Digital Markers of Mobility in Daily Life to Track Progression in Newly Diagnosed Parkinson's Disease

项目摘要/摘要 帕金森氏病(PD)和其他疾病的疾病修正干预措施发展的关键限制 神经退行性疾病是缺乏可靠的、客观的疾病进展的衡量标准。步行和 帕金森病早期出现转向功能障碍，并使用惯性传感器测量步行和 翻身可以提供疾病进展和生活质量下降的敏感、客观的标志。 新的可穿戴技术可以提供可靠的、客观的行走和转身措施，这些措施对 临床试验。然而，在无人监督的情况下，日常生活中的行走和转弯都是未被开发的 有可能提供对疾病进展、生活质量更敏感的客观衡量标准 和跌倒的风险比目前主观的临床活动能力衡量标准更高。我们预测车削质量可能会持平。 在早期帕金森病患者中，由于增加了动力，因此对疾病的进展比笔直行走更敏感 平衡挑战。目的我将确定100名患者中最敏感的行动能力(日常生活)指标 早期、未经治疗的帕金森病患者和50名老年对照组受试者。我们假设无人监督的日常生活流动性 对于早期帕金森病，措施将是敏感和具体的。AIM II将确定日常生活中行动能力的衡量标准 对疾病进展最敏感。我们假设日常生活中的转向特征(特别是 性能的可变性)将是最近3年内变化最敏感的移动性指标 被诊断为帕金森病患者。AIM III将根据日常生活中步行和步行的客观测量来预测未来的跌倒 转身。我们假设，日常生活步态和转身质量的客观测量将显著改善 预测谁将摔倒和第一次摔倒的时间与临床测量(即跌倒风险)进行比较。身份识别 使用可穿戴设备在现实生活活动中对行动障碍进展进行最敏感的一组测量 技术将为测试新技术的有效性提供可量化和客观的结果衡量标准 治疗疾病的疗法。活动度下降预后的改善也将改善临床治疗的时机 干预措施。

Project Summary/Abstract A critical limitation in development of disease-modifying interventions for Parkinson's disease (PD) and other neurodegenerative diseases is the lack of reliable, objective measures of disease progression. Walking and turning dysfunction appear early in Parkinson's disease and use of inertial sensors to measure walking and turning may provide sensitive, objective markers of disease progression as well as of decline in quality of life. New wearable technology can provide reliable, objective measures of walking and turning that are feasible for clinical trials. However, quantifying walking and turning during unsupervised, daily life has the untapped potential to provide objective measures that are even more sensitive to disease progression, to quality of life and fall risk than current subjective clinical measures of mobility. We predict that turning quality may be even more sensitive to progression of disease in early PD, than straight walking because of the added dynamic balance challenges. Aim I will determine the most sensitive measures of mobility (daily life) in 100 people with early, untreated PD and 50 older control subjects. We hypothesize that unsupervised daily life mobility measures will be sensitive and specific for early PD. Aim II will determine the measures of mobility in daily life most sensitive to disease progression. We hypothesize that turning characteristics during daily life (particularly variability of performance) will be the most sensitive mobility measures to change over 3 years in recently diagnosed people with PD. Aim III will predict future falls based on daily life objective measures of walking and turning. We hypothesize that objective measures of daily life gait and turning quality will significantly improve prediction of who will fall and time-to-first-fall compared to clinical measures (i.e., fall risk). Identification of the most sensitive set of measures of mobility disability progression during real life activities with wearable technology will provide quantifiable and objective outcome measures for testing the effectiveness of new disease-modifying therapies. Improved prognosis of mobility decline will also improve timing of clinical interventions.