Impaired bed mobility: quantitative torque analysis with axial inertial sensors

Assessing impaired bed mobility in patients with Parkinson's disease: a scoping review

BACKGROUND

Although most patients with Parkinson's disease (PD) experience difficulties in bed mobility, evidence on the suitability of the methods for assessing impaired bed mobility in PD are lacking.

OBJECTIVES

To identify objective methods for assessing impaired bed mobility in PD and to discuss their clinimetric properties and feasibility for use in clinical practice.

DATA SOURCES

PubMed, Web of Science, and Cochrane Library were searched between 1995 and 2022.

SELECTION CRITERIA

Studies were included if they described an objective assessment method for assessing impaired bed mobility in PD.

DATA EXTRACTION AND DATA SYNTHESIS

Characteristics of the identified measurement methods such as clinimetric properties and feasibility were extracted by two authors. The methodological quality of studies was evaluated using the Appraisal of studies tool.

RESULTS

Twenty-three studies were included and categorised into three assessment methods: sensor-based assessments (48%), rating scales (39%), and timed-tests (13%). The risk of bias was low for all but one study, which was medium.

LIMITATIONS

Despite applying wide selection criteria, a relatively small number of studies were identified in our results.

CONCLUSION

Rating scales may be the most preferred for assessing impaired bed mobility in PD in clinical practice, until clinimetric validity are adequately demonstrated in the other assessment methods. CONTRIBUTION OF PAPER.

Determinants of impaired bed mobility in Parkinson’s disease: Impact of hip muscle strength and motor symptoms

BACKGROUND: Although most patients with Parkinson’s disease (PD) present difficulties of bed mobility, the contributing factors to impaired bed mobility in PD are unknown. OBJECTIVE: To compare bed mobility and muscle strength between PD patients and healthy controls, and investigate the determinants of bed mobility in PD. METHODS: Sixteen patients with PD and ten age- and sex-matched healthy controls (HC) were enrolled. Time and pattern to get out of bed to their preferred side at usual speed, muscle torque in lower extremities and motor symptom burden were also measured. RESULTS: PD exhibited significantly slower speed in bed mobility and lower torque in the hip adductor/abductor/flexor muscle than HC. Slower movement time in PD was correlated with weaker hip adductor torque on the more affected side (Rs = –0.56, p < 0.05) and with higher score in arm rigidity both sides (Rs≥0.79, p < 0.01). There were no significant differences between the categorised movement patterns and movement time in PD (p = 0.31). CONCLUSIONS: Reduced hip adductors torque and severe arm rigidity are associated with slowness of getting out of bed, implying that these components could be used as targets for rehabilitation practice to improve bed mobility in PD.

Shedding Light on Nocturnal Movements in Parkinson's Disease: Evidence from Wearable Technologies

In Parkinson’s disease (PD), abnormal movements consisting of hypokinetic and hyperkinetic manifestations commonly lead to nocturnal distress and sleep impairment, which significantly impact quality of life. In PD patients, these nocturnal disturbances can reflect disease-related complications (e.g., nocturnal akinesia), primary sleep disorders (e.g., rapid eye movement behaviour disorder), or both, thus requiring different therapeutic approaches. Wearable technologies based on actigraphy and innovative sensors have been proposed as feasible solutions to identify and monitor the various types of abnormal nocturnal movements in PD. This narrative review addresses the topic of abnormal nocturnal movements in PD and discusses how wearable technologies could help identify and assess these disturbances. We first examine the pathophysiology of abnormal nocturnal movements and the main clinical and instrumental tools for the evaluation of these disturbances in PD. We then report and discuss findings from previous studies assessing nocturnal movements in PD using actigraphy and innovative wearable sensors. Finally, we discuss clinical and technical prospects supporting the use of wearable technologies for the evaluation of nocturnal movements.

Using wearables to assess bradykinesia and rigidity in patients with Parkinson's disease: a focused, narrative review of the literature

The potential of using wearable technologies for the objective assessment of motor symptoms in Parkinson's disease (PD) has gained prominence recently. Nonetheless, compared to tremor and gait impairment, less emphasis has been placed on the quantification of bradykinesia and rigidity. This review aimed to consolidate the existing research on objective measurement of bradykinesia and rigidity in PD through the use of wearables, focusing on the continuous monitoring of these two symptoms in free-living environments. A search of PubMed was conducted through a combination of keyword and MeSH searches. We also searched the IEEE, Google Scholar, Embase, and Scopus databases to ensure thorough results and to minimize the chances of missing relevant studies. Papers published after the year 2000 with sample sizes greater than five were included. Studies were assessed for quality and information was extracted regarding the devices used and their location on the body, the setting and duration of the study, the "gold standard" used as a reference for validation, the metrics used, and the results of each paper. Thirty-one and eight studies met the search criteria and evaluated bradykinesia and rigidity, respectively. Several studies reported strong associations between wearable-based measures and the gold-standard references for bradykinesia, and, to a lesser extent, rigidity. Only a few, pilot studies investigated the measurement of bradykinesia and rigidity in the home and free-living settings. While the current results are promising for the future of wearables, additional work is needed on their validation and adaptation in ecological, free-living settings. Doing so has the potential to improve the assessment and treatment of motor fluctuations and symptoms of PD more generally through real-time objective monitoring of bradykinesia and rigidity.