A home environment test battery for status assessment in patients with motor fluctuations

Document identifier: oai:dalea.du.se:1915
Keyword: Parkinson, Movement disorder, Fluctuation, Test battery, Status assessment, E-diary, Motor test
Publication year: 2006
Relevant Sustainable Development Goals (SDGs):
SDG 3 Good health and wellbeing
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Abstract:

Background and aims Evaluating status in patients with motor fluctuations is complex and occasional observations/measurements do not give an adequate picture as to the time spent in different states. We developed a test battery to assess advanced Parkinson patients' status consisting of diary assessments and motor tests. This battery was constructed and implemented on a handheld computer with built-in mobile communication. In fluctuating patients, it should typically be used several times daily in the home environment, over periods of about one week. The aim of this battery is to provide status information in order to evaluate treatment effects in clinical practice and research, follow up treatments and disease progression and predict outcome to optimize treatment strategy. Methods Selection of diary questions was based on a previous study with Duodopa® (DIREQT). Tapping tests (with and without visual cueing) and a spiral drawing test were added. Rapid prototyping was used in development of the user interface. An evaluation with two pilot patients was performed before and after receiving new treatments for advanced disease (one received Duodopa® and one received DBS). Speed and proportion missed taps were calculated for the tapping tests and entropy of the radial drawing velocity was calculated for the spiral tests. Test variables were evaluated using non-parametric statistics. Results Post-treatment improvement was detected in both patients in many of the test variables. Conclusions Although validation work remains, preliminary results are promising and the test battery is currently being evaluated in a long-term health economics study with Duodopa® (DAPHNE).

Authors

Jerker Westin

Högskolan Dalarna; Datateknik
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Mark Dougherty

Högskolan Dalarna; Datateknik
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Dag Nyholm

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Torgny Groth

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