TESTING OBJECTIVE MEASURES OF MOTOR IMPAIRMENT IN EARLY PARKINSON’S DISEASE: FEASIBILITY STUDY OF AN AT-HOME TESTING DEVICE
Identifieur interne : 002457 ( Ncbi/Checkpoint ); précédent : 002456; suivant : 002458TESTING OBJECTIVE MEASURES OF MOTOR IMPAIRMENT IN EARLY PARKINSON’S DISEASE: FEASIBILITY STUDY OF AN AT-HOME TESTING DEVICE
Auteurs : Christopher G. Goetz [États-Unis] ; Glenn T. Stebbins [États-Unis] ; David Wolff [États-Unis] ; William Deleeuw [États-Unis] ; Helen Bronte-Stewart [États-Unis] ; Rodger Elble [États-Unis] ; Mark Hallett [États-Unis] ; John Nutt [États-Unis] ; Lorraine Ramig [États-Unis] ; Terence Sanger [États-Unis] ; Allan D. Wu [États-Unis] ; Peter H. Kraus [Allemagne] ; Lucia M. Blasucci [États-Unis] ; Ejaz A. Shamim [États-Unis] ; Kapil D. Sethi [États-Unis] ; Jennifer Spielman [États-Unis] ; Ken Kubota [États-Unis] ; Andrew S. Grove [États-Unis] ; Eric Dishman [États-Unis] ; C Barr Taylor [États-Unis]Source :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2009.
English descriptors
- KwdEn :
- Aged, Biomechanical Phenomena, Computer-Aided Design, Disability Evaluation, Feasibility Studies, Female, Humans, Hypokinesia (diagnosis), Hypokinesia (etiology), Male, Middle Aged, Neurologic Examination (methods), Outcome Assessment (Health Care), Parkinson Disease (complications), Parkinson Disease (etiology), Patient Satisfaction (statistics & numerical data), Reproducibility of Results, Severity of Illness Index, Tremor (diagnosis), Tremor (etiology).
- MESH :
- complications : Parkinson Disease.
- diagnosis : Hypokinesia, Tremor.
- etiology : Hypokinesia, Parkinson Disease, Tremor.
- methods : Neurologic Examination.
- statistics & numerical data : Patient Satisfaction.
- Aged, Biomechanical Phenomena, Computer-Aided Design, Disability Evaluation, Feasibility Studies, Female, Humans, Male, Middle Aged, Outcome Assessment (Health Care), Reproducibility of Results, Severity of Illness Index.
Abstract
We tested the feasibility of a computer based at-home testing device (AHTD) in early-stage, unmedicated Parkinson’s disease (PD) patients over 6 months. We measured compliance, technical reliability, and patient satisfaction to weekly assessments of tremor, small and large muscle bradykinesia, speech, reaction/movement times, and complex motor control. relative to the UPDRS motor score. The AHTD is a 6.5 x 10 computerized assessment battery. Data are stored on a USB memory stick and sent by internet to a central data repository as encrypted data packets. Although not designed or powered to measure change, the study collected data to observe patterns relative to UPDRS motor scores. Fifty-two PD patients enrolled, and 50 completed the six month trial, 48 remaining without medication. Patients complied with 90.6% of weekly 30-minute assessments, and 98.5% of data packets were successfully transmitted and decrypted. On a 100-point scale, patient satisfaction with the program at study end was 87.2 (range 80–100). UPDRS motor scores significantly worsened over 6 months, and trends for worsening over time occurred for alternating finger taps (p=.08), tremor (p=.06) and speech (p=.11). Change in tremor was a significant predictor of change in UPDRS (p=0.047) and was detected in the first month of the study. This new computer-based technology offers a feasible format for assessing PD-related impairment from home. The high patient compliance and satisfaction suggest the feasibility of its incorporation into larger clinical trials, especially when travel is difficult and early changes or frequent data collection are considered important to document.
