Objective: To develop a wearable device with novel software features for real-time analysis and assessment of tremor in the clinical environment.

Background: Visual examination of tremor is common in clinical practice to describe the impact on functional ability. However, this approach is highly subjective. Inertial and bioelectrical sensors are able to objectively quantify the severity of a wide range of symptoms in movement disorders. For example, tremor, bradykinesia, dyskinesia and freezing of gait in Parkinson’s disease (PD).

Methods: TreCap is a custom-built prototype and the software is tailored to tremor research in PD and essential tremor. Inertial sensors on the device measure limb kinematics, such as acceleration and angular velocity. A bioelectrical unit is able to measure neuromuscular activity via surface electromyography. Sensor data is streamed via Bluetooth® to a custom-written MATLAB® software. For clinical testing, a graphical user interface (GUI) is provided to visualize and assess tremor during visually-guided movements. To classify the clinical test manoeuvres, a magnetic field sensor is integrated in the device and the software is able to visualize the trajectory. Real-time data is processed semi-automatically, i.e. tailored to each movement and allocated to the assessment. The device is able to ensure long-term measurements outside the clinical environment via a microSD card. To evaluate TreCap, a clinical expert has measured tremor on the upper extremities of ten subjects. Results were compared to visual ratings.

Results: TreCap was developed based on well-defined clinical research purposes to assist in analysis, diagnosis and treatment of various types of tremor. The software allows high configurability of the device via Bluetooth®. Results from our small cohort demonstrate that TreCap is able to visualize small deviations of tremor kinetics with high resolution. In addition, the GUI provides the framework to implement an automated tremor classification and assessment in the future.

Conclusions: TreCap has the potential to quantify various types of movement disorders. The combination of inertial and bioelectrical measurements may help to quantify effects of DBS, anti-Parkinsonian medication, or other treatments more precisely.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/trecap-quantify-and-assess-tremor-in-real-time-with-a-new-wearable-device/