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

What is it about?

Parkinson's disease (PD) is a progressive neurological condition known for its motor symptoms like tremors, stiffness, and slow movement. These symptoms significantly affect a person's ability to move and their overall well-being. Measuring and tracking the impact of these symptoms on mobility is challenging due to the diverse nature of PD. Currently, clinician’s use a clinical assessment called the Movement Disorder Society–Unified Parkinson’s Disease Rating Scale Part III (MDS-UPDRS III) to evaluate motor severity. However, this assessment is done in person, takes time, and may not capture the changing nature of PD symptoms. Most fundamentally it does assess the impact of Parkinson’s upon aspects of health that people with PD care about the most, such as their ability to walk independently and safely in their daily lives. One potential solution is remote monitoring using digital health technology, like body-worn sensors, which can continuously and quantitatively measure walking speed and various gait characteristics in the real world. These measurements, known as digital mobility outcomes (DMOs), could provide valuable information about aspects of health meaningful to patients, PD symptoms, motor function, and fall risk, complementing clinical assessments. For example, real-world walking speed has shown promise in distinguishing PD from older adults, assessing motor symptoms, and monitoring medication effects. Despite its potential, the widespread use of real-world gait analysis in clinical settings and trials has not yet happened. To make this a reality, extensive technical and clinical validation is needed to understand what insights real-world walking speed (or other DMOs) can offer beyond traditional clinical assessments. This study aims to compare walking speed in people with PD to those without PD and explore how it changes over time in PD. Additionally, it seeks to understand the relationship between walking speed and motor disease severity, as assessed by MDS-UPDRS III, in PD patients.

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Photo by Emma Simpson on Unsplash

Photo by Emma Simpson on Unsplash

Why is it important?

The findings of this study hold significant importance for the management and understanding of Parkinson's disease (PD): 1. Remote Monitoring Potential: The study revealed that real-world walking speed (RWS) was significantly lower in individuals with PD compared to older adults without PD. This suggests that RWS could be a valuable tool for remotely monitoring aspects of PD that are not currently captured in routine clinical assessments. By remotely tracking RWS, clinicians can gain insights into the mobility disability experienced by people with PD, with a specific focus on preserving their ability to walk. 2. Targeted Management: The ability to remotely monitor mobility-related aspects of PD allows for more targeted and personalized management strategies. This is crucial because walking ability is of paramount importance to individuals with PD. With RWS data, clinicians can tailor interventions to address specific mobility challenges, thereby improving the quality of life for PD patients. 3. Advantages of Remote Evaluation: Remote monitoring of RWS offers significant advantages for both clinical research and clinical management. It reduces the need for in-person assessments, making it more convenient for patients. Moreover, it can provide a more comprehensive picture of a patient's mobility over time, enabling early intervention and personalized care. 4. Sensitivity to Change: The study found that RWS is sensitive to changes over time, and its decline in PD patients was more rapid than in older adults without PD. This sensitivity to change makes RWS a valuable tool for monitoring motor function remotely in PD, even in the face of the condition's diverse nature. In conclusion, the study's findings highlight the potential of real-world walking speed as a valuable tool for remote monitoring of PD, with the capacity to provide insights into mobility disability, enable targeted interventions, and support both clinical research and clinical management. Further research and technological advancements in this area hold promise for improving the care and quality of life for individuals living with PD.

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