Url:
DOI: 10.1002/mds.22379
PubMed: 19086085
PubMed Central: 4161502
Affiliations:
- Allemagne, États-Unis
- Californie, Colorado, District de Columbia, Géorgie (États-Unis), Illinois
- Washington (district de Columbia)
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Goetz</name><affiliation wicri:level="2"><nlm:aff id="A1">Rush University Medical Center, Chicago, IL USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Illinois</region></placeName><wicri:cityArea>Rush University Medical Center, Chicago</wicri:cityArea></affiliation></author><author><name sortKey="Stebbins, Glenn T" sort="Stebbins, Glenn T" uniqKey="Stebbins G" first="Glenn T." last="Stebbins">Glenn T. Stebbins</name><affiliation wicri:level="2"><nlm:aff id="A1">Rush University Medical Center, Chicago, IL USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Illinois</region></placeName><wicri:cityArea>Rush University Medical Center, Chicago</wicri:cityArea></affiliation></author><author><name sortKey="Wolff, David" sort="Wolff, David" uniqKey="Wolff D" first="David" last="Wolff">David Wolff</name><affiliation wicri:level="2"><nlm:aff id="A2">Kinetics Foundation, Los Altos, CA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Kinetics Foundation, Los Altos, CA</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Deleeuw, William" sort="Deleeuw, William" uniqKey="Deleeuw W" first="William" last="Deleeuw">William Deleeuw</name><affiliation wicri:level="2"><nlm:aff id="A3">Intel Corporation, Santa Clara, CA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Intel Corporation, Santa Clara, CA</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Bronte Stewart, Helen" sort="Bronte Stewart, Helen" uniqKey="Bronte Stewart H" first="Helen" last="Bronte-Stewart">Helen Bronte-Stewart</name><affiliation wicri:level="2"><nlm:aff id="A4">Stanford University, Palo Alto, CA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Stanford University, Palo Alto, CA</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Elble, Rodger" sort="Elble, Rodger" uniqKey="Elble R" first="Rodger" last="Elble">Rodger Elble</name><affiliation wicri:level="2"><nlm:aff id="A5">Southern Illinois University, Springfield, IL, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Southern Illinois University, Springfield, IL</wicri:regionArea><placeName><region type="state">Illinois</region></placeName></affiliation></author><author><name sortKey="Hallett, Mark" sort="Hallett, Mark" uniqKey="Hallett M" first="Mark" last="Hallett">Mark Hallett</name><affiliation wicri:level="1"><nlm:aff id="A6">National Institutes of Health, Bethesda MD, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>National Institutes of Health, Bethesda MD</wicri:regionArea><wicri:noRegion>Bethesda MD</wicri:noRegion></affiliation></author><author><name sortKey="Nutt, John" sort="Nutt, John" uniqKey="Nutt J" first="John" last="Nutt">John Nutt</name><affiliation wicri:level="1"><nlm:aff id="A7">Oregon Health Sciences University, Portland OR, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Oregon Health Sciences University, Portland OR</wicri:regionArea><wicri:noRegion>Portland OR</wicri:noRegion></affiliation></author><author><name sortKey="Ramig, Lorraine" sort="Ramig, Lorraine" uniqKey="Ramig L" first="Lorraine" last="Ramig">Lorraine Ramig</name><affiliation wicri:level="1"><nlm:aff id="A8">University of Colorado, Boulder CO, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>University of Colorado, Boulder CO</wicri:regionArea><wicri:noRegion>Boulder CO</wicri:noRegion></affiliation><affiliation wicri:level="2"><nlm:aff id="A9">National Center for Voice and Speech, Denver, CO, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>National Center for Voice and Speech, Denver, CO</wicri:regionArea><placeName><region type="state">Colorado</region></placeName></affiliation></author><author><name sortKey="Sanger, Terence" sort="Sanger, Terence" uniqKey="Sanger T" first="Terence" last="Sanger">Terence Sanger</name><affiliation wicri:level="2"><nlm:aff id="A4">Stanford University, Palo Alto, CA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Stanford University, Palo Alto, CA</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Wu, Allan D" sort="Wu, Allan D" uniqKey="Wu A" first="Allan D." last="Wu">Allan D. Wu</name><affiliation wicri:level="2"><nlm:aff id="A10">University of California, Los Angeles, CA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>University of California, Los Angeles, CA</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Kraus, Peter H" sort="Kraus, Peter H" uniqKey="Kraus P" first="Peter H." last="Kraus">Peter H. Kraus</name><affiliation wicri:level="1"><nlm:aff id="A11">Univerität Bochum, Bochum, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Univerität