McKay Gregory Neal, Harrigan Timothy P, Brašić James Robert
Johns Hopkins University, Baltimore, MD, United States.
MethodsX. 2019 Jan 4;6:169-189. doi: 10.1016/j.mex.2018.12.017. eCollection 2019.
The assessment of Parkinson's disease currently relies on the history of the present illness, the clinical interview, the physical examination, and structured instruments. Drawbacks to the use of clinical ratings include the reliance on real-time human vision to quantify small differences in motion and significant inter-rater variability due to inherent subjectivity in scoring the procedures. Rating tools are semi-quantitative by design, however, in addition to significant inter-rater variability, there is inherent subjectivity in administering these tools, which are not blinded in clinical settings. Sophisticated systems to quantify movements are too costly to be used by some providers with limited resources. A simple procedure is described to obtain continuous quantitative measurements of movements of people with Parkinson's disease for objective analysis and correlation with visual observation of the movements. •Inexpensive accelerometers are attached to the upper and lower extremities of patients with Parkinson's disease and related conditions to generate a continuous, three-dimensional recorded representation of movements occurring while performing tasks to characterize the deficits of Parkinson's disease.•Movements of the procedure are rated by trained examiners live in real-time and later by videotapes.•The output of the instrumentation can be conveyed to experts for interpretation for diagnostic and therapeutic purposes.
目前,帕金森病的评估依赖于现病史、临床访谈、体格检查以及结构化工具。使用临床评分的缺点包括:依赖实时的人工视觉来量化运动中的微小差异,以及由于评分过程中固有的主观性导致的评分者间显著差异。评分工具在设计上是半定量的,然而,除了评分者间的显著差异外,在临床环境中使用这些工具时还存在固有的主观性,因为这些工具在临床环境中并非盲法使用。一些资源有限的医疗机构难以承担复杂的运动量化系统的费用。本文描述了一种简单的方法,用于对帕金森病患者的运动进行连续定量测量,以便进行客观分析并与运动的视觉观察结果相关联。•将廉价的加速度计附着于帕金森病患者及相关病症患者的上肢和下肢,以生成在执行任务时发生的运动的连续三维记录表示,从而表征帕金森病的缺陷。•该过程的运动由训练有素的检查人员进行实时现场评分,随后通过录像带评分。•仪器的输出结果可传达给专家进行解读,以用于诊断和治疗目的。