Department of Electrical, Computer and Biomedical Engineering, University of Rhode Island, Kingston, RI 02881, USA.
Department of Physical Therapy, University of Rhode Island, Kingston, RI 02881, USA.
Sensors (Basel). 2023 Mar 7;23(6):2877. doi: 10.3390/s23062877.
Parkinson's disease (PD) is a neurological progressive movement disorder, affecting more than 10 million people globally. PD demands a longitudinal assessment of symptoms to monitor the disease progression and manage the treatments. Existing assessment methods require patients with PD (PwPD) to visit a clinic every 3-6 months to perform movement assessments conducted by trained clinicians. However, periodic visits pose barriers as PwPDs have limited mobility, and healthcare cost increases. Hence, there is a strong demand for using telemedicine technologies for assessing PwPDs in remote settings. In this work, we present an in-home telemedicine kit, named iTex (ntelligent tile), which is a patient-centered design to carry out accessible tele-assessments of movement symptoms in people with PD. iTex is composed of a pair of smart textile gloves connected to a customized embedded tablet. iTex gloves are integrated with flex sensors on the fingers and inertial measurement unit (IMU) and have an onboard microcontroller unit with IoT (Internet of Things) capabilities including data storage and wireless communication. The gloves acquire the sensor data wirelessly to monitor various hand movements such as finger tapping, hand opening and closing, and other movement tasks. The gloves are connected to a customized tablet computer acting as an IoT device, configured to host a wireless access point, and host an MQTT broker and a time-series database server. The tablet also employs a patient-centered interface to guide PwPDs through the movement exam protocol. The system was deployed in four PwPDs who used iTex at home independently for a week. They performed the test independently before and after medication intake. Later, we performed data analysis of the in-home study and created a feature set. The study findings reported that the iTex gloves were capable to collect movement-related data and distinguish between pre-medication and post-medication cases in a majority of the participants. The IoT infrastructure demonstrated robust performance in home settings and offered minimum barriers for the assessment exams and the data communication with a remote server. In the post-study survey, all four participants expressed that the system was easy to use and poses a minimum barrier to performing the test independently. The present findings indicate that the iTex glove system has the potential for periodic and objective assessment of PD motor symptoms in remote settings.
帕金森病（PD）是一种神经退行性运动障碍，影响着全球超过 1000 万人。PD 需要对症状进行纵向评估，以监测疾病进展并管理治疗。现有的评估方法要求 PD 患者（PwPD）每 3-6 个月到诊所进行一次由训练有素的临床医生进行的运动评估。然而，定期就诊存在障碍，因为 PwPD 行动不便，而且医疗成本增加。因此，强烈需要使用远程医疗技术在远程环境中评估 PwPD。在这项工作中，我们提出了一种名为 iTex（智能瓷砖）的家庭远程医疗套件，这是一种以患者为中心的设计，用于对 PD 患者进行可访问的运动症状远程评估。iTex 由一对连接到定制嵌入式平板电脑的智能纺织手套组成。iTex 手套集成了手指上的柔性传感器和惯性测量单元（IMU），并具有带有物联网（IoT）功能的板载微控制器单元，包括数据存储和无线通信。手套通过无线方式获取传感器数据，以监测各种手部运动，例如手指敲击、手开合和其他运动任务。手套连接到充当 IoT 设备的定制平板电脑，该平板电脑配置为承载无线接入点，并承载 MQTT 代理和时间序列数据库服务器。平板电脑还采用以患者为中心的界面来指导 PwPD 完成运动检查协议。该系统已在四名 PwPD 中部署，他们在家中独立使用 iTex 一周。他们在服药前和服药后独立进行了测试。之后，我们对家庭研究中的数据进行了分析并创建了一个特征集。研究结果报告说，iTex 手套能够收集与运动相关的数据，并在大多数参与者中区分服药前和服药后的情况。家庭环境中的 IoT 基础设施表现出稳健的性能，并为评估考试和与远程服务器的数据通信提供了最小的障碍。在研究后的调查中，所有四名参与者都表示系统易于使用，并且独立进行测试的障碍最小。目前的研究结果表明，iTex 手套系统具有在远程环境中定期和客观评估 PD 运动症状的潜力。
