1
|
Langer A, Roth D, Santer A, Flotz A, Gruber J, Wizany L, Hasenauer S, Pokan R, Dabnichki P, Treven M, Zimmel S, Schmoeger M, Willinger U, Gassner L, Maetzler W, Zach H. Climb up! Head up! Climbing improves posture in Parkinson's disease. A secondary analysis from a randomized controlled trial. Clin Rehabil 2023; 37:1492-1500. [PMID: 37157229 PMCID: PMC10492431 DOI: 10.1177/02692155231174990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 04/14/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE To investigate the effect of sport climbing on a biomechanical marker of axial posture in patients with Parkinson's disease, as well as its association with age, body mass index and health-related quality-of-life outcome measures. DESIGN Pre-planned secondary analysis of our randomized controlled, semi-blind trial (unblinded patients, blinded assessors) comparing sport climbing to unsupervised exercise. SETTING Single-centre study conducted at the Department of Neurology of the Medical University of Vienna, Austria. PARTICIPANTS Forty-eight Parkinson's disease patients (aged 64 ± 8 years, Hoehn & Yahr stage 2-3) were included. INTERVENTION Sport climbers (n = 24) followed a 12-week, 90 min/week supervised top-rope sport climbing course in an indoor climbing gym. The unsupervised training group (n = 24) independently followed the 'European Physiotherapy Guidelines for Parkinson's Disease' and World Health Organization recommendations for an active lifestyle for 12 weeks. MAIN MEASURES Posture was assessed with the horizontal distance of the seventh cervical vertebra to the wall at baseline and after the intervention. RESULTS Participating in the sport climbing group significantly predicted the biomechanical marker of axial posture (P = 0.044). The improvement in the biomechanical marker did not affect the quality of life, depression, fatigue, physical activity or fear of falling. Participants in the sport climbing group showed a significantly decreased horizontal distance of the seventh cervical vertebra to the wall after the intervention (-1.7 cm (95%CI [-2.6, -0.8]). In the unsupervised training group, no difference was found (-0.5 cm; 95%CI -1.3, 0.2]). CONCLUSIONS We conclude that sport climbing improves a biomechanical marker of axial posture in Parkinson's disease.
Collapse
Affiliation(s)
- Agnes Langer
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Dominik Roth
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Agnes Santer
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Anna Flotz
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Jakob Gruber
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Laurenz Wizany
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | | | - Rochus Pokan
- Department of Sport Physiology, Institute of Sports Sciences, University of Vienna, Vienna, Austria
| | - Peter Dabnichki
- School of Engineering, RMIT University, Melbourne, Victoria, Australia
| | - Marco Treven
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Sarah Zimmel
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | | | - Ulrike Willinger
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Lucia Gassner
- Department of Sport Physiology, Institute of Sports Sciences, University of Vienna, Vienna, Austria
- School of Engineering, RMIT University, Melbourne, Victoria, Australia
| | - Walter Maetzler
- Department of Neurology, University Hospital Schleswig-Holstein and Kiel University, Kiel, Germany
| | - Heidemarie Zach
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
2
|
Deb R, An S, Bhat G, Shill H, Ogras UY. A Systematic Survey of Research Trends in Technology Usage for Parkinson's Disease. SENSORS (BASEL, SWITZERLAND) 2022; 22:5491. [PMID: 35897995 PMCID: PMC9371095 DOI: 10.3390/s22155491] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/17/2022] [Accepted: 07/20/2022] [Indexed: 06/15/2023]
Abstract
Parkinson's disease (PD) is a neurological disorder with complicated and disabling motor and non-motor symptoms. The complexity of PD pathology is amplified due to its dependency on patient diaries and the neurologist's subjective assessment of clinical scales. A significant amount of recent research has explored new cost-effective and subjective assessment methods pertaining to PD symptoms to address this challenge. This article analyzes the application areas and use of mobile and wearable technology in PD research using the PRISMA methodology. Based on the published papers, we identify four significant fields of research: diagnosis, prognosis and monitoring, predicting response to treatment, and rehabilitation. Between January 2008 and December 2021, 31,718 articles were published in four databases: PubMed Central, Science Direct, IEEE Xplore, and MDPI. After removing unrelated articles, duplicate entries, non-English publications, and other articles that did not fulfill the selection criteria, we manually investigated 1559 articles in this review. Most of the articles (45%) were published during a recent four-year stretch (2018-2021), and 19% of the articles were published in 2021 alone. This trend reflects the research community's growing interest in assessing PD with wearable devices, particularly in the last four years of the period under study. We conclude that there is a substantial and steady growth in the use of mobile technology in the PD contexts. We share our automated script and the detailed results with the public, making the review reproducible for future publications.
