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Feasibility and Utility of mHealth for the Remote Monitoring of Parkinson Disease: Ancillary Study of the PD_manager Randomized Controlled Trial

BACKGROUND: Mobile health, predominantly wearable technology and mobile apps, have been considered in Parkinson disease to provide valuable ecological data between face-to-face visits and improve monitoring of motor symptoms remotely. OBJECTIVE: We explored the feasibility of using a technology-base...

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Autores principales: Gatsios, Dimitris, Antonini, Angelo, Gentile, Giovanni, Marcante, Andrea, Pellicano, Clelia, Macchiusi, Lucia, Assogna, Francesca, Spalletta, Gianfranco, Gage, Heather, Touray, Morro, Timotijevic, Lada, Hodgkins, Charo, Chondrogiorgi, Maria, Rigas, George, Fotiadis, Dimitrios I, Konitsiotis, Spyridon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7367523/
https://www.ncbi.nlm.nih.gov/pubmed/32442154
http://dx.doi.org/10.2196/16414
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author Gatsios, Dimitris
Antonini, Angelo
Gentile, Giovanni
Marcante, Andrea
Pellicano, Clelia
Macchiusi, Lucia
Assogna, Francesca
Spalletta, Gianfranco
Gage, Heather
Touray, Morro
Timotijevic, Lada
Hodgkins, Charo
Chondrogiorgi, Maria
Rigas, George
Fotiadis, Dimitrios I
Konitsiotis, Spyridon
author_facet Gatsios, Dimitris
Antonini, Angelo
Gentile, Giovanni
Marcante, Andrea
Pellicano, Clelia
Macchiusi, Lucia
Assogna, Francesca
Spalletta, Gianfranco
Gage, Heather
Touray, Morro
Timotijevic, Lada
Hodgkins, Charo
Chondrogiorgi, Maria
Rigas, George
Fotiadis, Dimitrios I
Konitsiotis, Spyridon
author_sort Gatsios, Dimitris
collection PubMed
description BACKGROUND: Mobile health, predominantly wearable technology and mobile apps, have been considered in Parkinson disease to provide valuable ecological data between face-to-face visits and improve monitoring of motor symptoms remotely. OBJECTIVE: We explored the feasibility of using a technology-based mHealth platform comprising a smartphone in combination with a smartwatch and a pair of smart insoles, described in this study as the PD_manager system, to collect clinically meaningful data. We also explored outcomes and disease-related factors that are important determinants to establish feasibility. Finally, we further validated a tremor evaluation method with data collected while patients performed their daily activities. METHODS: PD_manager trial was an open-label parallel group randomized study.The mHealth platform consists of a wristband, a pair of sensor insoles, a smartphone (with dedicated mobile Android apps) and a knowledge platform serving as the cloud backend. Compliance was assessed with statistical analysis and the factors affecting it using appropriate regression analysis. The correlation of the scores of our previous algorithm for tremor evaluation and the respective Unified Parkinson’s Disease Rating Scale estimations by clinicians were explored. RESULTS: Of the 75 study participants, 65 (87%) completed the protocol. They used the PD_manager system for a median 11.57 (SD 3.15) days. Regression analysis suggests that the main factor associated with high use was caregivers’ burden. Motor Aspects of Experiences of Daily Living and patients’ self-rated health status also influence the system’s use. Our algorithm provided clinically meaningful data for the detection and evaluation of tremor. CONCLUSIONS: We found that PD patients, regardless of their demographics and disease characteristics, used the system for 11 to 14 days. The study further supports that mHealth can be an effective tool for the ecologically valid, passive, unobtrusive monitoring and evaluation of symptoms. Future studies will be required to demonstrate that an mHealth platform can improve disease management and care. TRIAL REGISTRATION: ISRCTN Registry ISRCTN17396879; http://www.isrctn.com/ISRCTN17396879 INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s13063-018-2767-4
