Center for the study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel.
Institute of Neuroscience, Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK.
Parkinsonism Relat Disord. 2019 May;62:85-90. doi: 10.1016/j.parkreldis.2019.01.022. Epub 2019 Jan 29.
Recent work suggests that wearables can augment conventional measures of Parkinson's disease (PD). We evaluated the relationship between conventional measures of disease and motor severity (e.g., MDS-UPDRS part III), laboratory-based measures of gait and balance, and daily-living physical activity measures in patients with PD.
Data from 125 patients (age: 71.7 ± 6.5 years, Hoehn and Yahr: 1-3, 60.5% men) were analyzed. The MDS-UPDRS-part III was used as the gold standard of motor symptom severity. Gait and balance were quantified in the laboratory. Daily-living gait and physical activity metrics were extracted from an accelerometer worn on the lower back for 7 days.
In multivariate analyses, daily-living physical activity and gait metrics, laboratory-based balance, demographics and subject characteristics together explained 46% of the variance in MDS-UPDRS-part III scores. Daily-living measures accounted for 62% of the explained variance, laboratory measures 30%, and demographics and subject characteristics 7% of the explained variance. Conversely, demographics and subject characteristics, laboratory-based measures of gait symmetry, and motor symptom severity together explained less than 30% of the variance in total daily-living physical activity. MDS-UPDRS-part III scores accounted for 13% of the explained variance, i.e., <4% of all the variance in total daily-living activity.
Our findings suggest that conventional measures of motor symptom severity do not strongly reflect daily-living activity and that daily-living measures apparently provide important information that is not captured in a conventional one-time, laboratory assessment of gait, balance or the MDS-UPDRS. To provide a more complete evaluation, wearable devices should be considered.
最近的研究表明，可穿戴设备可以增强帕金森病（PD）的常规测量。我们评估了 PD 患者的传统疾病测量指标（例如 MDS-UPDRS 第三部分）与运动严重程度之间的关系、实验室步态和平衡测量以及日常生活体力活动测量之间的关系。
分析了 125 名患者（年龄：71.7±6.5 岁，Hoehn 和 Yahr：1-3，60.5%为男性）的数据。MDS-UPDRS 第三部分被用作运动症状严重程度的金标准。在实验室中量化步态和平衡。从佩戴在后腰上的加速度计中提取 7 天的日常生活步态和体力活动指标。
在多变量分析中，日常生活体力活动和步态指标、实验室平衡、人口统计学和受试者特征共同解释了 MDS-UPDRS 第三部分评分的 46%。日常生活测量解释了 62%的方差，实验室测量解释了 30%，人口统计学和受试者特征解释了 7%的方差。相反，人口统计学和受试者特征、实验室步态对称性测量和运动症状严重程度共同解释了不到 30%的日常生活总体力活动的方差。MDS-UPDRS 第三部分评分解释了 13%的方差，即总日常生活活动中不到 4%的方差。
我们的研究结果表明，运动症状严重程度的常规测量并不能很好地反映日常生活活动，而日常生活测量显然提供了重要的信息，这些信息在传统的单次实验室步态、平衡或 MDS-UPDRS 评估中无法捕捉到。为了提供更全面的评估，应考虑使用可穿戴设备。
