scholarly journals Virtual Exam for Parkinson's Disease Enables Frequent and Reliable Measurements of Motor Function

2021 ◽  
Author(s):  
Maximilien Burq ◽  
Erin Rainaldi ◽  
King Chung Ho ◽  
Chen Chen ◽  
Bastiaan R Bloem ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Early Stage ◽  
Real Life ◽  
Dropout Rate ◽  
Therapeutic Interventions ◽  
Retest Reliability ◽  
Time Sensitivity ◽  
Remote Measurements ◽  
Test Retest Reliability

Sensor-based remote monitoring could help us better track Parkinson's disease (PD) progression, and measure patients' response to putative disease-modifying therapeutic interventions. To be useful, the remotely-collected measurements should be valid, reliable and sensitive to change, and people with PD must engage with the technology. We developed a smartwatch-based active assessment that enables unsupervised measurement of motor signs of PD. 388 study participants with early-stage PD (Personalized Parkinson Project, 64% men, average age 63 years) wore a smartwatch for a median of 390 days, allowing for continuous passive monitoring. Participants performed unsupervised motor tasks both in the clinic (once) and remotely (twice weekly for one year). Dropout rate was 2% at the end of follow-up. Median wear-time was 21.1 hours/day, and 59% of per-protocol remote assessments were completed. In-clinic performance of the virtual exam verified that most participants correctly followed watch-based instructions. Analytical validation was established for in-clinic measurements, which showed moderate-to-strong correlations with consensus MDS-UPDRS Part III ratings for rest tremor (R=0.70), bradykinesia (R=-0.62), and gait (R=-0.46). Test-retest reliability of remote measurements, aggregated monthly, was good-to-excellent (ICC: 0.75 - 0.96). Remote measurements were sensitive to the known effects of dopaminergic medication (on vs off Cohen's d: 0.19 - 0.54). Of note, in-clinic assessments often did not reflect the patients' typical status at home. This demonstrates the feasibility of using smartwatch-based unsupervised active tests, and establishes the analytical validity of associated digital measurements. Weekly measurements can create a more complete picture of patient functioning by providing a real-life distribution of disease severity, as it fluctuates over time. Sensitivity to medication-induced change, together with the improvement in test-retest reliability from temporal aggregation implies that these methods could help reduce sample sizes needed to demonstrate a response to therapeutic intervention or disease progression.

Construct validity and test-retest reliability of a free mobile application for spatio-temporal gait analysis in Parkinson’s disease patients

2020 ◽  
Vol 79 ◽  
pp. 86-91
Author(s):  
Sergio Clavijo-Buendía ◽  
Francisco Molina-Rueda ◽  
Patricia Martín-Casas ◽  
Paulina Ortega-Bastidas ◽  
Esther Monge-Pereira ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Construct Validity ◽  
Gait Analysis ◽  
Mobile Application ◽  
Retest Reliability ◽  
Spatio Temporal ◽  
Test Retest Reliability

Test-retest reliability of stride length-cadence gait relationship in Parkinson’s disease

2019 ◽  
Vol 71 ◽  
pp. 177-180
Author(s):  
Mira Ambrus ◽  
Jose A. Sanchez ◽  
Jose A Sanchez Miguel ◽  
Fernandez del-Olmo
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Stride Length ◽  
Retest Reliability ◽  
Test Retest Reliability

scholarly journals Test-retest reliability of physical activity questionnaires in Parkinson’s disease

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Samuel Ånfors ◽  
Ann-Sofi Kammerlind ◽  
Maria H. Nilsson
Keyword(s):  
Physical Activity ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Weighted Kappa ◽  
Activity Level ◽  
Single Item ◽  
Retest Reliability ◽  
Activity Questionnaires ◽  
Test Retest Reliability