Bochum, Bochum</wicri:regionArea><wicri:noRegion>Bochum</wicri:noRegion><wicri:noRegion>Bochum</wicri:noRegion><wicri:noRegion>Bochum</wicri:noRegion></affiliation></author><author><name sortKey="Blasucci, Lucia M" sort="Blasucci, Lucia M" uniqKey="Blasucci L" first="Lucia M." last="Blasucci">Lucia M. Blasucci</name><affiliation wicri:level="2"><nlm:aff id="A1">Rush University Medical Center, Chicago, IL USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Illinois</region></placeName><wicri:cityArea>Rush University Medical Center, Chicago</wicri:cityArea></affiliation></author><author><name sortKey="Shamim, Ejaz A" sort="Shamim, Ejaz A" uniqKey="Shamim E" first="Ejaz A." last="Shamim">Ejaz A. Shamim</name><affiliation wicri:level="1"><nlm:aff id="A6">National Institutes of Health, Bethesda MD, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>National Institutes of Health, Bethesda MD</wicri:regionArea><wicri:noRegion>Bethesda MD</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="A12">Georgetown University Hospital, Washington DC, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Georgetown University Hospital, Washington DC</wicri:regionArea><placeName><settlement type="city">Washington (district de Columbia)</settlement><region type="state">District de Columbia</region></placeName></affiliation></author><author><name sortKey="Sethi, Kapil D" sort="Sethi, Kapil D" uniqKey="Sethi K" first="Kapil D." last="Sethi">Kapil D. Sethi</name><affiliation wicri:level="2"><nlm:aff id="A13">Medical College of Georgia, Augusta, GA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Medical College of Georgia, Augusta, GA</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author><author><name sortKey="Spielman, Jennifer" sort="Spielman, Jennifer" uniqKey="Spielman J" first="Jennifer" last="Spielman">Jennifer Spielman</name><affiliation wicri:level="2"><nlm:aff id="A9">National Center for Voice and Speech, Denver, CO, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>National Center for Voice and Speech, Denver, CO</wicri:regionArea><placeName><region type="state">Colorado</region></placeName></affiliation></author><author><name sortKey="Kubota, Ken" sort="Kubota, Ken" uniqKey="Kubota K" first="Ken" last="Kubota">Ken Kubota</name><affiliation wicri:level="2"><nlm:aff id="A2">Kinetics Foundation, Los Altos, CA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Kinetics Foundation, Los Altos, CA</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Grove, Andrew S" sort="Grove, Andrew S" uniqKey="Grove A" first="Andrew S." last="Grove">Andrew S. Grove</name><affiliation wicri:level="2"><nlm:aff id="A3">Intel Corporation, Santa Clara, CA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Intel Corporation, Santa Clara, CA</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Dishman, Eric" sort="Dishman, Eric" uniqKey="Dishman E" first="Eric" last="Dishman">Eric Dishman</name><affiliation wicri:level="2"><nlm:aff id="A3">Intel Corporation, Santa Clara, CA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Intel Corporation, Santa Clara, CA</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Taylor, C Barr" sort="Taylor, C Barr" uniqKey="Taylor C" first="C Barr" last="Taylor">C Barr Taylor</name><affiliation wicri:level="2"><nlm:aff id="A2">Kinetics Foundation, Los Altos, CA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Kinetics Foundation, Los Altos, CA</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Biomechanical Phenomena</term><term>Computer-Aided Design</term><term>Disability Evaluation</term><term>Feasibility Studies</term><term>Female</term><term>Humans</term><term>Hypokinesia (diagnosis)</term><term>Hypokinesia (etiology)</term><term>Male</term><term>Middle Aged</term><term>Neurologic Examination (methods)</term><term>Outcome Assessment (Health Care)</term><term>Parkinson Disease (complications)</term><term>Parkinson Disease (etiology)</term><term>Patient Satisfaction (statistics & numerical data)</term><term>Reproducibility of Results</term><term>Severity of Illness Index</term><term>Tremor (diagnosis)</term><term>Tremor (etiology)</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Hypokinesia</term><term>Tremor</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Hypokinesia</term><term>Parkinson Disease</term><term>Tremor</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Neurologic Examination</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Patient Satisfaction</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Biomechanical Phenomena</term><term>Computer-Aided Design</term><term>Disability Evaluation</term><term>Feasibility Studies</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Outcome Assessment (Health Care)</term><term>Reproducibility of Results</term><term>Severity of Illness Index</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p id="P1">We tested