Collapse
Affiliation(s)
| | - Sizhe An
- Department of Electrical and Computer Engineering, University of Wisconsin-Madison, Madison, WI 53705, USA;
| | - Ganapati Bhat
- School of Electrical Engineering & Computer Science, Washington State University, Pullman, WA 99164, USA;
| | - Holly Shill
- Lonnie and Muhammad Ali Movement Disorder Center, Phoenix, AZ 85013, USA;
| | - Umit Y. Ogras
- Department of Electrical and Computer Engineering, University of Wisconsin-Madison, Madison, WI 53705, USA;
| |
Collapse
|
3
|
Pigott JS, Kane EJ, Ambler G, Walters K, Schrag A. Systematic review and meta-analysis of clinical effectiveness of self-management interventions in Parkinson's disease. BMC Geriatr 2022; 22:45. [PMID: 35016613 PMCID: PMC8753859 DOI: 10.1186/s12877-021-02656-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 11/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Parkinson's disease is a complex neurodegenerative condition with significant impact on quality of life (QoL), wellbeing and function. The objective of this review is to evaluate the clinical effectiveness of self-management interventions for people with Parkinson's disease, taking a broad view of self-management and considering effects on QoL, wellbeing and function. METHODS Systematic searches of four databases (MEDLINE, Embase, PsycINFO, Web of Science) were conducted for studies evaluating self-management interventions for people with Parkinson's disease published up to 16th November 2020. Original quantitative studies of adults with idiopathic Parkinson's disease were included, whilst studies of atypical Parkinsonism were excluded. Full-text articles were independently assessed by two reviewers, with data extracted by one reviewer and reliability checked by a second reviewer, then synthesised through a narrative approach and, for sufficiently similar studies, a meta-analysis of effect size was conducted (using a random-effects meta-analysis with restricted maximum likelihood method pooled estimate). Interventions were subdivided into self-management components according to PRISMS Taxonomy. Risk of bias was examined with the Cochrane Risk of Bias 2 (RoB2) tool or ROBIN-I tool as appropriate. RESULTS Thirty-six studies were included, evaluating a diverse array of interventions and encompassing a range of study designs (RCT n = 19; non-randomised CT n = five; within subject pre- and post-intervention comparisons n = 12). A total of 2884 participants were assessed in studies across ten countries, with greatest output from North America (14 studies) and UK (six studies). Risk of bias was moderate to high for the majority of studies, mostly due to lack of participant blinding, which is not often practical for interventions of this nature. Only four studies reported statistically significant improvements in QoL, wellbeing or functional outcomes for the intervention compared to controls. These interventions were group-based self-management education and training programmes, either alone, combined with multi-disciplinary rehabilitation, or combined with Cognitive Behaviour Therapy; and a self-guided community-based exercise programme. Four of the RCTs evaluated sufficiently similar interventions and outcomes for meta-analysis: these were studies of self-management education and training programmes evaluating QoL (n = 478). Meta-analysis demonstrated no significant difference between the self-management and the control groups with a standardised mean difference (Hedges g) of - 0.17 (- 0.56, 0.21) p = 0.38. By the GRADE approach, the quality of this evidence was deemed "very low" and the effect of the intervention is therefore uncertain. Components more frequently observed in effective interventions, as per PRISMS taxonomy analysis, were: information about resources; training or rehearsing psychological strategies; social support; and lifestyle advice and support. The applicability of these findings is weakened by the ambiguous and at times overlapping nature of self-management components. CONCLUSION Approaches and outcomes to self-management interventions in Parkinson's disease are heterogenous. There are insufficient high quality RCTs in this field to show effectiveness of self-management interventions in Parkinson's disease. Whilst it is not possible to draw conclusions on specific intervention components that convey effectiveness, there are promising findings from some studies, which could be targeted in future evaluations.
