Irina Galperin1, Inbar Hillel1, Silvia Del Din2, Esther M J Bekkers3, Alice Nieuwboer3, Giovanni Abbruzzese4, Laura Avanzino5, Freek Nieuwhof6, Bastiaan R Bloem7, Lynn Rochester8, Ugo Della Croce9, Andrea Cereatti10, Nir Giladi11, Anat Mirelman11, Jeffrey M Hausdorff12. 1. Center for the study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel. 2. Institute of Neuroscience, Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK. 3. Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Belgium. 4. Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genova, Italy; IRCCS San Martino Teaching Hospital, Genoa, Italy. 5. IRCCS San Martino Teaching Hospital, Genoa, Italy; Department of Experimental Medicine, Section of Human Physiology, University of Genova, Italy. 6. Donders Institute for Brain, Cognition and Behaviour; Radboudumc, Department of Neurology, Nijmegen, the Netherlands; Radboud university Medical Center, Departments of Geriatric Medicine, Neurology and Parkinson's Disease Center Nijmegen (ParC), Nijmegen, the Netherlands. 7. Donders Institute for Brain, Cognition and Behaviour; Radboudumc, Department of Neurology, Nijmegen, the Netherlands. 8. Institute of Neuroscience, Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK; The Newcastle upon Tyne Hospitals NHS Foundation Trust, UK. 9. Department of Biomedical Sciences, Bioengineering unit, University of Sassari, Sassari (SS), Italy; Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, Sassari (SS), Italy. 10. Department of Biomedical Sciences, Bioengineering unit, University of Sassari, Sassari (SS), Italy; Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, Sassari (SS), Italy; Department of Electronics and Telecommunications, Politecnico di Torino, Torino (TO), Italy. 11. Center for the study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel; Sagol School of Neuroscience, Tel Aviv University, Israel; Department of Neurology and Neurosurgery, Sackler School of Medicine, Tel Aviv University, Israel. 12. Center for the study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel; Department of Physical Therapy, Sackler Faculty of Medicine, Israel; Sagol School of Neuroscience, Tel Aviv University, Israel; Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, USA. Electronic address: jhausdor@tlvmc.gov.il.
Abstract
INTRODUCTION: Recent work suggests that wearables can augment conventional measures of Parkinson's disease (PD). We evaluated the relationship between conventional measures of disease and motor severity (e.g., MDS-UPDRS part III), laboratory-based measures of gait and balance, and daily-living physical activity measures in patients with PD. METHODS: Data from 125 patients (age: 71.7 ± 6.5 years, Hoehn and Yahr: 1-3, 60.5% men) were analyzed. The MDS-UPDRS-part III was used as the gold standard of motor symptom severity. Gait and balance were quantified in the laboratory. Daily-living gait and physical activity metrics were extracted from an accelerometer worn on the lower back for 7 days. RESULTS: In multivariate analyses, daily-living physical activity and gait metrics, laboratory-based balance, demographics and subject characteristics together explained 46% of the variance in MDS-UPDRS-part III scores. Daily-living measures accounted for 62% of the explained variance, laboratory measures 30%, and demographics and subject characteristics 7% of the explained variance. Conversely, demographics and subject characteristics, laboratory-based measures of gait symmetry, and motor symptom severity together explained less than 30% of the variance in total daily-living physical activity. MDS-UPDRS-part III scores accounted for 13% of the explained variance, i.e., <4% of all the variance in total daily-living activity. CONCLUSIONS: Our findings suggest that conventional measures of motor symptom severity do not strongly reflect daily-living activity and that daily-living measures apparently provide important information that is not captured in a conventional one-time, laboratory assessment of gait, balance or the MDS-UPDRS. To provide a more complete evaluation, wearable devices should be considered.
INTRODUCTION: Recent work suggests that wearables can augment conventional measures of Parkinson's disease (PD). We evaluated the relationship between conventional measures of disease and motor severity (e.g., MDS-UPDRS part III), laboratory-based measures of gait and balance, and daily-living physical activity measures in patients with PD. METHODS: Data from 125 patients (age: 71.7 ± 6.5 years, Hoehn and Yahr: 1-3, 60.5% men) were analyzed. The MDS-UPDRS-part III was used as the gold standard of motor symptom severity. Gait and balance were quantified in the laboratory. Daily-living gait and physical activity metrics were extracted from an accelerometer worn on the lower back for 7 days. RESULTS: In multivariate analyses, daily-living physical activity and gait metrics, laboratory-based balance, demographics and subject characteristics together explained 46% of the variance in MDS-UPDRS-part III scores. Daily-living measures accounted for 62% of the explained variance, laboratory measures 30%, and demographics and subject characteristics 7% of the explained variance. Conversely, demographics and subject characteristics, laboratory-based measures of gait symmetry, and motor symptom severity together explained less than 30% of the variance in total daily-living physical activity. MDS-UPDRS-part III scores accounted for 13% of the explained variance, i.e., <4% of all the variance in total daily-living activity. CONCLUSIONS: Our findings suggest that conventional measures of motor symptom severity do not strongly reflect daily-living activity and that daily-living measures apparently provide important information that is not captured in a conventional one-time, laboratory assessment of gait, balance or the MDS-UPDRS. To provide a more complete evaluation, wearable devices should be considered.
Authors: Martina Mancini; Bastiaan R Bloem; Fay B Horak; Simon J G Lewis; Alice Nieuwboer; Jorik Nonnekes Journal: Mov Disord Date: 2019-05-02 Impact factor: 10.338
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Authors: Annemarie Smid; Jan Willem J Elting; J Marc C van Dijk; Bert Otten; D L Marinus Oterdoom; Katalin Tamasi; Tjitske Heida; Teus van Laar; Gea Drost Journal: J Clin Med Date: 2022-04-19 Impact factor: 4.241