Tailoring the use of wearable systems and telehealth for Parkinson's disease

Peacock, Dakota; Yoneda, Joshua; Thomson, Vanessa; Wile, Daryl

doi:10.1016/j.parkreldis.2021.07.004

“…In recent years, small sensors that can be attached to the body to acquire biological data, called “wearable devices,” have been used extensively worldwide [ 1 ]. Wearable devices are utilized in clinical research as well as in Human–Computer Interaction (HCI) areas in many medical and healthcare fields including neurology [ 2 ], cardiology [ 3 ], respiratory medicine [ 4 ], and rehabilitation medicine [ 5 ]. In the field of neurology, for example, applications that collect data from accelerometers in mobile devices have been used to quantify postural instability in Parkinson's disease [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Potential Usefulness of Tracking Head Movement via a Wearable Device for Equilibrium Function Testing at Home

Yamanobe

¹

,

Fujioka

²

,

Ohashi

³

et al. 2022

View full text Add to dashboard Cite

Many studies have reported the use of wearable devices to acquire biological data for the diagnosis and treatment of various diseases. Balance dysfunction, however, is difficult to evaluate in real time because the equilibrium function is conventionally examined using a stabilometer installed on the ground. Here, we used a wearable accelerometer that measures head motion to evaluate balance and examined whether it performs comparably to a conventional stabilometer. We constructed a simplified physical head-feet model that simultaneously records “head” motion measured using an attached wearable accelerometer and center-of-gravity motion at the “feet”, which is measured using an attached stabilometer. Total trajectory length (r = 0.818, p -false discovery rate [FDR] = 0.004) and outer peripheral area (r = 0.691, p -FDR = 0.026) values measured using the wearable device and stabilometer were significantly positively correlated. Root mean square area values were not significantly correlated with wearable device stabilometry but were comparable. These results indicate that wearable, widely available, non-medical devices may be used to assess balance outside the hospital setting, and new approaches for testing balance function should be considered.

show abstract

“…In recent years, small sensors that can be attached to the body to acquire biological data, called "wearable devices," have been used extensively worldwide [1] . Wearable devices are used in clinical research and many medical and healthcare fields including neurology [2] , cardiology [3] , respiratory medicine [4] , and rehabilitation medicine [5] . In the field of neurology, for example, applications that collect data from accelerometers in mobile devices have been used to quantify postural instability in Parkinson's disease [6] .…”

Section: Introductionmentioning

confidence: 99%

Potential Usefulness of Tracking Head Movement via a Wearable Device for Equilibrium Function Testing at Home

Yamanobe

¹

,

Fujioka

²

,

Ohashi

³

et al. 2022

Preprint

0

View full text Add to dashboard Cite

Many studies have reported the use of wearable devices to acquire biological data for the diagnosis and treatment of various diseases. Balance dysfunction, however, is difficult to evaluate in real time because the equilibrium function is conventionally examined using a stabilometer installed on the ground. Here, we used a wearable accelerometer that measures head motion to evaluate balance and examined whether it performs comparably to a conventional stabilometer. We constructed a simplified physical head-feet model that simultaneously records “head” motion measured using an attached wearable accelerometer and center-of-gravity motion at the “feet”, which is measured using an attached stabilometer. Total trajectory length (r = 0.818, p -false discovery rate [FDR] = 0.004) and outer peripheral area (r = 0.691, p -FDR = 0.026) values measured using the wearable device and stabilometer were significantly positively correlated. Root mean square area values were not significantly correlated with wearable device stabilometry but were comparable. These results indicate that wearable, widely available, non-medical devices may be used to assess balance outside the hospital setting, and new approaches for testing balance function should be considered.

show abstract

Devices for remote continuous monitoring of people with Parkinson’s disease: a systematic review and cost-effectiveness analysis

