Combining inertial sensors and optical flow to assess finger movements: Pilot study for telehealth applications.

Parkinson's disease is the fastest growing neurological disorder worldwide. Traditionally, diagnosis and monitoring of its motor manifestations depend on examination of the speed, amplitude, and frequency of movement by trained providers. Despite the use of validated scales, clinical examination of movement is semi-quantitative, relatively subjective and it has become a major challenge during the ongoing pandemic. Using digital and technology-based tools during synchronous telehealth can overcome these barriers but it requires access to powerful computers and high-speed internet. In resource-limited settings without consistent access to trained providers, computers and internet, there is a need to develop accessible tools for telehealth application. We simulated a controlled asynchronous telehealth environment to develop and pre-test optical flow and inertial sensors (accelerometer and gyroscope) to assess sequences of 10 repetitive finger-tapping movements performed at a cued frequency of 1 Hz. In 42 sequences obtained from 7 healthy volunteers, we found positive correlations between the frequencies estimated by all modalities (ρ=0.63-0.93, P<0.01). Test-retest experiments showed median coefficients of variation of 7.04% for optical flow, 7.78% for accelerometer and 11.79% for gyroscope measures. This pilot study shows that combining optical flow and inertial sensors is a potential telehealth approach to accurately measure the frequency of repetitive finger movements.Clinical relevance- This pilot study presents a comparative analysis between inertial sensors and optical flow to characterize repetitive finger-tapping movements in healthy volunteers. These methods are feasible for the objective evaluation of bradykinesia as part of telehealth applications.