Abstract Background People with Parkinson’s disease are less physically active than controls. It is important to promote physical activity, which can be assessed using different methods. Subjective measures include physical activity questionnaires, which are easy and cheap to administer in clinical practice. Knowledge of the psychometric properties of physical activity questionnaires for people with Parkinson’s disease is limited. The aim of this study was to evaluate the test-retest reliability of physical activity questionnaires in individuals with Parkinson’s disease without cognitive impairment. Methods Forty-nine individuals with Parkinson’s disease without cognitive impairment participated in a test-retest reliability study. At two outpatient visits 8 days apart, the participants completed comprehensive questionnaires and single-item questions: International Physical Activity Questionnaire-Short Form (IPAQ-SF), Physical Activity Scale for the Elderly (PASE), Saltin-Grimby Physical Activity Level Scale (SGPALS) and Health on Equal Terms (HOET). Test-retest reliability was evaluated using the intraclass correlation coefficient (ICC), standard error of measurement (SEM), limits of agreement, weighted kappa or the Svensson method. Results Several of the physical activity questionnaires had relatively low test-retest reliability, including the comprehensive questionnaires (IPAQ-SF and PASE). Total physical activity according to IPAQ-SF had an ICC value of 0.46 (95% confidence interval [CI], 0.21–0.66) and SEM was 2891 MET-min/week. The PASE total score had an ICC value of 0.66 (95% CI, 0.46–0.79), whereas the SEM was 30 points. The single-item scales of SGPALS-past six months (SGPALS-6 m) and HOET question 1 (HOET-q1) with longer time frames (6 or 12 months, respectively) showed better results. Weighted kappa values were 0.64 (95% CI, 0.45–0.83) for SGPALS-6 m and 0.60 (95% CI, 0.39–0.80) for HOET-q1, whereas the single-item questions with a shorter recall period had kappa values < 0.40. Conclusions Single-item questions with a longer time frame (6 or 12 months) for physical activity were shown to be more reliable than multi-item questionnaires such as the IPAQ-SF and PASE in individuals with Parkinson’s disease without cognitive impairments. There is a need to develop a core outcome set to measure physical activity in people with Parkinson’s disease, and there might be a need to develop new physical activity questionnaires.

scholarly journals P.015 Long-term progression and prognosis in different subtypes of Parkinson’s disease: validation of a new multi-domain subtyping method

2019 ◽  
Vol 46 (s1) ◽  
pp. S17
Author(s):  
S Fereshtehnejad ◽  
Y Zeighami ◽  
A Dagher ◽  
RB Postuma
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
De Novo ◽  
Early Stage ◽  
Real Life ◽  
Clinical Manifestations ◽  
Personalized Care ◽  
Autonomic Disturbance ◽  
Progression Markers

Background: Parkinson’s disease (PD) varies in clinical manifestations and course of progression from person to person. Identification of distinct PD subtypes is of great priority to develop personalized care approaches. We aimed to compare long-term progression and prognosis between different PD subtypes. Methods: Data on 421 individuals with de novo early-onset PD was retrieved from Parkinson’s Progression Markers Initiative (PPMI). Using a newly developed multi-domain subtyping method (based on motor phenotype, RBD, autonomic disturbance, early cognitive deficit), we divided PD population into three subtypes at baseline: “mild motor-predominant”, “Diffuse malignant” and “Intermediate”. Rate of global progression (mixed motor and non-motor features) and developing dementia were compared between the subtypes. Results: Patients with “diffuse malignant” PD experienced 0.5 z-score further worsening of global composite outcome (p=0.017) and 2.2 further decline in MOCA score (p=0.001) after 6-years of follow-up. Hazard for MCI/dementia was significantly higher in “diffuse malignant” (HR=3.2, p&lt;0.001) and “intermediate” (HR=1.8, p&lt;0.001) subtypes. Individuals with “diffuse malignant” PD had the lowest level of CSF amyloid-beta (p=0.006) and SPECT striatal binding ratio (p=0.001). Conclusions: This multi-domain subtyping is a valid method to predict subgroups of PD with distinct patterns of long-term progression at drug-naïve early-stage with potential application in real-life clinical practice.

