Using Smartphones to Track Parkinson’s Disease Symptoms

There are apps (smartphone applications) for all sorts of things these days, and apps for health are plentiful. There are apps to help you track diet, exercise, blood pressure, blood sugar, and more. Now, some researchers focused on Parkinson’s disease (PD) are studying the use of smartphone apps to track symptoms of PD in clinical trials. The apps provide valuable data on how well people with PD are functioning, potentially giving researchers information on how well a treatment is working.

In one clinical trial, 44 patients with a relatively early stage of PD were given smartphones for 24 weeks. A control group of 35 people without PD were also given smartphones with the same instructions. The patients were prompted to perform six tests daily that measured postural tremor, rest tremor, sustained phonation (how long a person can hold a vowel tone), balance, gait, and dexterity. This data was termed active data, as the person had to actively engage with the smartphone. The smartphone also gathered passive data: each person in the trial was asked to carry the smartphone throughout their regular day, such as in a pocket.

Researchers found that the patients were fairly compliant with the active data, with 61% of the patients performing the assessments an average of at least three times a week. With the passive monitoring, there was more adherence, although the participation waned slightly from about 6 hours a day at the beginning of the trial to about 4 hours a day at week 25.

Technology matches physician assessment

The study found that the technology was in line with physician scores using the Movement Disorders Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). In addition, the app allows for much more data on an individual’s symptoms of PD than is possible to evaluate in a doctor’s visit. Typically, a person with PD sees their doctor once every 6 months, and even in a clinical trial, the assessment of an individual’s functioning is only given monthly at best. A smartphone app enables daily collection of a person’s symptoms and could give doctors a better understanding of disease fluctuation and progression.

Technology recognizes resting tremor

One finding that was notable was that the smartphones were able to detect resting tremor in patients with PD whose doctors had not identified that symptom. This may suggest that the technology is more precise than the doctor’s assessment, or the variation may be due to the short time a person sees a doctor versus the daily monitoring done by the smartphone. In addition, symptoms of PD like resting tremor fluctuate and may not always be present, such as at the time of a doctor’s appointment.

Passive data reveals the impact of PD on daily motor functioning

The passive data the smartphones picked up showed how PD affects everyday motor functioning. Compared to the control group who did not have PD, the study participants with PD had significantly reduced functioning in their mobility, including their gait (way of walking) and sit-to-stand transitions.

More data isn’t necessary better data

While the study provides insight into how mobile apps can benefit the research process in PD, it’s important to remember than more isn’t always better. More data doesn’t always mean it’s all good data, and there is a potential that more data could lead researchers down a rabbit hole that isn’t productive.

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