the feasibility of a computer based at-home testing device (AHTD) in early-stage, unmedicated Parkinson’s disease (PD) patients over 6 months. We measured compliance, technical reliability, and patient satisfaction to weekly assessments of tremor, small and large muscle bradykinesia, speech, reaction/movement times, and complex motor control. relative to the UPDRS motor score. The AHTD is a 6.5 x 10 computerized assessment battery. Data are stored on a USB memory stick and sent by internet to a central data repository as encrypted data packets. Although not designed or powered to measure change, the study collected data to observe patterns relative to UPDRS motor scores. Fifty-two PD patients enrolled, and 50 completed the six month trial, 48 remaining without medication. Patients complied with 90.6% of weekly 30-minute assessments, and 98.5% of data packets were successfully transmitted and decrypted. On a 100-point scale, patient satisfaction with the program at study end was 87.2 (range 80–100). UPDRS motor scores significantly worsened over 6 months, and trends for worsening over time occurred for alternating finger taps (p=.08), tremor (p=.06) and speech (p=.11). Change in tremor was a significant predictor of change in UPDRS (p=0.047) and was detected in the first month of the study. This new computer-based technology offers a feasible format for assessing PD-related impairment from home. The high patient compliance and satisfaction suggest the feasibility of its incorporation into larger clinical trials, especially when travel is difficult and early changes or frequent data collection are considered important to document.</p></div></front></TEI><affiliations><list><country><li>Allemagne</li><li>États-Unis</li></country><region><li>Californie</li><li>Colorado</li><li>District de Columbia</li><li>Géorgie (États-Unis)</li><li>Illinois</li></region><settlement><li>Washington (district de Columbia)</li></settlement></list><tree><country name="États-Unis"><region name="Illinois"><name sortKey="Goetz, Christopher G" sort="Goetz, Christopher G" uniqKey="Goetz C" first="Christopher G." last="Goetz">Christopher G. Goetz</name></region><name sortKey="Blasucci, Lucia M" sort="Blasucci, Lucia M" uniqKey="Blasucci L" first="Lucia M." last="Blasucci">Lucia M. Blasucci</name><name sortKey="Bronte Stewart, Helen" sort="Bronte Stewart, Helen" uniqKey="Bronte Stewart H" first="Helen" last="Bronte-Stewart">Helen Bronte-Stewart</name><name sortKey="Deleeuw, William" sort="Deleeuw, William" uniqKey="Deleeuw W" first="William" last="Deleeuw">William Deleeuw</name><name sortKey="Dishman, Eric" sort="Dishman, Eric" uniqKey="Dishman E" first="Eric" last="Dishman">Eric Dishman</name><name sortKey="Elble, Rodger" sort="Elble, Rodger" uniqKey="Elble R" first="Rodger" last="Elble">Rodger Elble</name><name sortKey="Grove, Andrew S" sort="Grove, Andrew S" uniqKey="Grove A" first="Andrew S." last="Grove">Andrew S. Grove</name><name sortKey="Hallett, Mark" sort="Hallett, Mark" uniqKey="Hallett M" first="Mark" last="Hallett">Mark Hallett</name><name sortKey="Kubota, Ken" sort="Kubota, Ken" uniqKey="Kubota K" first="Ken" last="Kubota">Ken Kubota</name><name sortKey="Nutt, John" sort="Nutt, John" uniqKey="Nutt J" first="John" last="Nutt">John Nutt</name><name sortKey="Ramig, Lorraine" sort="Ramig, Lorraine" uniqKey="Ramig L" first="Lorraine" last="Ramig">Lorraine Ramig</name><name sortKey="Ramig, Lorraine" sort="Ramig, Lorraine" uniqKey="Ramig L" first="Lorraine" last="Ramig">Lorraine Ramig</name><name sortKey="Sanger, Terence" sort="Sanger, Terence" uniqKey="Sanger T" first="Terence" last="Sanger">Terence Sanger</name><name sortKey="Sethi, Kapil D" sort="Sethi, Kapil D" uniqKey="Sethi K" first="Kapil D." last="Sethi">Kapil D. Sethi</name><name sortKey="Shamim, Ejaz A" sort="Shamim, Ejaz A" uniqKey="Shamim E" first="Ejaz A." last="Shamim">Ejaz A. Shamim</name><name sortKey="Shamim, Ejaz A" sort="Shamim, Ejaz A" uniqKey="Shamim E" first="Ejaz A." last="Shamim">Ejaz A. Shamim</name><name sortKey="Spielman, Jennifer" sort="Spielman, Jennifer" uniqKey="Spielman J" first="Jennifer" last="Spielman">Jennifer Spielman</name><name sortKey="Stebbins, Glenn T" sort="Stebbins, Glenn T" uniqKey="Stebbins G" first="Glenn T." last="Stebbins">Glenn T. Stebbins</name><name sortKey="Taylor, C Barr" sort="Taylor, C Barr" uniqKey="Taylor C" first="C Barr" last="Taylor">C Barr Taylor</name><name sortKey="Wolff, David" sort="Wolff, David" uniqKey="Wolff D" first="David" last="Wolff">David Wolff</name><name sortKey="Wu, Allan D" sort="Wu, Allan D" uniqKey="Wu A" first="Allan D." last="Wu">Allan D. Wu</name></country><country name="Allemagne"><noRegion><name sortKey="Kraus, Peter H" sort="Kraus, Peter H" uniqKey="Kraus P" first="Peter H." last="Kraus">Peter H. 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