scholarly journals Reliability and Validity of the Geriatric Depression Scale in Italian Subjects with Parkinson’s Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Perla Massai ◽  
Francesca Colalelli ◽  
Julita Sansoni ◽  
Donatella Valente ◽  
Marco Tofani ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Internal Consistency ◽  
Discriminant Validity ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Reliability And Validity ◽  
Geriatric Depression ◽  
Retest Reliability ◽  
Test Retest Reliability

Introduction. The Geriatric Depression Scale (GDS) is commonly used to assess depressive symptoms, but its psychometric properties have never been examined in Italian people with Parkinson’s disease (PD). The aim of this study was to study the reliability and validity of the Italian version of the GDS in a sample of PD patients. Methods. The GDS was administered to 74 patients with PD in order to study its internal consistency, test-retest reliability, construct, and discriminant validity. Results. The internal consistency of GDS was excellent (α = 0.903), as well as the test-retest reliability (ICC = 0.941 [95% CI: 0.886–0.970]). GDS showed a strong correlation with instruments related to the depression (ρ = 0.880) in PD (ρ = 0.712) and a weak correlation with generic measurement instruments (−0.320 < ρ <−0.217). An area under the curve of 0.892 (95% CI 0.809–0.975) indicated a moderate capability to discriminate depressed patients to nondepressed patient, with a cutoff value between 15 and 16 points that predicts depression (sensitivity = 87%; specificity = 82%). Conclusion. The GDS is a reliable and valid tool in a sample of Italian PD subjects; this scale can be used in clinical and research contexts.

Reliability of using foot-worn devices to measure gait parameters in people with Parkinson’s disease

2021 ◽  
pp. 1-8
Author(s):  
Ya-Yun Lee ◽  
Ming-Hao Li ◽  
Jer-Junn Luh ◽  
Chun-Hwei Tai
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Severity ◽  
Wearable Sensors ◽  
Good Reliability ◽  
Retest Reliability ◽  
Early Stages ◽  
Gait Parameters ◽  
Advanced Stages ◽  
Test Retest Reliability

BACKGROUND: Recent advances in technology have warranted the use of wearable sensors to monitor gait and posture. However, the psychometric properties of using wearable devices to measure gait-related outcomes have not been fully established in patients with Parkinson’s disease (PD). OBJECTIVE: This study aimed to investigate the test-retest reliability of body-worn sensors for gait evaluation in people with PD. Additionally, the influence of disease severity on the reliability was determined. METHODS: Twenty individuals with PD were recruited. During the first evaluation, the participants wore inertial sensors on their shoes and walked along a walkway thrice at their comfortable walking speed. The participants were then required to return to the lab after 3–5 days to complete the second evaluation with the same study procedure. Test-retest reliability of gait-related outcomes were calculated. To determine whether the results would be affected by disease severity, reliability was re-calculated by subdividing the participants into early and mid-advanced stages of the disease. RESULTS: The results showed moderate to good reliability (ICC = 0.64–0.87) of the wearable sensors for gait assessment in the general population with PD. Subgroup analysis showed that the reliability was higher among patients at early stages (ICC = 0.71–0.97) compared to those at mid-advanced stages (ICC = 0.65–0.81) of PD. CONCLUSIONS: Wearable sensors could reliably measure gait parameters in people with PD, and the reliability was higher among individuals at early stages of the disease compared to those at mid-advanced stages. Absolute reliability values were calculated to act as references for future studies.

scholarly journals Translation, adaptation and validation of the Bulgarian version of the King’s Parkinson’s Disease Pain Scale

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Galina Stoyanova-Piroth ◽  
Ivan Milanov ◽  
Katerina Stambolieva
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Intraclass Correlation ◽  
Pain Scale ◽  
Radicular Pain ◽  
Good Reliability ◽  
Retest Reliability ◽  
Nocturnal Pain ◽  
Test Retest Reliability

