Objective: To explore perspectives of people with Parkinson’s disease (PD), carers and health and social care professionals (HSCPs) in Ghana and Kenya on the acceptability and feasibility of digital mobility assessment in PD clinical care.

Background: Mobility impairments are a defining feature of PD. Real-world mobility outcomes (e.g. walking speed) can be objectively assessed in people with PD (PwP) using a wearable device placed on the lower back, with feasibility demonstrated in PwP in West Africa (1) and frail older adults in East Africa (2). However, acceptability of digital mobility assessment in these settings, and feasibility for routine care, remains unclear.

Method: 15 PwP, 13 carers, and 37 HSCPs (n=65) participated in eight workshops across four urban and rural clinical sites in Ghana (West Africa) and Kenya (East Africa). Participants wore the device on their lower backs during the workshop to experience its use, followed by a brief explanation of data collection over a seven day period and potential clinical relevance. Discussions explored perspectives on digital mobility assessment. Data were analysed using thematic analysis.

Results: PwP and carers found the devices comfortable and appreciated the discreet placement, which could reduce stigma. HSCPs expressed interest in digital mobility assessment for supporting medication adjustment, understanding real-world function beyond the clinic, and informing goal-setting and behaviour change, with all groups emphasising the importance of sharing and discussing data with patients. HSCPs also highlighted the need for local validation in Ghana and Kenya. Substantial infrastructure and ethical challenges were identified, including limited technical, financial and staff resources and the appropriateness of digital monitoring in contexts where many individuals lack access to basic needs and medication.

Conclusion: Digital mobility assessment may offer useful insights into real-world mobility in PD in Ghana and Kenya. Future work should prioritise local validation and small clinical pilots to assess whether benefits justify wider implementation in digitally limited health systems with restricted access to medication and allied health services, without worsening inequities.

References: 1. Bicer, M, Kirk, C, Agoriwo, M, Cham, M, Akpalu, A, Okubadeio, N, Sarvestan, J, Lumdsdon, J, Brittain, K, Mc Ardle, R, Alcock, L, Yarnall, A, Fothergill-Misbah, N, Walker, R, Rochester, L, Del Din, S (Under Revision). Digital mobility assessment using wearable devices to support diagnosis of Parkinson’s Disease in Ghana: Feasibility and Implementation results from the Transforming Parkinson’s Care in Africa (TraPCAf) study. Journal of Parkinson’s Disease

2. Del Din, S., Lewis, E.G., Gray, W.K., Collin, H., Kissima, J., Rochester, L., Dotchin, C., Urasa, S. and Walker, R., 2020. Monitoring Walking activity with wearable technology in rural-dwelling older adults in Tanzania: a feasibility study nested within a frailty prevalence study. Experimental Aging Research, 46(5), pp.367-381.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/acceptability-and-feasibility-of-digital-mobility-assessment-for-parkinsons-disease-perspectives-from-people-with-parkinsons-carers-and-health-and-social-care-professionals-in-ghan/