concerns regarding device visibility or data privacy transmitted over the internet when it comes to their health. In terms of wearing a monitor, the preferable part of the body for all participants was the wrist. Healthcare professionals stated a need for an economical solution that is easy to interpret. Some design aspects identified by patients included clasps, material choice, and form factor. Conclusion The study concluded that current assessment methods are limited. Patients’ and healthcare professionals’ involvement in wearable devices design process has a pivotal role in terms of ultimate user acceptance. This includes the provision of additional functions to the wearable device, such as fall detection and medication reminders, which could be attractive features for patients.

Screening of Parkinson’s Disease Using Geometric Features Extracted from Spiral Drawings

“…Furthermore, disease severity and progression are characterized using the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), which is also based on observation of clinical features associated with PD [3,4]. These types of assessments are subjective and prone to overlooking small changes in motor function that are representative of the disease, which poses challenges for PD screening [5]. This makes additional clinical tools that can be layered on to clinical evaluations by neurologists all the more critical [6].…”

Fading of brain network fingerprint in Parkinson’s disease predicts motor clinical impairment

“…Our results are in line with these findings and demonstrate that in PD, the connectome-based identifiability conveys the severity of the disease. Since the UPDRS is one of the most reliable and used motor scales in the clinical settings [33][34][35] , we believe that a scalar score, based on the whole connectome conveying subject-specific features of the brain functional connectivity may be of help in the management of the disease.…”

“…Then, we obtained the time series of 116 regions of interest (ROIs), based on the AAL atlas 45 , using the volume conduction model proposed by Nolte 46 , and applying the Linearly Constrained Minimum Variance 47 beamformer algorithm included in the Fieldtrip toolbox 42 . The resulting time series were band-pass filtered in each canonical frequency band (i.e., delta (0.5 -4 Hz), theta (4 -8 Hz), alpha (8 -13 Hz), beta (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30), and gamma (30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)). Only 90 ROIs were selected for further analysis, since we excluded ROIs related to the cerebellum because of low reliability.…”

Impact of Actual Use Behavior of Healthcare Wearable Devices on Quality of Life: A Cross-Sectional Survey of People with Dementia and Their Caregivers in Ghana

“…Due to issues of cognitive limitations and other risk factors associated with aging, studies have suggested that elderly users, especially PWDs exhibit resistance to the use of healthcare devices [ 2 , 13 ]. Notwithstanding the existence of these studies, other research and projects have demonstrated that, with the right approach to design considerations, this resistance could be reduced tremendously, leading to the adoption of wearable devices by PWDs [ 14 , 15 , 16 , 17 , 18 , 19 ]. For instance, studies have revealed that GPS-based wireless tracking devices, such as GPS Smart Sole, Freedom GPS Locator Watch, Safe-link, Mindme Locate, MXLOCareTM, iTraq3, and PocketFinder+, and others, such as Fitbit, Mi band, Oura ring, and Alice PDx, have been preferred and widely used by PWDs [ 20 ].…”