Collapse
Affiliation(s)
- Jennifer S Pigott
- Queen Square Institute of Neurology, University College London, London, UK
| | - Edward J Kane
- South London & Maudsley NHS Foundation Trust, London, UK
| | - Gareth Ambler
- Department of Statistical Science, University College London, London, UK
| | - Kate Walters
- Centre for Ageing Population Studies, Research Department of Primary Care and Population Health, University College London, London, UK
| | - Anette Schrag
- Queen Square Institute of Neurology, University College London, London, UK.
- UCL Institute of Neurology, Royal Free Campus, University College London, London, NW3 2PF, UK.
| |
Collapse
|
4
|
Iwai M, Koyama S, Takeda K, Hirakawa Y, Motoya I, Kumazawa N, Sakurai H, Kanada Y, Kawamura N, Kawamura M, Tanabe S. Effect of LSVT® BIG on standing balance in a Parkinson's patient: A case report. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2021; 26:e1921. [PMID: 34482577 DOI: 10.1002/pri.1921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 08/21/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND AND PURPOSE There are no reports regarding the effect of Lee Silverman Voice Treatment® BIG (LSVT® BIG) on standing balance ability evaluated using quantitative assessment. This case report aimed to describe and evaluate the influence of LSVT® BIG on the center of pressure (COP) trajectory in a patient with Parkinson's disease (PD). METHODS Although this paper focused on one case, quantitative assessment on the effect of LSVT® BIG on standing balance ability was performed. A 67-year-old woman patient diagnosed with PD at age 59, with a Hoehn and Yahr stage 3 disability severity, underwent a 4-weeks supervised LSVT® BIG program. The total distances of the COP trajectory (two-dimensional [2D] horizontal plane, anterior-posterior [AP] direction, and medial-lateral [ML] direction), and the mean COP velocity for each direction, postural stability, and posture subsections of the Unified Parkinson's Disease Rating Scale (UPDRS) Part 3 were assessed at pre- and post-intervention. RESULTS The total distances of the COP trajectory, mean COP velocities, and scores of postural stability and posture subsections of the UPDRS Part 3 improved after intervention (from 124.6 to 76.6 cm [2D], 89.4 to 57.7 cm [AP], 77.4 to 38.5 cm [ML]; 4.0 to 2.6 cm/s [2D], 3.0 to 1.9 cm/s [AP], 2.6 to 1.3 cm/s [ML]; and 3 to 0, and 3 to 2, respectively). DISCUSSION LSVT® BIG may be effective in improving the total distance of the COP trajectory, mean COP velocity, and both postural stability and posture subsections of the UPDRS Part 3 in the presented PD case.
