Tzallas Alexandros T, Tsipouras Markos G, Rigas Georgios, Tsalikakis Dimitrios G, Karvounis Evaggelos C, Chondrogiorgi Maria, Psomadellis Fotis, Cancela Jorge, Pastorino Matteo, Waldmeyer María Teresa Arredondo, Konitsiotis Spiros, Fotiadis Dimitrios I
Unit of Medical Technology and Intelligent Information Systems, Dept. of Materials Science and Engineering, University of Ioannina, P.O. Box 1186, GR 45110 Ioannina, Greece.
Dept. of Informatics and Telecommunication Engineering, University of Western Macedonia, GR 50100 Kozani, Greece.
Sensors (Basel). 2014 Nov 11;14(11):21329-57. doi: 10.3390/s141121329.
In this paper, we describe the PERFORM system for the continuous remote monitoring and management of Parkinson's disease (PD) patients. The PERFORM system is an intelligent closed-loop system that seamlessly integrates a wide range of wearable sensors constantly monitoring several motor signals of the PD patients. Data acquired are pre-processed by advanced knowledge processing methods, integrated by fusion algorithms to allow health professionals to remotely monitor the overall status of the patients, adjust medication schedules and personalize treatment. The information collected by the sensors (accelerometers and gyroscopes) is processed by several classifiers. As a result, it is possible to evaluate and quantify the PD motor symptoms related to end of dose deterioration (tremor, bradykinesia, freezing of gait (FoG)) as well as those related to over-dose concentration (Levodopa-induced dyskinesia (LID)). Based on this information, together with information derived from tests performed with a virtual reality glove and information about the medication and food intake, a patient specific profile can be built. In addition, the patient specific profile with his evaluation during the last week and last month, is compared to understand whether his status is stable, improving or worsening. Based on that, the system analyses whether a medication change is needed--always under medical supervision--and in this case, information about the medication change proposal is sent to the patient. The performance of the system has been evaluated in real life conditions, the accuracy and acceptability of the system by the PD patients and healthcare professionals has been tested, and a comparison with the standard routine clinical evaluation done by the PD patients' physician has been carried out. The PERFORM system is used by the PD patients and in a simple and safe non-invasive way for long-term record of their motor status, thus offering to the clinician a precise, long-term and objective view of patient's motor status and drug/food intake. Thus, with the PERFORM system the clinician can remotely receive precise information for the PD patient's status on previous days and define the optimal therapeutical treatment.
在本文中，我们描述了用于帕金森病（PD）患者持续远程监测和管理的PERFORM系统。PERFORM系统是一个智能闭环系统，它无缝集成了各种可穿戴传感器，持续监测PD患者的多种运动信号。采集到的数据通过先进的知识处理方法进行预处理，再通过融合算法进行整合，以便医疗专业人员远程监测患者的整体状况、调整用药计划并实现个性化治疗。传感器（加速度计和陀螺仪）收集的信息由多个分类器进行处理。结果，可以评估和量化与剂量末期恶化相关的PD运动症状（震颤、运动迟缓、步态冻结（FoG））以及与药物过量浓度相关的症状（左旋多巴诱导的运动障碍（LID））。基于这些信息，结合使用虚拟现实手套进行测试得出的信息以及有关药物和食物摄入的信息，可以建立患者特定档案。此外，将患者特定档案与其上周和上个月的评估结果进行比较，以了解其病情是稳定、改善还是恶化。在此基础上，系统会分析是否需要调整药物——始终在医疗监督下进行——如果需要，会将药物调整建议信息发送给患者。该系统的性能已在实际生活条件下进行评估，测试了PD患者和医疗保健专业人员对该系统的准确性和可接受性，并与PD患者的医生进行的标准常规临床评估进行了比较。PD患者以简单、安全的非侵入性方式使用PERFORM系统来长期记录其运动状态，从而为临床医生提供患者运动状态以及药物/食物摄入的精确、长期且客观的视图。因此，借助PERFORM系统临床医生可以远程接收有关PD患者前几日状态的精确信息，并确定最佳治疗方案。
