Telehealth Management of Parkinson's Disease Using Wearable Sensors: An Exploratory Study.
Telehealth Management of Parkinson's Disease Using Wearable Sensors: An Exploratory Study.
复制标题
DOI：
10.1159/000475801
复制
发表时间：
2017-09
影响因子：
--
通讯作者：
Burack MA
中科院分区：
文献类型：
--
作者：
Heldman DA;Harris DA;Felong T;Andrzejewski KL;Dorsey ER;Giuffrida JP;Goldberg B;Burack MA
帕金森病（PD）的运动症状可以波动，可能不能准确反映在临床评估。此外，对于许多PD患者来说，接触运动障碍专家的机会有限。目的是评估基于运动传感器的远程医疗诊断对PD临床护理和管理的影响。18名成年PD患者被随机分为对照组和实验组。所有参与者都被要求在家中使用基于运动传感器的监测系统，每周一天，持续七个月。该系统包括一个手指佩戴的运动传感器和基于平板电脑的软件界面，指导患者完成量化震颤、运动迟缓和运动障碍的任务。数据被处理成运动症状严重程度报告，由运动障碍神经科医生对实验组参与者进行审查。三个月和六个月后，对照组的参与者去诊所进行常规预约，而实验组的参与者则进行视频会议或电话会议。以家庭为基础的评估完成，中位依从性为95.7%。对于一部分参与者，神经科医生成功地利用报告中的信息，如量化治疗反应或随着时间的推移进行治疗调整。从研究开始到结束，临床特征的变化在两组之间无显著差异。PD患者能够并且愿意使用远程监控技术。远程医疗诊断辅助下的患者管理提供了与标准护理相当的结果。远程医疗技术与可穿戴传感器相结合，有可能改善对不同PD人群或无法旅行的人的护理。
Parkinson’s disease (PD) motor symptoms can fluctuate and may not be accurately reflected during a clinical evaluation. In addition, access to movement disorder specialists is limited for many with PD. The objective was to assess the impact of motion sensor-based telehealth diagnostics on PD clinical care and management. Eighteen adults with PD were randomized to control or experimental groups. All participants were instructed to use a motion sensor-based monitoring system at home one day per week, for seven months. The system included a finger-worn motion sensor and tablet-based software interface that guided patients through tasks to quantify tremor, bradykinesia, and dyskinesia. Data were processed into motor symptom severity reports, which were reviewed by a movement disorders neurologist for experimental group participants. After three months and six months, control group participants visited the clinic for a routine appointment, while experimental group participants had a videoconference or phone call instead. Home based assessments were completed with median compliance of 95.7%. For a subset of participants, the neurologist successfully used information in the reports such as quantified response to treatment or progression over time to make therapy adjustments. Changes in clinical characteristics from study start to end were not significantly different between groups. Individuals with PD were able and willing to use remote monitoring technology. Patient management aided by telehealth diagnostics provided comparable outcomes to standard care. Telehealth technologies combined with wearable sensors have the potential to improve care for disparate PD populations or those unable to travel.