Cox,

Wade,

Hodgson

et al. 2024

Health Technol Assess

0

View full text Add to dashboard Cite

Background Parkinson’s disease is a brain condition causing a progressive loss of co ordination and movement problems. Around 145,500 people have Parkinson’s disease in the United Kingdom. Levodopa is the most prescribed treatment for managing motor symptoms in the early stages. Patients should be monitored by a specialist every 6–12 months for disease progression and treatment of adverse effects. Wearable devices may provide a novel approach to management by directly monitoring patients for bradykinesia, dyskinesia, tremor and other symptoms. They are intended to be used alongside clinical judgement. Objectives To determine the clinical and cost-effectiveness of five devices for monitoring Parkinson’s disease: Personal KinetiGraph, Kinesia 360, KinesiaU, PDMonitor and STAT-ON. Methods We performed systematic reviews of all evidence on the five devices, outcomes included: diagnostic accuracy, impact on decision-making, clinical outcomes, patient and clinician opinions and economic outcomes. We searched MEDLINE and 12 other databases/trial registries to February 2022. Risk of bias was assessed. Narrative synthesis was used to summarise all identified evidence, as the evidence was insufficient for meta-analysis. One included trial provided individual-level data, which was re-analysed. A de novo decision-analytic model was developed to estimate the cost-effectiveness of Personal KinetiGraph and Kinesia 360 compared to standard of care in the UK NHS over a 5-year time horizon. The base-case analysis considered two alternative monitoring strategies: one-time use and routine use of the device. Results Fifty-seven studies of Personal KinetiGraph, 15 of STAT-ON, 3 of Kinesia 360, 1 of KinesiaU and 1 of PDMonitor were included. There was some evidence to suggest that Personal KinetiGraph can accurately measure bradykinesia and dyskinesia, leading to treatment modification in some patients, and a possible improvement in clinical outcomes when measured using the Unified Parkinson’s Disease Rating Scale. The evidence for STAT-ON suggested it may be of value for diagnosing symptoms, but there is currently no evidence on its clinical impact. The evidence for Kinesia 360, KinesiaU and PDMonitor is insufficient to draw any conclusions on their value in clinical practice. The base-case results for Personal KinetiGraph compared to standard of care for one-time and routine use resulted in incremental cost-effectiveness ratios of £67,856 and £57,877 per quality-adjusted life-year gained, respectively, with a beneficial impact of the Personal KinetiGraph on Unified Parkinson’s Disease Rating Scale domains III and IV. The incremental cost-effectiveness ratio results for Kinesia 360 compared to standard of care for one-time and routine use were £38,828 and £67,203 per quality-adjusted life-year gained, respectively. Limitations The evidence was limited in extent and often low quality. For all devices, except Personal KinetiGraph, there was little to no evidence on the clinical impact of the technology. Conclusions Personal KinetiGraph could reasonably be used in practice to monitor patient symptoms and modify treatment where required. There is too little evidence on STAT-ON, Kinesia 360, KinesiaU or PDMonitor to be confident that they are clinically useful. The cost-effectiveness of remote monitoring appears to be largely unfavourable with incremental cost-effectiveness ratios in excess of £30,000 per quality-adjusted life-year across a range of alternative assumptions. The main driver of cost-effectiveness was the durability of improvements in patient symptoms. Study registration This study is registered as PROSPERO CRD42022308597. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Evidence Synthesis programme (NIHR award ref: NIHR135437) and is published in full in Health Technology Assessment; Vol. 28, No. 30. See the NIHR Funding and Awards website for further award information.

show abstract

Tailoring the use of wearable systems and telehealth for Parkinson's disease

Cited by 3 publications

References 6 publications

Potential Usefulness of Tracking Head Movement via a Wearable Device for Equilibrium Function Testing at Home

Potential Usefulness of Tracking Head Movement via a Wearable Device for Equilibrium Function Testing at Home

Potential Usefulness of Tracking Head Movement via a Wearable Device for Equilibrium Function Testing at Home

Devices for remote continuous monitoring of people with Parkinson’s disease: a systematic review and cost-effectiveness analysis

Contact Info

Product

Resources

About