Objective: To clinically assess wearable motion sensors for measuring tremor, dyskinesia, slowness, and mobility and an electronic diary for Parkinson’s disease (PD)

Background: A patient or caretaker is often asked to record their perceived state in a diary at 30 minute intervals to capture PD state outside the clinic. Diaries, however, can be burdensome, suffer from poor compliance, and rely entirely on patient perception. Wearable sensors can record body motion throughout the day and could potentially provide a less burdensome means to detect and quantify PD symptoms.

Methods: Thirteen adults (Age 53-74) with Parkinson’s disease and at least two hours of OFF time and/or one hour of troublesome dyskinesia participated in a 5-month study. Participants were trained to don motion sensors on the wrist and ankle and use a smartphone app to record a diary of their disease state. Participants were instructed to use the system throughout the waking day for blocks of four consecutive days during the first week, third week, and each of months 2-5. Previously validated algorithms processed the motion data to detect and quantify tremor, dyskinesia, slowness, and mobility, which were compared to diary entries.

Results: Tremor, dyskinesia, slowness, and mobility were successfully recorded throughout the 5-month study. Participants reporting tremor at the start of the study spent significantly more time experiencing tremor and had a higher tremor score as measured by the motion sensor system than those who did not report tremor (p<0.00001). In these participants there was a significant correlation between the percent of diary entries in the OFF state and percent of day tremor was detected by the motion sensor system (r=0.58, p=0.005). Likewise, participants reporting dyskinesia experienced significantly more dyskinesia and exhibited higher dyskinesia scores (p<0.05). Percent of day marked in the diary as dyskinetic correlated to percent of day dyskinesia was detected by the motion sensor system (r=0.45, p=0.003).

Conclusions: The wearable system captures clinically relevant data throughout the day with increased temporal resolution. Differences in symptom categorical output of motion sensors and diary recordings may be explained as a combination of patient sensation subjectivity, overestimation of brief symptom states into 30-minute blocks of time, effects of different reporting time-scales, and patient or sensor error.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/wearable-motion-quantification-and-electronic-diaries-for-long-term-monitoring-of-parkinsons-disease/