Electronically monitoring Parkinson’s symptoms as people go about their day is a feasible way of collecting clinically relevant data, a proof-of-concept study shows.
Titled “Monitoring Parkinson’s disease symptoms during daily life: a feasibility study,” the study was published in the journal npj Parkinson’s Disease.
Currently, most healthcare providers monitor Parkinson’s symptoms with tools like the MDS-UPDRS (MDS-sponsored Revision of the Unified Parkinson’s Disease Rating Scale). Essentially, these tools are questionnaires completed jointly by healthcare providers and patients during hospital visits.
However, such tools are inherently limited: the data is only collected during hospital visits, so collection of new data doesn’t happen often, and symptoms perceived or recalled in a hospital don’t necessarily line up with what patients experience in their day-to-day life.
Wearable sensors that pair with a phone application may help to overcome these limitations because they can collect data daily — and, ideally, without too much interference in the person’s life. Such systems have showed promise in other conditions, but studies of their use with Parkinson’s patients are limited.
Researchers tested one such system for monitoring Parkinson’s symptoms. The system included wearable sensors designed by the researchers to measure physical movements and tremors. For each participant, two sensors were worn on the wrist (similar to watches), and one was worn around the chest.
These were paired with an app (PsyMate; its manufacturers were not affiliated with the study), which gave participants symptom-related questionnaires at random times throughout the day.
The dual system aimed to collect both objective movement data from the worn sensors and subjective data from the questionnaires in order to provide a holistic picture of symptoms experienced by each individual.
In total, 20 people with Parkinson’s (ages 46-74; disease durations of 1 to 21 years) were asked to use the system for two weeks to test its feasibility and comfort.
Adherence was high, the study reported: participants wore the sensors for nearly 15 hours each day on average, and they fully completed 79.1% of the questionnaires.
Patients’ attitudes toward the system were largely positive. For instance, 60% and 80% of participants said the wrist and chest sensors, respectively, were comfortable to wear, and 30% and 50% said they would be willing to wear them long-term.
Similarly, 85% found the questionnaires clear and unobtrusive, with 50% reporting they would be willing to fill out questionnaires long-term.
As a proof-of-concept of the system’s effectiveness, the researchers highlighted one participant with particularly severe “on/off” fluctuations. They found that data from the sensors and from the questionnaires correlated well, suggesting that sensor data were broadly in agreement with the person’s experience.
“These initial results highlight the feasibility of using wearable sensors to detect symptom severity,” the researchers wrote.
Of note, on periods are those when parkinsonian medication is exerting its effects; off periods occur when the effects of a medication wear off before a new dose can be taken, and are characterized by the re-emergence of Parkinson’s motor symptoms.
“This study showed that combining wearable sensors with ESM [the questionnaires] is a feasible method for monitoring PD patients in daily life,” the researchers concluded.