How Does Technology Development Influence the Assessment of Parkinson’s Disease? A Systematic Review

abstract: Parkinson’s disease (PD) is a neurological disorder with complicated and disabling motor and non-motor symptoms. The pathology for PD is difficult and expensive. Furthermore, it depends on patient diaries and the neurologist’s subjective assessment of clinical scales. Objective, accurate, and continuous patient monitoring have become possible with the advancement in mobile and portable equipment. Consequently, a significant amount of work has been done to explore new cost-effective and subjective assessment methods or PD symptoms. For example, smart technologies, such as wearable sensors and optical motion capturing systems, have been used to analyze the symptoms of a PD patient to assess their disease progression and even to detect signs in their nascent stage for early diagnosis of PD. This review focuses on the use of modern equipment for PD applications that were developed in the last decade. Four significant fields of research were identified: Assistance diagnosis, Prognosis or Monitoring of Symptoms and their Severity, Predicting Response to Treatment, and Assistance to Therapy or Rehabilitation. This study reviews the papers published between January 2008 and December 2018 in the following four databases: Pubmed Central, Science Direct, IEEE Xplore and MDPI. After removing unrelated articles, ones published in languages other than English, duplicate entries and other articles that did not fulfill the selection criteria, 778 papers were manually investigated and included in this review. A general overview of PD applications, devices used and aspects monitored for PD management is provided in this systematic review.Dissertation/ThesisMasters Thesis Computer Engineering 201

Machine Learning in Tremor Analysis: Critique and Directions

Tremor is the most frequent human movement disorder, and its diagnosis is based on clinical assessment. Yet finding the accurate clinical diagnosis is not always straightforward. Fine-tuning of clinical diagnostic criteria over the past few decades, as well as device-based qualitative analysis, has resulted in incremental improvements to diagnostic accuracy. Accelerometric assessments are commonplace, enabling clinicians to capture high-resolution oscillatory properties of tremor, which recently have been the focus of various machine-learning (ML) studies. In this context, the application of ML models to accelerometric recordings provides the potential for less-biased classification and quantification of tremor disorders. However, if implemented incorrectly, ML can result in spurious or nongeneralizable results and misguided conclusions. This work summarizes and highlights recent developments in ML tools for tremor research, with a focus on supervised ML. We aim to highlight the opportunities and limitations of such approaches and provide future directions while simultaneously guiding the reader through the process of applying ML to analyze tremor data. We identify the need for the movement disorder community to take a more proactive role in the application of these novel analytical technologies, which so far have been predominantly pursued by the engineering and data analysis field. Ultimately, big-data approaches offer the possibility to identify generalizable patterns but warrant meaningful translation into clinical practice. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society

Automatic resting tremor assessment in Parkinson’s disease using smartwatches and multitask convolutional neural networks

Resting tremor in Parkinson’s disease (PD) is one of the most distinctive motor symptoms. Appropriate symptom monitoring can help to improve management and medical treatments and improve the patients’ quality of life. Currently, tremor is evaluated by physical examinations during clinical appointments; however, this method could be subjective and does not represent the full spectrum of the symptom in the patients’ daily lives. In recent years, sensor-based systems have been used to obtain objective information about the disease. However, most of these systems require the use of multiple devices, which makes it difficult to use them in an ambulatory setting. This paper presents a novel approach to evaluate the amplitude and constancy of resting tremor using triaxial accelerometers from consumer smartwatches and multitask classification models. These approaches are used to develop a system for an automated and accurate symptom assessment without interfering with the patients’ daily lives. Results show a high agreement between the amplitude and constancy measurements obtained from the smartwatch in comparison with those obtained in a clinical assessment. This indicates that consumer smartwatches in combination with multitask convolutional neural networks are suitable for providing accurate and relevant information about tremor in patients in the early stages of the disease, which can contribute to the improvement of PD clinical evaluation, early detection of the disease, and continuous monitoring.This research was funded by the following projects: (1) "Tecnologias Capacitadoras para la Asistencia, Seguimiento y Rehabilitacion de Pacientes con Enfermedad de Parkinson". Centro Internacional sobre el envejecimiento, CENIE (codigo 0348_CIE_6_E) Interreg V-A Espana-Portugal (POCTEP). (2) Ecuadorian Government Granth "Becas internacionales de posgrado 2019" of the Secretaria de Educacion Superior, Ciencia, Tecnologia e Innovacion (SENESCYT), received by the author Luis Sigcha

A wearable system to objectify assessment of motor tasks for supporting parkinson’s disease diagnosis