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spelling pubmed-73675232020-08-07 Feasibility and Utility of mHealth for the Remote Monitoring of Parkinson Disease: Ancillary Study of the PD_manager Randomized Controlled Trial Gatsios, Dimitris Antonini, Angelo Gentile, Giovanni Marcante, Andrea Pellicano, Clelia Macchiusi, Lucia Assogna, Francesca Spalletta, Gianfranco Gage, Heather Touray, Morro Timotijevic, Lada Hodgkins, Charo Chondrogiorgi, Maria Rigas, George Fotiadis, Dimitrios I Konitsiotis, Spyridon JMIR Mhealth Uhealth Original Paper BACKGROUND: Mobile health, predominantly wearable technology and mobile apps, have been considered in Parkinson disease to provide valuable ecological data between face-to-face visits and improve monitoring of motor symptoms remotely. OBJECTIVE: We explored the feasibility of using a technology-based mHealth platform comprising a smartphone in combination with a smartwatch and a pair of smart insoles, described in this study as the PD_manager system, to collect clinically meaningful data. We also explored outcomes and disease-related factors that are important determinants to establish feasibility. Finally, we further validated a tremor evaluation method with data collected while patients performed their daily activities. METHODS: PD_manager trial was an open-label parallel group randomized study.The mHealth platform consists of a wristband, a pair of sensor insoles, a smartphone (with dedicated mobile Android apps) and a knowledge platform serving as the cloud backend. Compliance was assessed with statistical analysis and the factors affecting it using appropriate regression analysis. The correlation of the scores of our previous algorithm for tremor evaluation and the respective Unified Parkinson’s Disease Rating Scale estimations by clinicians were explored. RESULTS: Of the 75 study participants, 65 (87%) completed the protocol. They used the PD_manager system for a median 11.57 (SD 3.15) days. Regression analysis suggests that the main factor associated with high use was caregivers’ burden. Motor Aspects of Experiences of Daily Living and patients’ self-rated health status also influence the system’s use. Our algorithm provided clinically meaningful data for the detection and evaluation of tremor. CONCLUSIONS: We found that PD patients, regardless of their demographics and disease characteristics, used the system for 11 to 14 days. The study further supports that mHealth can be an effective tool for the ecologically valid, passive, unobtrusive monitoring and evaluation of symptoms. Future studies will be required to demonstrate that an mHealth platform can improve disease management and care. TRIAL REGISTRATION: ISRCTN Registry ISRCTN17396879; http://www.isrctn.com/ISRCTN17396879 INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s13063-018-2767-4 JMIR Publications 2020-06-29 /pmc/articles/PMC7367523/ /pubmed/32442154 http://dx.doi.org/10.2196/16414 Text en ©Dimitris Gatsios, Angelo Antonini, Giovanni Gentile, Andrea Marcante, Clelia Pellicano, Lucia Macchiusi, Francesca Assogna, Gianfranco Spalletta, Heather Gage, Morro Touray, Lada Timotijevic, Charo Hodgkins, Maria Chondrogiorgi, George Rigas, Dimitrios I Fotiadis, Spyridon Konitsiotis. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 29.06.2020. https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mHealth and uHealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included.
spellingShingle Original Paper
Gatsios, Dimitris
Antonini, Angelo
Gentile, Giovanni
Marcante, Andrea
Pellicano, Clelia
Macchiusi, Lucia
Assogna, Francesca
Spalletta, Gianfranco
Gage, Heather
Touray, Morro
Timotijevic, Lada
Hodgkins, Charo
Chondrogiorgi, Maria
Rigas, George
Fotiadis, Dimitrios I
Konitsiotis, Spyridon
Feasibility and Utility of mHealth for the Remote Monitoring of Parkinson Disease: Ancillary Study of the PD_manager Randomized Controlled Trial
title Feasibility and Utility of mHealth for the Remote Monitoring of Parkinson Disease: Ancillary Study of the PD_manager Randomized Controlled Trial
title_full Feasibility and Utility of mHealth for the Remote Monitoring of Parkinson Disease: Ancillary Study of the PD_manager Randomized Controlled Trial
title_fullStr Feasibility and Utility of mHealth for the Remote Monitoring of Parkinson Disease: Ancillary Study of the PD_manager Randomized Controlled Trial
title_full_unstemmed Feasibility and Utility of mHealth for the Remote Monitoring of Parkinson Disease: Ancillary Study of the PD_manager Randomized Controlled Trial
title_short Feasibility and Utility of mHealth for the Remote Monitoring of Parkinson Disease: Ancillary Study of the PD_manager Randomized Controlled Trial
title_sort feasibility and utility of mhealth for the remote monitoring of parkinson disease: ancillary study of the pd_manager randomized controlled trial
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7367523/
https://www.ncbi.nlm.nih.gov/pubmed/32442154
http://dx.doi.org/10.2196/16414
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