Collapse
Affiliation(s)
- Masanobu Iwai
- Department of Rehabilitation, Kawamura Hospital, Gifu, Japan
| | - Soichiro Koyama
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Kazuya Takeda
- Comprehensive Community Care Core Center, Fujita Health University, Toyoake, Japan
| | - Yuichi Hirakawa
- Department of Rehabilitation, Kawamura Hospital, Gifu, Japan
| | - Ikuo Motoya
- Department of Rehabilitation, Kawamura Hospital, Gifu, Japan
| | - Nobuhiro Kumazawa
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Hiroaki Sakurai
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Yoshikiyo Kanada
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | | | - Mami Kawamura
- Department of Neurology, Kawamura Hospital, Gifu, Japan
| | - Shigeo Tanabe
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| |
Collapse
|
5
|
De Angelis S, Princi AA, Dal Farra F, Morone G, Caltagirone C, Tramontano M. Vibrotactile-Based Rehabilitation on Balance and Gait in Patients with Neurological Diseases: A Systematic Review and Metanalysis. Brain Sci 2021; 11:brainsci11040518. [PMID: 33921655 PMCID: PMC8072538 DOI: 10.3390/brainsci11040518] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/10/2021] [Accepted: 04/14/2021] [Indexed: 01/06/2023] Open
Abstract
Postural instability and fear of falling represent two major causes of decreased mobility and quality of life in cerebrovascular and neurologic diseases. In recent years, rehabilitation strategies were carried out considering a combined sensorimotor intervention and an active involvement of the patients during the rehabilitation sessions. Accordingly, new technological devices and paradigms have been developed to increase the effectiveness of rehabilitation by integrating multisensory information and augmented feedback promoting the involvement of the cognitive paradigm in neurorehabilitation. In this context, the vibrotactile feedback (VF) could represent a peripheral therapeutic input, in order to provide spatial proprioceptive information to guide the patient during task-oriented exercises. The present systematic review and metanalysis aimed to explore the effectiveness of the VF on balance and gait rehabilitation in patients with neurological and cerebrovascular diseases. A total of 18 studies met the inclusion criteria and were included. Due to the lack of high-quality studies and heterogeneity of treatments protocols, clinical practice recommendations on the efficacy of VF cannot be made. Results show that VF-based intervention could be a safe complementary sensory-motor approach for balance and gait rehabilitation in patients with neurological and cerebrovascular diseases. More high-quality randomized controlled trials are needed.
Collapse
Affiliation(s)
- Sara De Angelis
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.D.A.); (A.A.P.); (G.M.); (C.C.)
| | | | | | - Giovanni Morone
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.D.A.); (A.A.P.); (G.M.); (C.C.)
| | - Carlo Caltagirone
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.D.A.); (A.A.P.); (G.M.); (C.C.)
| | - Marco Tramontano
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.D.A.); (A.A.P.); (G.M.); (C.C.)
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00185 Rome, Italy
- Correspondence: ; Tel.: +39-06-5150-1420
| |
Collapse
|
6
|
Kim SH, Yun SJ, Dang QK, Chee Y, Chung SG, Oh BM, Kim K, Seo HG. Measurement and Correction of Stooped Posture during Gait Using Wearable Sensors in Patients with Parkinsonism: A Preliminary Study. SENSORS 2021; 21:s21072379. [PMID: 33808057 PMCID: PMC8038058 DOI: 10.3390/s21072379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/16/2021] [Accepted: 03/25/2021] [Indexed: 11/16/2022]
Abstract
Stooped posture, which is usually aggravated during walking, is one of the typical postural deformities in patients with parkinsonism. However, the degree of stooped posture is difficult to quantitatively measure during walking. Furthermore, continuous feedback on posture is also difficult to provide. The purpose of this study is to measure the degree of stooped posture during gait and to investigate whether vibration feedback from sensor modules can improve a patient's posture. Parkinsonian patients with stooped posture were recruited for this study. Two wearable sensors with three-axis accelerometers were attached, one at the upper neck and the other just below the C7 spinous process of the patients. After being calibrated in the most upright posture, the sensors continuously recorded the sagittal angles at 20 Hz and averaged the data at every second during a 6 min walk test. In the control session, the patients walked with the sensors as usual. In the vibration session, sensory feedback was provided through vibrations from the neck sensor module when the sagittal angle exceeded a programmable threshold value. Data were collected and analyzed successfully in a total of 10 patients. The neck flexion and back flexion were slightly aggravated during gait, although the average change was <10° in most patients in both measurement sessions. Therefore, it was difficult to evaluate the effect of sensory feedback through vibration. However, some patients showed immediate response to the feedback and corrected their posture during gait. In conclusion, this preliminary study suggests that stooped posture could be quantitatively measured during gait by using wearable sensors in patients with parkinsonism. Sensory feedback through vibration from sensor modules may help in correcting posture during gait in selected patients.