Objective assessment of the motor evaluation test for Parkinson’s disease (PD) diagnosis is an open issue both for clinical and technical experts since it could improve current clinical practice with benefits both for patients and healthcare systems. In this work, a wearable system composed of four inertial devices (two SensHand and two SensFoot), and related processing algorithms for extracting parameters from limbs motion was tested on 40 healthy subjects and 40 PD patients. Seventy-eight and 96 kinematic parameters were measured from lower and upper limbs, respectively. Statistical and correlation analysis allowed to define four datasets that were used to train and test five supervised learning classifiers. Excellent discrimination between the two groups was obtained with all the classifiers (average accuracy ranging from 0.936 to 0.960) and all the datasets (average accuracy ranging from 0.953 to 0.966), over three conditions that included parameters derived from lower, upper or all limbs. The best performances (accuracy = 1.00) were obtained when classifying all the limbs with linear support vector machine (SVM) or gaussian SVM. Even if further studies should be done, the current results are strongly promising to improve this system as a support tool for clinicians in objectifying PD diagnosis and monitoring

Future Opportunities for IoT to Support People with Parkinson’s

Recent years have seen an explosion of internet of things (IoT) technologies being released to the market. There has also been an emerging interest in the potentials of IoT devices to support people with chronic health conditions. In this paper, we describe the results of engagements to scope the future potentials of IoT for supporting people with Parkinson’s. We ran a 2-day multi-disciplinary event with professionals with expertise in Parkinson’s and IoT, to explore the opportunities, challenges and benefits. We then ran 4 workshops, engaging 13 people with Parkinson’s and caregivers, to scope out the needs, values and desires that the community has for utilizing IoT to monitor their symptoms. This work contributes a set of considerations for future IoT solutions that might support people with Parkinson’s in better understanding their condition, through the provision of objective measurements that correspond to their, currently unmeasured, subjective experiences

Rehabilitation Engineering

Population ageing has major consequences and implications in all areas of our daily life as well as other important aspects, such as economic growth, savings, investment and consumption, labour markets, pensions, property and care from one generation to another. Additionally, health and related care, family composition and life-style, housing and migration are also affected. Given the rapid increase in the aging of the population and the further increase that is expected in the coming years, an important problem that has to be faced is the corresponding increase in chronic illness, disabilities, and loss of functional independence endemic to the elderly (WHO 2008). For this reason, novel methods of rehabilitation and care management are urgently needed. This book covers many rehabilitation support systems and robots developed for upper limbs, lower limbs as well as visually impaired condition. Other than upper limbs, the lower limb research works are also discussed like motorized foot rest for electric powered wheelchair and standing assistance device

Wearable sensor technologies applied for post-stroke rehabilitation

Stroke is a common cerebrovascular disease that is recognized as one of the leading causes of death and ongoing disability around the globe. Stroke can lead to losses of various body functions depending on the affected area of the brain and leave significant impacts to the victim’s daily life. Post-stroke rehabilitation plays an important role in improving the life quality of stroke survivors. Properly designed rehabilitation training programs can not only prevent further functional deterioration, but also helps patients gradually regain their body functionalities. However, the delivery of rehabilitation service can be a complex and labour intensive task. In conventional rehabilitation systems, the chart-based ordinal scales are considered the dominant tools for impairment assessment and the administration of the scales primarily relies on the doctor’s manual observation. Measuring instruments such as strain gauge and force platforms can sometimes be used to collect quantitative evidence for some of the body functions such as grip strength and balance. However, the evaluation of the patients’ impairment level using ordinal scales still depend on the human interpretation of the data which can be both subjective and inefficient. The preferred scale and evaluation standard also vary among institutions across different regions which make the comparison of data difficult and sometimes unreliable. Furthermore, the intensive manual supervision and support required in rehabilitation training session limits the accessibility of the service as the regular visit to qualified hospital can be onerous for many patients and the associated cost can impose an enormous financial burden on both the government and the households. The situation can be even more challenging in developing countries due to higher growing rate of stroke population and more limited medical resources. The works presented in this thesis are focused on exploring the possibilities of integrating wearable sensor and pattern recognition techniques to improve the efficiency and the effectiveness of post-stroke rehabilitation by addressing the abovementioned issues. The study was initiated by a comprehensive literature review on the latest motion tracking technologies and non-visual based Inertia Measurement Unit (IMU) had been selected as the most suitable candidate for motion sensing in unsupervised training environment due to its low-cost and easy-to-operate characteristics. Following the design and construction of the 6-axis IMU based Body Area Network (BAN), a series of stroke patient motion data collection experiments had been conducted in conjunction with the Jiaxing 2nd Hospital Rehabilitation Centre in Zhejiang province, China. The collected motion samples were then investigated using various signal processing algorithms and pattern recognition techniques to achieve the three major objectives: automatic impairment level classification for reducing human effort involved in regular clinical assessment, single-index based limb mobility evaluation for providing objective evidence to support unified body function assessment standards, and training motion classification for enabling home or community based rehabilitation training with reduced supervision. At last, the study has been further expanded by incorporating surface Electromyography (sEMG) signal sampled during rehabilitation exercises as an alternative input to enhance accurate impairment level classification. The outcome of the investigations demonstrate that the wearable technology can play an important role within a tele-rehabilitation system by providing objective, accurate and often realtime indications of the recovery process as well as the assistance for training management