Wearables in the home-based assessment of abnormal movements in Parkinson’s disease: a systematic review of the literature

Ancona, Stefania; Faraci, Francesca Dalia; Khatab, Elina; Fiorillo, Luigi; Gnarra, Oriella; Nef, Tobias; Bassetti, Claudio L.; Bargiotas, Panagiotis

doi:10.1007/s00415-020-10350-3

Cited by 45 publications

(47 citation statements)

References 39 publications

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“…Telemonitoring is the remote gathering of information about a patient which is used to inform healthcare providers (in a clinical setting) or researchers (in the framework of a trial). A wide and expanding spectrum of tools can be used for telemonitoring, including body-worn sensors [ 27 , 28 ], home sensors [ 29 ], specific apps for the smartphone [ 30 , 31 ], digital diaries [ 32 ], or analysis of common appliances such as computer keyboards [ 33 ] (only several selected high-quality references are given here). The promise of remote monitoring is to offer objective, continuous measures of relevant symptoms while patients are at home.…”

Section: Telemonitoringmentioning

confidence: 99%

The state of telemedicine for persons with Parkinson's disease

Bergh

Bloem

Meinders³

et al. 2021

Current Opinion in Neurology

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Purpose of review The COVID-pandemic has facilitated the implementation of telemedicine in both clinical practice and research. We highlight recent developments in three promising areas of telemedicine: teleconsultation, telemonitoring, and teletreatment. We illustrate this using Parkinson's disease as a model for other chronic neurological disorders. Recent findings Teleconsultations can reliably administer parts of the neurological examination remotely, but are typically not useful for establishing a reliable diagnosis. For follow-ups, teleconsultations can provide enhanced comfort and convenience to patients, and provide opportunities for blended and proactive care models. Barriers include technological challenges, limited clinician confidence, and a suboptimal clinician-patient relationship. Telemonitoring using wearable sensors and smartphone-based apps can support clinical decision-making, but we lack large-scale randomized controlled trials to prove effectiveness on clinical outcomes. Increasingly many trials are now incorporating telemonitoring as an exploratory outcome, but more work remains needed to demonstrate its clinical meaningfulness. Finding a balance between benefits and burdens for individual patients remains vital. Recent work emphasised the promise of various teletreatment solutions, such as remotely adjustable deep brain stimulation parameters, virtual reality enhanced exercise programs, and telephone-based cognitive behavioural therapy. Personal contact remains essential to ascertain adherence to teletreatment. Summary The availability of different telemedicine tools for remote consultation, monitoring, and treatment is increasing. Future research should establish whether telemedicine improves outcomes in routine clinical care, and further underpin its merits both as intervention and outcome in research settings.

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Section: Telemonitoringmentioning

confidence: 99%

The state of telemedicine for persons with Parkinson's disease

Bergh

Bloem

Meinders³

et al. 2021

Current Opinion in Neurology

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“…Importantly, it is possible the high acceptance and adherence reported within this study was influenced by the intentional strategies built into the protocol to achieve the following: (1) limit participant engagement with devices (the devices required no interaction beyond attachment and removal), and (2) offset device-related challenges experienced by participants by including a study partner and providing access to a research coordinator. Previous studies have reported that adherence depended on the complexity of the technology being used [ 62 ] and the degree of user engagement required [ 27 , 56 ]. No participants required research coordinator support to engage with the devices; however, one study partner did receive additional support from the study team when a participant became agitated by the devices.…”

Section: Discussionmentioning

confidence: 99%

“…willingness to wear and commitment to prescribed wear schedule) [ 25 , 26 ]. The literature tends to focus on issues of technical efficacy such as precision and reliability [ 27 ] and while warranted, there remains need to understand user acceptance and adherence to device-wearing in daily life. Among studies that have evaluated feasibility from this perspective in those with impaired function or cognition, acceptability is generally high [ 26 , 28 – 30 ], with reduced adherence linked to high user engagement requirements [ 31 ], multi-day wear [ 26 ], and specific cohorts such as those living with dementia [ 32 ].…”

