An experience of health technology assessment in new models of care for subjects with Parkinson's disease by means of a new wearable device.

Step counting is an important index of motion activity and it is currently used in the management of obesity, in applications for the prevention of cardiovascular problems, in diabetes care, and in motion rehabilitation. Commercial pedometers are not appropriate for telemonitoring subjects with motion disability such as Parkinson's disease. The aim of this paper was to test the integration of a Gastrocnemius Expansion Measurement Unit (GEMU) for step counting in a telemedicine application involving subjects with Parkinson's Disease. The test of GEMU in a new model of care was performed on 6 subjects with Parkinson's disease at Level 3 of the Tinetti test of unbalance. They were asked to record binary information about the correct assumption of dopaminergic therapy. Results showed greater than 97% success of monitoring. A statistical analysis also shows (p < 0.05) the feasibility of correlating the decrement of mobility in terms of the step counting with an incorrect assumption of dopaminergic therapy. Furthermore, the methodology showed a high degree of acceptance, and the users gave suggestions for future improvements, especially related to the interface between GEMU and home care itself.