Collapse
Affiliation(s)
- Se Hoon Kim
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul 03080, Korea; (S.H.K.); (S.J.Y.); (S.G.C.); (B.-M.O.); (K.K.)
| | - Seo Jung Yun
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul 03080, Korea; (S.H.K.); (S.J.Y.); (S.G.C.); (B.-M.O.); (K.K.)
| | - Quoc Khanh Dang
- MKS Instruments Korea, 543 Beonji, Daedeok Techno Valley, Yongsan-dong, Yuseong-gu, Daejeon 34028, Korea;
- School of Electrical Engineering, Biomedical Engineering, College of Engineering, University of Ulsan, Ulsan 44610, Korea;
| | - Youngjoon Chee
- School of Electrical Engineering, Biomedical Engineering, College of Engineering, University of Ulsan, Ulsan 44610, Korea;
| | - Sun Gun Chung
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul 03080, Korea; (S.H.K.); (S.J.Y.); (S.G.C.); (B.-M.O.); (K.K.)
| | - Byung-Mo Oh
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul 03080, Korea; (S.H.K.); (S.J.Y.); (S.G.C.); (B.-M.O.); (K.K.)
- National Traffic Injury Rehabilitation Hospital, Yangpyeong-gun 12564, Korea
| | - Keewon Kim
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul 03080, Korea; (S.H.K.); (S.J.Y.); (S.G.C.); (B.-M.O.); (K.K.)
| | - Han Gil Seo
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul 03080, Korea; (S.H.K.); (S.J.Y.); (S.G.C.); (B.-M.O.); (K.K.)
- Correspondence: ; Tel.: +82-2-2072-1659; Fax: +82-2-743-7473
| |
Collapse
|
7
|
Passos-Monteiro E, Peyré-Tartaruga LA, Zanardi APJ, da Silva ES, Jimenez-Reyes P, Morin JB, Pagnussat AS. Sprint exercise for subjects with mild-to-moderate Parkinson's disease: Feasibility and biomechanical outputs. Clin Biomech (Bristol, Avon) 2020; 72:69-76. [PMID: 31838213 DOI: 10.1016/j.clinbiomech.2019.11.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 10/28/2019] [Accepted: 11/18/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND High-intensity training, a still unexplored exercise for individuals with Parkinson's disease, is positively related with increased functionality and aerobic profile in healthy individuals. The aim of this work was to evaluate the feasibility, safety, and acceptance of sprint running in individuals with mild-to-moderate Parkinson's. Additionally, we compared sprint biomechanical outputs of force, velocity and power between individuals with Parkinson's disease and healthy. METHODS Physically trained subjects with Parkinson's, men, (n = 16, 64:9.01 years, stage between 1 and 3 in the Hoehn and Yahr, 16.8:7.1 at Unified Parkinson's disease Rating Scales, and control group (n = 21, 65:9.27 years) performed 20 m sprint sessions. We analyzed the self-reported satisfaction and acceptance using a self-administered questionnaire, and the sprint biomechanics and performance based on high-speed video recordings. FINDINGS All participants completed the tests with high feasibility, acceptability and satisfaction scores. The sprint maximal force and maximal power outputs were higher in Parkinson's disease. Conversely, control group showed higher mechanical effectiveness values. Interestingly, no difference in velocity capabilities and overall 20-m sprint performance was observed between groups, possibly explained by different mechanical strategies in both groups over the sprint accelerations. Linear regression analyses showed that physical qualities are predictors of mechanical effectiveness, and mechanical variables are important determinants of sprint performance on Parkinson's disease. INTERPRETATION Sprint is a feasible exercise for people with mild-to-moderate Parkinson's disease. Even though differences in physical qualities and mechanical effectiveness exist between subjects with Parkinson's disease and healthy, there is no overall substantial impact on sprint running performance.
