Department of Neurosciences "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy.
Unità Operativa Complessa di Neurologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy.
Eur J Neurol. 2022 Apr;29(4):1266-1278. doi: 10.1111/ene.15235. Epub 2022 Jan 10.
Portable and wearable devices can monitor a number of physical performances and lately have been applied to patients with neuromuscular disorders (NMDs).
We performed a systematic search of literature databases following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) principles, including all studies reporting the use of technological devices for motor function assessment in NMDs from 2000 to 2021. We also summarized the evidence on measurement properties (validity, reliability, responsiveness) of the analyzed technological outcome measures.
One hundred studies fulfilled the selection criteria, most of them published in the past 10 years. We defined four categories that gathered similar technologies: gait analysis tools, for clinical assessment of pace and posture; continuous monitoring of physical activity with inertial sensors, which allow "unsupervised" activity assessment; upper limb evaluation tools, including Kinect-based outcome measures to assess the reachable workspace; and new muscle strength assessment tools, such as Myotools. Inertial sensors have the evident advantage of being applied in the "in-home" setting, which has become especially appealing during the COVID-19 pandemic, although poor evidence from psychometric property assessment and results of the analyzed studies may limit their research application. Both Kinect-based outcome measures and Myotools have already been validated in multicenter studies and different NMDs, showing excellent characteristics for application in clinical trials.
This overview is intended to raise awareness on the potential of the different technology outcome measures in the neuromuscular field and to be an informative source for the design of future clinical trials, particularly in the era of telemedicine.
便携式和可穿戴设备可以监测许多身体机能,最近已应用于神经肌肉疾病(NMDs)患者。
我们按照 PRISMA(系统评价和荟萃分析的首选报告项目)原则对文献数据库进行了系统搜索,包括所有报告 2000 年至 2021 年间使用技术设备评估 NMD 运动功能的研究。我们还总结了分析技术结果测量指标(有效性、可靠性、反应性)的证据。
有 100 项研究符合选择标准,其中大部分发表于过去 10 年。我们定义了四个类别,这些类别汇集了相似的技术:步态分析工具,用于临床评估步伐和姿势;使用惯性传感器对身体活动进行连续监测,这允许进行“无人监督”的活动评估;上肢评估工具,包括基于 Kinect 的评估措施,以评估可触及的工作空间;以及新的肌肉力量评估工具,如 Myotools。惯性传感器具有明显的优势,即可应用于“家庭”环境,这在 COVID-19 大流行期间变得特别有吸引力,尽管心理测量特性评估和分析研究的结果中的证据不足可能限制其研究应用。基于 Kinect 的评估措施和 Myotools 已在多中心研究和不同的 NMD 中得到验证,显示出在临床试验中应用的优异特性。
本文旨在提高对神经肌肉领域不同技术结果测量指标的潜力的认识,并为未来临床试验的设计提供信息来源,特别是在远程医疗时代。