Combined Fine-Motor Tests and Self-Assessments for Remote Detection of Motor Fluctuations
Mevludin Memedi, Dag Nyholm and Jerker Westin
Affiliation: Academy of Industry and Society, Computer Engineering, Dalarna University, SE- 781 88 Borlänge, Sweden.
Keywords: Remote patient monitoring, Parkinson’s disease, subjective, objective, telemedicine.
A major problem with the clinical management of fluctuating movement disorders, e.g. Parkinson’s disease
(PD), is the large variability in manifestation of symptoms among patients. In this condition, frequent measurements
which account for both patient-reported and objective assessments are needed in order to capture symptom fluctuations,
with the purpose to optimize therapy. The main focus of this paper is to present a mobile-based system for enabling remote
monitoring of PD patients from their home environment conditions. The system consists of a patient diary section
for collecting patient-based self-assessments, a motor test section for collecting fine motor movements through upper limb
motor tests, and a scheduler for restricting operation to a multitude of predetermined limited time intervals. The system
processes and compiles time series data into different summary scores representing symptom severity. In addition, the paper
presents a review of recent inventions which were filed after year 2000 in the field of telemedicine applications. The
review includes a summary of systems and methods which enable remote symptom assessments of patients, not necessarily
suffering from movement disorders, through repeated measurements and which take into account their subjective
and/or objective health indicators. The findings conclude that there are a small number of inventions which collect subjective
and objective health measures in telemedicine settings. Consequently, there is a lack of mechanisms that combine
these two types of information into scores to provide a more in-depth assessment of the patient’s general health, their motor
and non-motor symptom fluctuations and treatment effects. The paper also provides a discussion concerning different
approaches for analyzing and combining subjective and objective measures, and handling data from longitudinal studies.
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