Wednesday 13 April 2016

Validation of a Smartphone Application Measuring Motor Function in Parkinson's Disease

Another smart phone app to measure motor dysfunction from a good group... the correlations and repeatability they report is impressive...

J Parkinsons Dis. 2016 Apr 2. [Epub ahead of print]
Lee W, Evans A, Williams DR.


BACKGROUND:
Measurement of motor function is critical to the assessment and management of Parkinson's disease. Ambulatory motor assessment has the potential to provide a glimpse of the patient's clinical state beyond the consultation. We custom-designed a smartphone application that quantitatively measures hand dexterity and hypothesized that this can give an indication of a patient's overall motor function.

OBJECTIVE:
The aims of this study were to (i) validate this smartphone application against MDS-UPDRS motor assessment (MDS-UPDRS-III) and the two-target tapping test; (ii) generate a prediction model for MDS-UPDRS-III; (iii) assess repeatability of our smartphone application and (iv) examine compliance and user-satisfaction of this application.

METHODS:
103 patients with Parkinson's disease were recruited from two movement disorders clinics. After initial assessment, a group of patients underwent repeat assessment within two weeks. Patients were invited to use the smartphone application at home over three days, followed by a survey to assess their experience.

RESULTS:
Significant correlation between key smartphone application test parameters and MDS-UPDRS-III (r = 0.281-0.608, p <  0.0001) was demonstrated. A prediction model based on these parameters accounted for 52.3% of variation in MDS-UPDRS-III (R2 = 0.523, F(4,93) = 25.48, p <  0.0001). Forty-eight patients underwent repeat assessment under identical clinical conditions. Repeatability of key smartphone application tests parameters and predicted MDS-UPDRS-III was moderate to strong (intraclass correlation coefficient 0.584-0.763, p <  0.0001). The follow-up survey identified that our patients were very comfortable with the smartphone application and mobile technology.

CONCLUSIONS:

Our smartphone application demonstrated satisfactory repeatability and validity when measured against MDS-UPDRS-III. Its performance is acceptable considering our smartphone application measures hand dexterity only.

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