Telehealth Management of Parkinson’s Disease Using Wearable Sensors: An Exploratory Study

• Published in: Digital biomarkers 2017-09, Vol.1 (1), p.43-51
• Main Authors: Heldman, Dustin A., Harris, Denzil A., Felong, Timothy, Andrzejewski, Kelly L., Dorsey, E. Ray, Giuffrida, Joseph P., Goldberg, Barry, Burack, Michelle A.
• Format: Article
• Language: English
• Subjects: Chronic illnesses; Original Paper; Parkinson's disease; Patient assessment; Questionnaires; Sensors; Telemedicine; Usability; Video teleconferencing
• ISSN: 2504-110X; 2504-110X
• DOI: 10.1159/000475801

Background: Parkinson’s disease (PD) motor symptoms can fluctuate and may not be accurately reflected during a clinical evaluation. In addition, access to movement disorder specialists is limited for many people with PD. The objective of this study was to assess the impact of motion sensor-based telehealth diagnostics on PD clinical care and management. Methods: Eighteen adults with PD were randomized to control or experimental groups. All participants were instructed to use a motion sensor-based monitoring system at home 1 day per week for 7 months. The system included a finger-worn motion sensor and tablet-based software interface that guided patients through tasks to quantify tremor, bradykinesia, and dyskinesia. Data were processed into motor symptom severity reports, which were reviewed by a movement disorder neurologist for the experimental group participants. After 3 months and 6 months, the control group participants visited the clinic for a routine appointment, while the experimental group participants had a videoconference or phone call instead. Results: Home-based assessments were completed with a median compliance of 95.7%. For a subset of participants, the neurologist successfully used information in the reports, such as quantified responses to treatment or progression over time, to make therapy adjustments. Changes in clinical characteristics from study start to end were not significantly different between the groups. Discussion: Individuals with PD were able and willing to use remote monitoring technology. Patient management aided by telehealth diagnostics provided comparable outcomes to standard care. Telehealth technologies combined with wearable sensors have the potential to improve care for disparate PD populations or those unable to travel.