A Clinical Applicable Smartwatch Application for Measuring Hyperkinetic Movement Disorder Severity

Measuring the severity of hyperkinetic movement disorders like tremor and myoclonus is challenging. Although many accelerometers are available to quantify movements, the vast majority lacks real-time analysis and an interface that makes it possible to real-time adjust therapy like deep brain stimulation (DBS). Here, we developed a smartwatch / smartphone application that is capable of real-time analysing movement disorder severity. Movement analysis was realised by integrating acceleration values, to velocity and subsequently to distance. Measured distances were compared with a validated accelerometer already applied for quantifying movement disorders. Further validation was done by quantitative assessment of simulated movement disorders in 10 healthy volunteers. Finally, the approach was tested in two patients treated with DBS to quantify the effect of different DBS settings on myoclonus and tremor severity, respectively. The distance measured with the application had a 96% accuracy. This was non-inferior (p = 0.76) compared to accelerometers already clinically applied. Furthermore, (simulated) movement disorder severity could be classified correctly in 93% of the cases. Finally, the method was capable of distinguishing effective from non-effective DBS parameters in two patients. In summary, with our approach we realised an instantaneous and reliable estimation of the severity of movement disorders which can assist in real time titrating therapy like DBS.</p

Intraoperative Quantification of MDS-UPDRS Tremor Measurements Using 3D Accelerometry:A Pilot Study

The most frequently used method for evaluating tremor in Parkinson’s disease (PD) is currently the internationally standardized Movement Disorder Society—Unified PD Rating Scale (MDS-UPDRS). However, the MDS-UPDRS is associated with limitations, such as its inherent subjectivity and reliance on experienced raters. Objective motor measurements using accelerometry may overcome the shortcomings of visually scored scales. Therefore, the current study focuses on translating the MDS-UPDRS tremor tests into an objective scoring method using 3D accelerometry. An algorithm to measure and classify tremor according to MDS-UPDRS criteria is proposed. For this study, 28 PD patients undergoing neurosurgical treatment and 26 healthy control subjects were included. Both groups underwent MDS-UPDRS tests to rate tremor severity, while accelerometric measurements were performed at the index fingers. All measurements were performed in an off-medication state. Quantitative measures were calculated from the 3D acceleration data, such as tremor amplitude and area-under-the-curve of power in the 4–6 Hz range. Agreement between MDS-UPDRS tremor scores and objective accelerometric scores was investigated. The trends were consistent with the logarithmic relationship between tremor amplitude and MDS-UPDRS score reported in previous studies. The accelerometric scores showed a substantial concordance (>69.6%) with the MDS-UPDRS ratings. However, accelerometric kinetic tremor measures poorly associated with the given MDS-UPDRS scores (R2 < 0.3), mainly due to the noise between 4 and 6 Hz found in the healthy controls. This study shows that MDS-UDPRS tremor tests can be translated to objective accelerometric measurements. However, discrepancies were found between accelerometric kinetic tremor measures and MDS-UDPRS ratings. This technology has the potential to reduce rater dependency of MDS-UPDRS measurements and allow more objective intraoperative monitoring of tremor

Aplicação móvel e plataforma Web para suporte à estimação de gasto energético em actividade física

Esta dissertação descreve os trabalhos de investigação realizados na construção de uma plataforma informática para motivação para a realização de exercício físico, com recurso a técnicas de medição de energia dispendida no decurso do exercício, medição de distância percorrida e medição do tempo de salto de um indivíduo. Estas características encontram-se implementadas numa aplicação móvel, implementada sobre um telefone do tipo Smartphone e usando os sensores deste dispositivo, enquanto que outra parte da plataforma, uma aplicação usando tecnologias Web, gere o registo e as atividades dos utilizadores. Esta dissertação descreve ainda os trabalhos de validação das aplicações implementadas, e apresenta as conclusões sobre estes trabalhos.This dissertation describes the research work performed for the design and implementation of a physical exercise motivation platform, using energy expenditure techniques, measurement of the travelled distance, and the time of flight of a jump. These measurements are implemented in an application designed for a Smartphone, using the sensors available in many of these devices. The platform is also composed of an application using Web technologies, that records and manages the users and their activities. This dissertation describes also the validation procedures for the results given by the applications, and presents the relevant conclusions

Distance estimation from acceleration for quantitative evaluation of Parkinson tremor.

The purpose of this paper is to assess Parkinson tremor estimating actual distance amplitude. We propose a practical, useful and simple method for evaluating Parkinson tremor with distance value. We measured resting tremor of 7 Parkinson Disease (PD) patients with triaxial accelerometer. Resting tremor of participants was diagnosed by Unified Parkinson&apos;s Disease Rating Scale (UPDRS) by neurologist. First, we segmented acceleration signal during 7 seconds from recorded data. To estimate a displacement of tremor, we performed double integration from the acceleration. Prior to double integration, moving average method was used to reduce an error of integral constant. After estimation of displacement, we calculated tremor distance during 1s from segmented signal using Euclidean distance. We evaluated the distance values compared with UPDRS. Averaged moving distance during 1 second corresponding to UPDRS 1 was 11.52 mm, that of UPDRS 2 was 33.58 mm and tremor distance of UPDRS 3 was 382.22 mm. Estimated moving distance during 1s was proportional to clinical rating scale--UPDRS.N