Objective: 1. Test whether slow response to the medication and EMO-periods (Early Morning Off), affects the patient`s experience of being able to perform ADL-functions. 2. Extract new features from The Parkinson KinetiGraph-measures that predict scores in the MDS-UPDRS Part II. These include EMO (number of periods and duration), motor fluctuations and response to medication dosages.

Background: Parkinson’s Disease (PD) is a progressive neurodegenerative disease, where curative treatment is not available. Patients with PD exhibit very heterogeneous clinical phenotypes (1). The patients need to be able to handle the classical triad of motor symptoms; bradykinesia, tremor and rigidity, but also non-motor symptoms (2). The impact of the symptoms on everyday life and the execution of Activity of Daily Living (ADL, e.g. getting dressed, taking a shower, cooking etc.) are often measured by self-reported diaries alone (3). Coping behaviour regarding everyday life with the PD-symptoms, including the execution of ADL-functions, is associated with quality of life (QOL), depression, bodily discomfort and mortality (4). The complexity and irregular nature of motor manifestations needs observations from within the individual’s natural environment to obtain a realistic picture of the management of the symptoms (5). Therefore, objective measurements from devices capable of automatically and continuously detecting and recording motor symptoms may help provide insight into the PD patient`s everyday life.

Method: In this cross-sectional study with a convergent Mixed Methods design, 35 patients with PD are included. Both quantitative data (PKG-measurements and MDS-UPDRS Part II assessments) and qualitative data (the patient`s own descriptions of the impact of the symptoms on ADL-functions) are collected.

Results: Preliminary results reveal a relation between EMO, slow-response to medication and the patients’ self-reported experience of their execution of ADL. Furthermore, we will test a correlation with the MDS-UPDRS Part II score and PKG-scores. The study is so far limited to analysis of five patients. We expect to be able to present the full results from 35 patients in September 2019.

Conclusion: Not yet any conclusions, but we expext to present a conclusion and the clinical impact in September 2019.

References: 1. Pringsheim,T., Jette,N., Frolkis,A., Steeves,TD. The Prevalence of Parkinson`s Disease: a systematic review and metaanalysis. Society of Movement Disorders. 2014, Vol.29 (13), p.1583-90. 2. Jankovic J. Parkinson’s Disease: Clinical features and diagnosis. J Neurol Neurosurg Psychiatry (2008) 79; 368-376. 3. Papapetropoulos, SS. Patient diaries as a clinical endpoint in Parkinson`s Disease clinical trials. CNS Neuroscience Theraphy,2012, May (5), p.380-387. 4. Lawrence,BJ., Gasson,N., Kane,R., Bucks,RS., Loftus,A. Activities of Daily Living, Depression, and Quality of Life in Parkinson`s Disease. PLoS One. 2014, Vol.9(7). 5. Robert I. Griffiths, Katya Kotschet, Sian Arfona, Zheng Ming Xud, William Johnson, John Dragoa, Andrew Evans, Peter Kempster, San¬jay Raghav and Malcolm K. Horne. Automated assessment of Bradykinesia and Dyskinesia in Parkinson’s Disease. Journal of Parkin¬son’s disease 2, 47 (2012)

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-characterization-of-the-adl-level-in-daily-life-with-parkinsons-disease-based-on-objective-measurements-and-subjective-experiences/