Collapse
Affiliation(s)
- Elren Passos-Monteiro
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil; Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, Brazil; Laboratory of Locomotion PhysioMecanics, Faculty of Physical Education, Universidade Federal do Pará (UFPA), Brazil
| | | | - Ana P J Zanardi
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, Brazil
| | - Edson S da Silva
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, Brazil
| | | | | | - Aline S Pagnussat
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil; Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil.
| |
Collapse
|
8
|
Morgan C, Rolinski M, McNaney R, Jones B, Rochester L, Maetzler W, Craddock I, Whone AL. Systematic Review Looking at the Use of Technology to Measure Free-Living Symptom and Activity Outcomes in Parkinson's Disease in the Home or a Home-like Environment. JOURNAL OF PARKINSON'S DISEASE 2020; 10:429-454. [PMID: 32250314 PMCID: PMC7242826 DOI: 10.3233/jpd-191781] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/31/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The emergence of new technologies measuring outcomes in Parkinson's disease (PD) to complement the existing clinical rating scales has introduced the possibility of measurement occurring in patients' own homes whilst they freely live and carry out normal day-to-day activities. OBJECTIVE This systematic review seeks to provide an overview of what technology is being used to test which outcomes in PD from free-living participant activity in the setting of the home environment. Additionally, this review seeks to form an impression of the nature of validation and clinimetric testing carried out on the technological device(s) being used. METHODS Five databases (Medline, Embase, PsycInfo, Cochrane and Web of Science) were systematically searched for papers dating from 2000. Study eligibility criteria included: adults with a PD diagnosis; the use of technology; the setting of a home or home-like environment; outcomes measuring any motor and non-motor aspect relevant to PD, as well as activities of daily living; unrestricted/unscripted activities undertaken by participants. RESULTS 65 studies were selected for data extraction. There were wide varieties of participant sample sizes (<10 up to hundreds) and study durations (<2 weeks up to a year). The metrics evaluated by technology, largely using inertial measurement units in wearable devices, included gait, tremor, physical activity, bradykinesia, dyskinesia and motor fluctuations, posture, falls, typing, sleep and activities of daily living. CONCLUSIONS Home-based free-living testing in PD is being conducted by multiple groups with diverse approaches, focussing mainly on motor symptoms and sleep.
Collapse
Affiliation(s)
- Catherine Morgan
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- School of Computer Science, Electrical and Electronic Engineering, and Engineering Mathematics, Faculty of Engineering, University of Bristol, Bristol, UK
- Movement Disorders Group, Bristol Brain Centre, Southmead Hospital, North Bristol National Health Service Trust, Bristol, UK
| | - Michal Rolinski
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Movement Disorders Group, Bristol Brain Centre, Southmead Hospital, North Bristol National Health Service Trust, Bristol, UK
| | - Roisin McNaney
- School of Computer Science, Electrical and Electronic Engineering, and Engineering Mathematics, Faculty of Engineering, University of Bristol, Bristol, UK
| | - Bennet Jones
- Library and Knowledge Service, Learning and Research, Southmead Hospital, North Bristol National Health Service Trust, Bristol, UK
| | - Lynn Rochester
- Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, UK
- Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, Newcastle Upon Tyne, UK
| | - Walter Maetzler
- Department of Neurology, Christian-Albrechts University, Kiel, Germany
| | - Ian Craddock
- School of Computer Science, Electrical and Electronic Engineering, and Engineering Mathematics, Faculty of Engineering, University of Bristol, Bristol, UK
| | - Alan L. Whone
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Movement Disorders Group, Bristol Brain Centre, Southmead Hospital, North Bristol National Health Service Trust, Bristol, UK
| |
Collapse
|