Institute of Neuroscience, Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK.
Department of Mechanical Engineering, The University of Sheffield, Sheffield, UK.
Mov Disord. 2016 Sep;31(9):1293-313. doi: 10.1002/mds.26718. Epub 2016 Jul 25.
Wearable technology comprises miniaturized sensors (eg, accelerometers) worn on the body and/or paired with mobile devices (eg, smart phones) allowing continuous patient monitoring in unsupervised, habitual environments (termed free-living). Wearable technologies are revolutionizing approaches to health care as a result of their utility, accessibility, and affordability. They are positioned to transform Parkinson's disease (PD) management through the provision of individualized, comprehensive, and representative data. This is particularly relevant in PD where symptoms are often triggered by task and free-living environmental challenges that cannot be replicated with sufficient veracity elsewhere. This review concerns use of wearable technology in free-living environments for people with PD. It outlines the potential advantages of wearable technologies and evidence for these to accurately detect and measure clinically relevant features including motor symptoms, falls risk, freezing of gait, gait, functional mobility, and physical activity. Technological limitations and challenges are highlighted, and advances concerning broader aspects are discussed. Recommendations to overcome key challenges are made. To date there is no fully validated system to monitor clinical features or activities in free-living environments. Robust accuracy and validity metrics for some features have been reported, and wearable technology may be used in these cases with a degree of confidence. Utility and acceptability appears reasonable, although testing has largely been informal. Key recommendations include adopting a multidisciplinary approach for standardizing definitions, protocols, and outcomes. Robust validation of developed algorithms and sensor-based metrics is required along with testing of utility. These advances are required before widespread clinical adoption of wearable technology can be realized. © 2016 International Parkinson and Movement Disorder Society.
可穿戴技术包括佩戴在身体上的微型传感器（例如，加速计）和/或与移动设备（例如，智能手机）配对，从而可以在无人监督的日常环境（称为自由生活）中进行连续的患者监测。由于其实用性、可及性和可负担性，可穿戴技术正在彻底改变医疗保健方法。它们有望通过提供个性化、全面和有代表性的数据来改变帕金森病（PD）的管理。在 PD 中，这一点尤其重要，因为症状通常是由任务和自由生活环境挑战引发的，而在其他地方无法以足够的真实性复制这些挑战。这篇综述涉及在 PD 患者的自由生活环境中使用可穿戴技术。它概述了可穿戴技术的潜在优势及其准确检测和测量临床相关特征（包括运动症状、跌倒风险、步态冻结、步态、功能移动性和体力活动）的证据。突出了技术限制和挑战，并讨论了更广泛方面的进展。提出了克服关键挑战的建议。迄今为止，还没有用于监测自由生活环境中临床特征或活动的完全经过验证的系统。已经报道了一些特征的准确性和有效性的稳健指标，并且可以在这些情况下使用可穿戴技术，具有一定的置信度。虽然测试主要是非正式的，但实用性和可接受性似乎是合理的。主要建议包括采用多学科方法来标准化定义、协议和结果。需要对开发的算法和基于传感器的指标进行稳健验证，并测试其实用性。在可穿戴技术能够得到广泛临床应用之前，需要取得这些进展。©2016 国际帕金森病和运动障碍学会。