Section: Introductionmentioning

confidence: 99%

“…Among studies that have evaluated feasibility from this perspective in those with impaired function or cognition, acceptability is generally high [ 26 , 28 – 30 ], with reduced adherence linked to high user engagement requirements [ 31 ], multi-day wear [ 26 ], and specific cohorts such as those living with dementia [ 32 ]. Most studies, however, have focused on a single device and daytime wear [ 27 , 32 ], with specific gaps surrounding the feasibility of extended duration, multi-sensor wear paradigms.…”

Section: Introductionmentioning

confidence: 99%

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Feasibility of a continuous, multi-sensor remote health monitoring approach in persons living with neurodegenerative disease

et al. 2021

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Background Remote health monitoring with wearable sensor technology may positively impact patient self-management and clinical care. In individuals with complex health conditions, multi-sensor wear may yield meaningful information about health-related behaviors. Despite available technology, feasibility of device-wearing in daily life has received little attention in persons with physical or cognitive limitations. This mixed methods study assessed the feasibility of continuous, multi-sensor wear in persons with cerebrovascular (CVD) or neurodegenerative disease (NDD). Methods Thirty-nine participants with CVD, Alzheimer’s disease/amnestic mild cognitive impairment, frontotemporal dementia, Parkinson’s disease, or amyotrophic lateral sclerosis (median age 68 (45–83) years, 36% female) wore five devices (bilateral ankles and wrists, chest) continuously for a 7-day period. Adherence to device wearing was quantified by examining volume and pattern of device removal (non-wear). A thematic analysis of semi-structured de-brief interviews with participants and study partners was used to examine user acceptance. Results Adherence to multi-sensor wear, defined as a minimum of three devices worn concurrently, was high (median 98.2% of the study period). Non-wear rates were low across all sensor locations (median 17–22 min/day), with significant differences between some locations ( p = 0.006). Multi-sensor non-wear was higher for daytime versus nighttime wear ( p < 0.001) and there was a small but significant increase in non-wear over the collection period ( p = 0.04). Feedback from de-brief interviews suggested that multi-sensor wear was generally well accepted by both participants and study partners. Conclusion A continuous, multi-sensor remote health monitoring approach is feasible in a cohort of persons with CVD or NDD.

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“…Sensors that are currently in use, can help in the evaluation of motor symptoms in patients' home environment and have shown promising results in the care of patients with PD (9, 10). Nonetheless, disadvantages of these technologies still exist, like the fact that each device has shown satisfactory results only in the detection of specific symptoms and not sufficient correlation with patients' diaries (11,12), thus further enhancements and clinical validation will guarantee the applicability of wearable technologies in everyday clinical practice (13,14). Especially, in the era of the COVID-19 pandemic that disrupted the patients' access to healthcare, poor follow-up of the patients aggravates the difficulties on the clinical evaluation and threatens to deteriorate their quality of life (15,16).…”

mentioning

confidence: 99%

Accurate Monitoring of Parkinson’s Disease Symptoms With a Wearable Device During COVID-19 Pandemic

Tsamis

Rigas

Kostikis

et al. 2021

In Vivo

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Background: Accurate assessment of symptoms in Parkinson's disease (PD) is essential for optimal treatment decisions. During the past few years, different monitoring modalities have started to be used in the everyday clinical practice, mainly for the evaluation of motor symptoms. However, monitoring technologies for PD have not yet gained wide acceptance among physicians, patients, and caregivers. The COVID-19 pandemic disrupted the patients' access to healthcare, bringing to the forefront the need for wearable sensors, which provide effective remote symptoms' evaluation and follow-up. Case Report: We report two cases with PD, whose symptoms were monitored with a new wearable CEmarked system (PDMonitor ® ), enabling appropriate treatment modifications. Conclusion: Objective assessment of the patient's motor symptoms in his daily home environment is essential for an accurate monitoring in PD and enhances treatment decisions.

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Wearables in the home-based assessment of abnormal movements in Parkinson’s disease: a systematic review of the literature

Cited by 45 publications

References 39 publications

The state of telemedicine for persons with Parkinson's disease

The state of telemedicine for persons with Parkinson's disease

Feasibility of a continuous, multi-sensor remote health monitoring approach in persons living with neurodegenerative disease

Accurate Monitoring of Parkinson’s Disease Symptoms With a Wearable Device During COVID-19 Pandemic

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