Objective: We sought to investigate patient and clinician usability of a smartwatch-based wearable motor assessment system for measuring Parkinson’s disease (PD) motor symptoms in patients undergoing therapy changes.

Background: PD is poorly quantified by patients outside the clinic, and diaries have problems with subjective descriptions and bias. Wearable sensor platforms, however, can accurately quantify symptoms such as tremor, dyskinesia, and bradykinesia. Commercially-available smartwatches are equipped with accelerometers and gyroscopes that can measure motion for objective evaluation.

Method: Six participants (3 M, 3 F, age range 59-87 years, disease duration 6-17 years) were instructed to perform app-based motor tests while wearing a smartwatch to assess tremor, dyskinesia, and slowness over the course of five weeks following initiation of a new therapy regimen (three began inhaled levodopa, two began istradefylline, one began trihexyphenidyl). Patients were able to view reports detailing symptom severities on their smartphone as color-coded graphs corresponding to None, Mild, Moderate, and Severe. Clinicians and patients provided feedback on their experiences with the smartwatch and app. Analyses of the recordings to measure the effect of medication and exercise on symptom scores were also performed.

Results: Study participants used the app to assess PD symptoms an average of 4.7 times per day for 3 days per week during the five-week study. The smartwatch-based measure showed significant reduction in the symptom scores (p<0.05) in the hours following recorded use of the newly prescribed therapy in two participants (inhaled levodopa or istradefylline). Participants provided positive feedback on device capabilities, stating the tests were sufficiently easy, and expressed desire to use the system. Participants also expressed the desire for additional assessments to fit their particular symptom sets such as lower extremity tremor, facial tremor, and gait disorders.

Conclusion: The smartwatch-based app demonstrated temporal improvement in symptom scores following application of new therapy. Patients and clinicians agreed that the smartwatch-based motor assessment system including direct feedback to patients could be a useful supplement to PD therapy management.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/real-world-evidence-for-a-smartwatch-based-parkinsons-motor-assessment-app-in-patients-undergoing-therapy-changes/