The relationships between three-axis accelerometer measures of physical activity and motor symptoms in patients with Parkinson's disease: a single-center pilot study
The relationships between three-axis accelerometer measures of physical activity and motor symptoms in patients with Parkinson's disease: a single-center pilot study
复制标题
DOI：
10.1186/s12883-020-01896-w
复制
发表时间：
2020-09-10
期刊：
影响因子：
2.6
通讯作者：
Okuda, Satoshi
中科院分区：
文献类型：
--
作者：
Ito, Hiroto;Yokoi, Daichi;Okuda, Satoshi
已经开发了用于客观地评估帕金森病（PD）患者的运动症状的各种可穿戴设备。重要的是，以前的研究表明身体活动对PD有保护作用。然而，PD的常规临床评级与身体活动的三轴加速度计测量（例如，日常体力活动水平[PAL]或任务的代谢当量[MET]）仍然不清楚，特别是对于MET。在目前的研究中，我们试图每天阐明这些关系，并在30分钟的基础上阐明临床状态的最佳预测因子。方法选择因调整药物或脑深部电刺激治疗而住院的患者。使用腰戴式三轴加速度计，PAL和METs参数数据，并与EASTRS-3[On]和症状日记数据进行比较。我们从患者的最佳和最差天数中提取数据，分别由最佳和最差的CRISPR-3[On]评分定义。因此，提取了来自11名患者的22个数据集。我们检查了相关性，并制作了散点图来表示这些关系，然后研究了哪些MET参数和活动模式是“On”和“运动障碍”的最佳预测因子。结果参数“一天内95-92.5百分位数范围内的平均MET值（95-92.5百分位数值）”与常规每日临床评分显示出最强的相关性（Rho：对于RMRS-3[On]为-0.799，On小时为0.803 [p < 0.001]）。散点图表明，PAL往往有较高的值在患者不自主运动。然而，侧重于较高MET的MET参数似乎缓解了这一趋势。我们澄清了“超过2.0 MET的时间”和“超过1.5 MET的时间”可以分别作为30分钟基础上“开启”和“运动障碍”的预测因子（AUROC：0.779和0.959，95% CI：0.733-0.824和0.918-1.000）。最佳活性模式对“On”的特异性和敏感性分别为0.858和0.621。结论本研究提出了可行的活动模式和MET参数，以30分钟或每天为基础的运动症状的客观评价。三轴加速计测量侧重于较高的MET可能适合于评估身体活动。进一步的大规模研究是必要的，以澄清这些客观措施的有效性，可靠性和临床效用。
Background Various wearable devices for objectively evaluating motor symptoms of patients with Parkinson's disease (PD) have been developed. Importantly, previous studies have suggested protective effects of physical activity in PD. However, the relationships between conventional clinical ratings for PD and three-axis accelerometer measures of physical activity (e.g., daily physical activity levels [PAL] or metabolic equivalents of task [METs]) are still unclear, particularly for METs. In the current study, we sought to elucidate these relationships on a daily basis, and to clarify optimal predictors for clinical states on a 30-min basis. Methods Patients who were hospitalized for adjustment of drugs or deep brain stimulation were enrolled. Using waist-worn three-axis accelerometers, PAL and METs parameter data were obtained and compared with UPDRS-3[On] and symptom diary data. We extracted data from the patients' best and worst days, defined by the best and worst UPDRS-3[On] scores, respectively. Thus, 22 data sets from 11 patients were extracted. We examined the correlations and produced scatter plots to represent the relationships, then investigated which METs parameters and activity patterns were the best predictors for "On" and "dyskinesia". Results The parameter "mean METs value within the 95-92.5 percentile range on a day (95-92.5 percentile value)" exhibited the strongest correlation with conventional daily clinical ratings (Rho: - 0.799 for UPDRS-3[On], 0.803 for On hours [p < 0.001]). Scatter plots suggested that PAL tended to have higher values in patients with involuntary movement. However, METs parameters focusing on higher METs seemed to alleviate this tendency. We clarified that "time over 2.0 METs" and "time over 1.5 METs" could be predictors for "On" and "dyskinesia" on a 30-min basis, respectively (AUROC: 0.779 and 0.959, 95% CI: 0.733-0.824 and 0.918-1.000). The specificity and sensitivity of the optimal activity pattern for "On" were 0.858 and 0.621. Conclusions This study suggested feasible activity patterns and METs parameters for objective evaluation of motor symptoms on a 30-min or daily basis. Three-axis accelerometer measures focusing on higher METs may be appropriate for evaluating physical activity. Further larger-scale studies are necessary to clarify the validity, reliability, and clinical utility of these objective measures.