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帕金森病:运动障碍运动症状评估的当前评估方法和可穿戴设备——患者和医疗保健专业人员的视角。

Parkinson's disease: current assessment methods and wearable devices for evaluation of movement disorder motor symptoms - a patient and healthcare professional perspective.

机构信息

School of Science and Technology, Nottingham Trent University, Clifton Lane, Nottingham, NG11 8NS, UK.

Department of Psychology, University of British Columbia in Vancouver, West Mall, Vancouver, V6T 1Z4, Canada.

出版信息

BMC Neurol. 2020 Nov 18;20(1):419. doi: 10.1186/s12883-020-01996-7.

Abstract

BACKGROUND

Parkinson's disease is the second most common long-term chronic, progressive, neurodegenerative disease, affecting more than 10 million people worldwide. There has been a rising interest in wearable devices for evaluation of movement disorder diseases such as Parkinson's disease due to the limitations in current clinic assessment methods such as Unified Parkinson's Disease Rating Scale (UPDRS) and the Hoehn and Yahr (HY) scale. However, there are only a few commercial wearable devices available, which, in addition, have had very limited adoption and implementation. This inconsistency may be due to a lack of users' perspectives in terms of device design and implementation. This study aims to identify the perspectives of healthcare professionals and patients linked to current assessment methods and to identify preferences, and requirements of wearable devices.

METHODS

This was a qualitative study using semi-structured interviews followed by focus groups. Transcripts from sessions were analysed using an inductive thematic approach.

RESULTS

It was noted that the well-known assessment process such as Unified Parkinson's Disease Rating Scale (UPDRS) was not used routinely in clinics since it is time consuming, subjective, inaccurate, infrequent and dependent on patients' memories. Participants suggested that objective assessment methods are needed to increase the chance of effective treatment. The participants' perspectives were positive toward using wearable devices, particularly if they were involved in early design stages. Patients emphasized that the devices should be comfortable, but they did not have any concerns regarding device visibility or data privacy transmitted over the internet when it comes to their health. In terms of wearing a monitor, the preferable part of the body for all participants was the wrist. Healthcare professionals stated a need for an economical solution that is easy to interpret. Some design aspects identified by patients included clasps, material choice, and form factor.

CONCLUSION

The study concluded that current assessment methods are limited. Patients' and healthcare professionals' involvement in wearable devices design process has a pivotal role in terms of ultimate user acceptance. This includes the provision of additional functions to the wearable device, such as fall detection and medication reminders, which could be attractive features for patients.

摘要

背景

帕金森病是全球第二大常见的长期慢性、进行性神经退行性疾病,影响着超过 1000 万人。由于当前临床评估方法(如统一帕金森病评定量表(UPDRS)和 Hoehn 和 Yahr(HY)量表)存在局限性,因此人们对可用于评估运动障碍疾病(如帕金森病)的可穿戴设备产生了浓厚的兴趣。然而,目前仅有少数商业可穿戴设备可用,此外,这些设备的采用和实施非常有限。这种不一致可能是由于缺乏用户在设备设计和实施方面的观点。本研究旨在确定医疗保健专业人员和患者对当前评估方法的看法,并确定可穿戴设备的偏好和需求。

方法

这是一项使用半结构式访谈随后进行焦点小组的定性研究。使用归纳主题方法对会议记录进行分析。

结果

研究人员注意到,像统一帕金森病评定量表(UPDRS)这样著名的评估过程并没有在临床上常规使用,因为它耗时、主观、不准确、不频繁且依赖于患者的记忆。参与者建议需要使用客观的评估方法来提高有效治疗的机会。参与者对使用可穿戴设备的看法是积极的,特别是如果他们参与了早期设计阶段。患者强调,设备应该舒适,但他们对佩戴监测器时设备的可见性或通过互联网传输的数据隐私没有任何担忧,只要这对他们的健康有益。就佩戴监测器而言,所有参与者首选的身体部位是手腕。医疗保健专业人员表示需要一种经济实惠且易于解释的解决方案。患者提出的一些设计方面包括扣环、材料选择和外形因素。

结论

研究得出的结论是,目前的评估方法存在局限性。患者和医疗保健专业人员参与可穿戴设备的设计过程对于最终用户的接受度起着关键作用。这包括为可穿戴设备提供附加功能,例如跌倒检测和药物提醒,这可能是吸引患者的特色功能。

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