Abstract Background The purpose of the present study was to translate and cross-culturally adapt the King’s Parkinson’s Disease Pain Scale (KPPS) into Bulgarian and to investigate its psychometric properties in order to provide a validated Parkinson’s disease-specific pain instrument in Bulgarian language (KPPS-BG). Methods Translation into Bulgarian and a cultural adaptation were performed to obtain KPPS-BG. A total of 162 patients with idiopathic Parkinson’s disease were screened for pain using the complementary to the KPPS questionnaire – King’s Parkinson’s Disease Pain Questionnaire (KPPQ). KPPS-BG domain and total scores were calculated and internal consistency, construct validity and test-retest reliability were examined for 129 patients having one or more positive items in the KPPQ-BG. Results 79.6 % of the patients reported one or more types of pain. The most common type was musculoskeletal pain (83.7 %), followed by nocturnal pain (55.0 %), fluctuation-related pain (50.1 %), radicular pain (43.4 %), chronic pain (31.0 %), discoloration, edema/swelling (27.1 %) and, oro-facial pain (14.3 %). Mean KPPS-BG total score was 21.1 ± 17.3 SD. KPPS-BG showed a good reliability (Cronbach’s alpha 0.75). The test-retest reliability of the KPPS-BG was high and the intraclass correlation coefficient was 0.92, demonstrating а good repeatability. KPPS-BG total score was higher in patients with postural instability gait difficulty motor subtype, compared to tremor-dominant or indeterminate subtype. Significant positive correlations were found between KPPS-BG total score and modified H&Y, Movement Disorders Society Unified Parkinson’s Disease Rating Scale part III. Conclusions The KPPS-BG constitutes a reliable, comprehensive and useful tool for pain assessment in native Bulgarian patients with Parkinson’s disease.

scholarly journals Development of a Parkinson’s disease specific falls questionnaire

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dale M. Harris ◽  
Rachel L. Duckham ◽  
Robin M. Daly ◽  
Gavin Abbott ◽  
Liam Johnson ◽  
...  
Keyword(s):  
Older Adults ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Perfect Agreement ◽  
Retest Reliability ◽  
Falls In Older Adults ◽  
Near Falls ◽  
Test Retest Reliability ◽  
Recent Falls ◽  
Strong Agreement

Abstract Background Falls are a major health burden for older adults with Parkinson’s disease (PD), but there is currently no reliable questionnaire to capture the circumstances and consequences of falls in older adults with PD. This study aimed to develop a PD-specific falls questionnaire and to evaluate its test-retest reliability in older adults with PD. Methods A novel PD-specific falls questionnaire (PDF-Q) was developed in two modes (online and paper-based version) and used to assess falls and near-falls events over the past 12-months. Questions were agreed upon by an expert group, with the domains based on previous falls-related questionnaires. The questions included the number and circumstances (activities, location and direction) of falls and near-falls, and consequences (injuries and medical treatment) of falls. The PDF-Q was distributed to 46 older adults with PD (online n = 30, paper n = 16), who completed the questionnaire twice, 4 weeks apart. Kappa (κ) statistics were used to establish test-retest reliability of the questionnaire items. Results Pooled results from both questionnaires for all participants were used to assess the overall test-retest reliability of the questionnaire. Questions assessing the number of falls (κ = 0.41) and the number of near-falls (κ = 0.51) in the previous 12-months demonstrated weak agreement, while questions on the location of falls (κ = 0.89) and near-falls (κ = 1.0) demonstrated strong to almost perfect agreement. Questions on the number of indoor (κ = 0.86) and outdoor (κ = 0.75) falls demonstrated moderate to strong agreement, though questions related to the number of indoor (κ = 0.47) and outdoor (κ = 0.56) near-falls demonstrated weak agreement. Moderate to strong agreement scores were observed for the most recent fall and near-fall in terms of the direction (indoor fall κ = 0.80; outdoor fall κ = 0.81; near-fall κ = 0.54), activity (indoor fall κ = 0.70; outdoor fall κ = 0.82; near-fall κ = 0.65) and cause (indoor fall κ = 0.75; outdoor fall κ = 0.62; near-fall κ = 0.56). Conclusions The new PDF-Q developed in this study was found to be reliable for capturing the circumstances and consequences of recent falls and near-falls in older adults with PD.

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