Abstract
The increasing prevalence of neurodegenerative conditions such as Parkinson’s disease (PD) and related mobility issues places a serious burden on healthcare systems. The COVID-19 pandemic has reinforced the urgent need for better tools to manage chronic conditions remotely, as regular access to clinics may be problematic. Digital health technology in the form of remote monitoring with body-worn sensors offers significant opportunities for transforming research and revolutionizing the clinical management of PD. Significant efforts are being invested in the development and validation of digital outcomes to support diagnosis and track motor and mobility impairments “off-line”. Imagine being able to remotely assess your patient, understand how well they are functioning, evaluate the impact of any recent medication/intervention, and identify the need for urgent follow-up before overt, irreparable change takes place? This could offer new pragmatic solutions for personalized care and clinical research. So the question remains: how close are we to achieving this? Here, we describe the state-of-the-art based on representative papers published between 2017 and 2020. We focus on remote (i.e., real-world, daily-living) monitoring of PD using body-worn sensors (e.g., accelerometers, inertial measurement units) for assessing motor symptoms and their complications. Despite the tremendous potential, existing challenges exist (e.g., validity, regulatory) that are preventing the widespread clinical adoption of body-worn sensors as a digital outcome. We propose a roadmap with clear recommendations for addressing these challenges and future directions to bring us closer to the implementation and widespread adoption of this important way of improving the clinical care, evaluation, and monitoring of PD.
Highlights
INTRODUCTIONImportant opportunity for improving the evaluation and monitoring of Parkinson’s disease (PD) motor symptoms
THE “VISION”—ARE WE THERE YET?important opportunity for improving the evaluation and monitoring of PD motor symptoms.At the 2013 World Congress of the International Society of Posture and Gait Research, a keynote speaker predicted that digital health technology such as body-worn sensors (BWS) would soon become a routine, widely used tool to augment the clinical examination of patients with Parkinson’s disease (PD) and, more importantly, enhance patients’ quality of life [1]
An emerging, exciting set of studies demonstrated that continuous, “24/7” remote monitoring empowered by BWS had the potential to measure, characterize, and quantify both subtle and large changes in mobility and other critical motor symptoms of a patient with PD, providing a robust comprehensive map of the patient’s function and its changes over time
Summary
Important opportunity for improving the evaluation and monitoring of PD motor symptoms. An emerging, exciting set of studies demonstrated that continuous, “24/7” remote monitoring empowered by BWS had the potential to measure, characterize, and quantify both subtle and large changes in mobility and other critical motor symptoms of a patient with PD, providing a robust comprehensive map of the patient’s function and its changes over time. In this vision, a patient would receive a small package in the mail containing a BWS several weeks before a routine clinical exam. RodrıguezMartın et al, 2017 [36] RodrıguezMartın et al, 2017 [37] Mancini et al, 2018 [54]
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