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Can Digital Mobility Assessment Enhance the Clinical Assessment of Disease Severity in Parkinson’s Disease?

BACKGROUND: Real-world walking speed (RWS) measured using wearable devices has the potential to complement the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS III) for motor assessment in Parkinson’s disease (PD). OBJECTIVE: Explore cross-sectional and longitudinal diff...

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Detalles Bibliográficos
Autores principales: Kirk, Cameron, Zia Ur Rehman, Rana, Galna, Brook, Alcock, Lisa, Ranciati, Saverio, Palmerini, Luca, Garcia-Aymerich, Judith, Hansen, Clint, Schaeffer, Eva, Berg, Daniela, Maetzler, Walter, Rochester, Lynn, Del Din, Silvia, Yarnall, Alison J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: IOS Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578274/
https://www.ncbi.nlm.nih.gov/pubmed/37545259
http://dx.doi.org/10.3233/JPD-230044
Descripción
Sumario:BACKGROUND: Real-world walking speed (RWS) measured using wearable devices has the potential to complement the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS III) for motor assessment in Parkinson’s disease (PD). OBJECTIVE: Explore cross-sectional and longitudinal differences in RWS between PD and older adults (OAs), and whether RWS was related to motor disease severity cross-sectionally, and if MDS-UPDRS III was related to RWS, longitudinally. METHODS: 88 PD and 111 OA participants from ICICLE-GAIT (UK) were included. RWS was evaluated using an accelerometer at four time points. RWS was aggregated within walking bout (WB) duration thresholds. Between-group-comparisons in RWS between PD and OAs were conducted cross-sectionally, and longitudinally with mixed effects models (MEMs). Cross-sectional association between RWS and MDS-UPDRS III was explored using linear regression, and longitudinal association explored with MEMs. RESULTS: RWS was significantly lower in PD (1.04 m/s) in comparison to OAs (1.10 m/s) cross-sectionally. RWS significantly decreased over time for both cohorts and decline was more rapid in PD by 0.02 m/s per year. Significant negative relationship between RWS and the MDS-UPDRS III only existed at a specific WB threshold (30 to 60 s, β= – 3.94 points, p = 0.047). MDS-UPDRS III increased significantly by 1.84 points per year, which was not related to change in RWS. CONCLUSION: Digital mobility assessment of gait may add unique information to quantify disease progression remotely, but further validation in research and clinical settings is needed.