As many as one million Americans, and an estimated seven to ten million people worldwide live with Parkinson's disease (PD), and with an increasingly ageing population it is expected that this and other neurodegenerative illnesses will assume even greater importance: the cases for PD are expected to double worldwide by 2020.
The human cost of this illness is impossible to measure: being diagnosed with PD can put an immense burden on the sufferer and his or her family. The economic costs are also significant: proper medical care with lengthy hospital stays for of these patients is getting increasingly complex and expensive; just a short hospital visit or medical examinations, on the other hand, cannot provide a clear picture of the patient’s status and the disease progress.
A possible workaround comes from the academia. Researchers from the Polytechnic University of Madrid (UPM) have developed a tool to improve the monitoring of patients with Parkinson disease based on a system of "wearable" sensors which constantly measures the patient's symptoms and alerts health professionals in case of any outlier.
The system is called PERFORM (A soPhisticatEd multi-paRametric system FOR the continuous effective assessment and Monitoring of motor status in Parkinson’s disease and other neurodegenerative diseases) and has been developed in the framework of an a research project by the same name, funded by the European Commission through the Seventh Framework Programme. A fully operative prototype has been tested in three European hospitals: Clínica Universidad de Navarra (Spain), the University of Ioannina Hospital (Greece) and the Nuovo Ospedale Civile S.Agostino-Estense of Modena (Italy).
PERFORM is based on wearable accelerometers and gyroscopes for monitoring the disease evolution and uses intelligent techniques for detection and assessment of common PD motor disabilities like tremor, levodopa-induced dyskinesia (LID), bradykinesia, freezing of gait (FoG) and falling. The sensors are wrapped around the waist, wrists, and ankles. The data collected are sent to a data logger device which supports two modes of operation: stand-alone mode, and connected mode (when connected to a PC via a standard USB cable).
When in stand-alone mode, the device can store sensors data into a SD card, alerts the patient about the appointments with the doctor and the medicine to be taken, and send a SMS in the case the patient presses the emergency button or when a patient fall is detected. When connected, it can acquire the data stored into the SD card, configure its own parameters and design the patient medicine and appointment schedules.
The PERFORM system, together with information derived from tests performed with a virtual reality glove and other details, allows the physician to be constantly informed about the patient’s clinical state and readjust appropriately the treatment plan, by building a patient specific profile and accordingly changing the medication dosage and food intake.
The UPM's team has also conducted a wearability assessment of the product, to understand how patients reacted to it and if they felt comfortable wearing the sensors. Generally speaking, no huge problems were detected; the assessment, however, highlighted some weakest points and some possible improvements: the data logger device, for instance, could be transformed into a portable device and ultimately integrated into a commercial smartphone. The wrists sensors could be evolved to make them more imperceptible either by reducing the size or by imitating some item of clothing.
