Acceptability to patients, carers and clinicians of an mHealth platform for the management of Parkinson's disease (PD_Manager): study protocol for a pilot randomised controlled trial.

BACKGROUND: Parkinson's disease is a degenerative neurological condition causing multiple motor and non-motor symptoms that have a serious adverse effect on quality of life. Management is problematic due to the variable and fluctuating nature of symptoms, often hourly and daily. The PD_Manager mHealth platform aims to provide a continuous feed of data on symptoms to improve clinical understanding of the status of any individual patient and inform care planning. The objectives of this trial are to (1) assess patient (and family carer) perspectives of PD_Manager regarding comfort, acceptability and ease of use; (2) assess clinician views about the utility of the data generated by PD_Manager for clinical decision making and the acceptability of the system in clinical practice. METHODS/DESIGN: This trial is an unblinded, parallel, two-group, randomised controlled pilot study. A total of 200 persons with Parkinson's disease (Hoehn and Yahr stage 3, experiencing motor fluctuations at least 2 h per day), with primary family carers, in three countries (110 Rome, 50 Venice, Italy; 20 each in Ioannina, Greece and Surrey, England) will be recruited. Following informed consent, baseline information will be gathered, including the following: age, gender, education, attitudes to technology (patient and carer); time since Parkinson's diagnosis, symptom status and comorbidities (patient only). Randomisation will assign participants (1:1 in each country), to PD_Manager vs control, stratifying by age (1 ≤ 70 : 1 > 70) and gender (60% M: 40% F). The PD_Manager system captures continuous data on motor symptoms, sleep, activity, speech quality and emotional state using wearable devices (wristband, insoles) and a smartphone (with apps) for storing and transmitting the information. Control group participants will be asked to keep a symptom diary covering the same elements as PD_Manager records. After a minimum of two weeks, each participant will attend a consultation with a specialist doctor for review of the data gathered (by either means), and changes to management will be initiated as indicated. Patients, carers and clinicians will be asked for feedback on the acceptability and utility of the data collection methods. The PD_Manager intervention, compared to a symptom diary, will be evaluated in a cost-consequences framework. DISCUSSION: Information gathered will inform further development of the PD_Manager system and a larger effectiveness trial. TRIAL REGISTRATION: ISRCTN Registry, ISRCTN17396879 . Registered on 15 March 2017

An Adaptable Cognitive Microcontroller Node for Fitness Activity Recognition

The new generation of wireless technologies, fitness trackers, and devices with embedded sensors can have a big impact on healthcare systems and quality of life. Among the most crucial aspects to consider in these devices are the accuracy of the data produced and power consumption. Many of the events that can be monitored, while apparently simple, may not be easily detectable and recognizable by devices equipped with embedded sensors, especially on devices with low computing capabilities. It is well known that deep learning reduces the study of features that contribute to the recognition of the different target classes. In this work, we present a portable and battery-powered microcontroller-based device applicable to a wobble board. Wobble boards are low-cost equipment that can be used for sensorimotor training to avoid ankle injuries or as part of the rehabilitation process after an injury. The exercise recognition process was implemented through the use of cognitive techniques based on deep learning. To reduce power consumption, we add an adaptivity layer that dynamically manages the device’s hardware and software configuration to adapt it to the required operating mode at runtime. Our experimental results show that adjusting the node configuration to the workload at runtime can save up to 60% of the power consumed. On a custom dataset, our optimized and quantized neural network achieves an accuracy value greater than 97% for detecting some specific physical exercises on a wobble board