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Mobile systems for monitoring Parkinson's disease
Örebro University, School of Science and Technology.ORCID iD: 0000-0002-2372-4226
2011 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis presents the development and evaluation of IT-based methods and systems for supporting assessment of symptoms and enabling remote monitoring of Parkinson‟s disease (PD) patients. PD is a common neurological disorder associated with impaired body movements. Its clinical management regarding treatment outcomes and follow-up of patients is complex. In order to reveal the full extent of a patient‟s condition, there is a need for repeated and time-stamped assessments related to both patient‟s perception towards common symptoms and motor function. In this thesis, data from a mobile device test battery, collected during a three year clinical study, was used for the development and evaluation of methods. The data was gathered from a series of tests, consisting of selfassessments and motor tests (tapping and spiral drawing). These tests were carried out repeatedly in a telemedicine setting during week-long test periods. One objective was to develop a computer method that would process tracedspiral drawings and generate a score representing PD-related drawing impairments. The data processing part consisted of using the discrete wavelet transform and principal component analysis. When this computer method was evaluated against human clinical ratings, the results showed that it could perform quantitative assessments of drawing impairment in spirals comparatively well. As a part of this objective, a review of systems and methods for detecting the handwriting and drawing impairment using touch screens was performed. The review showed that measures concerning forces, accelerations, and radial displacements were the most important ones in detecting fine motor movement anomalies. Another objective of this thesis work was to design and evaluate an information system for delivering assessment support information to the treating clinical staff for monitoring PD symptoms in their patients. The system consisted of a patient node for data collection based on the mobile device test battery, a service node for data storage and processing, and a web application for data presentation. A system module was designed for compiling the test battery time series into summary scores on a test period level. The web application allowed adequate graphic feedback of the summary scores to the treating clinical staff. The evaluation results for this integrated system indicate that it can be used as a tool for frequent PD symptom assessments in home environments.

Place, publisher, year, edition, pages
Örebro: Örebro universitet , 2011. , 56 p.
Series
Örebro Studies in Technology, ISSN 1650-8580 ; 22
Keyword [en]
Home assessments, Parkinson‟s disease, mobile computing technology, e-diary, discrete wavelet transform, principal component analysis
National Category
Computer and Information Science
Research subject
Information technology
Identifiers
URN: urn:nbn:se:oru:diva-20552OAI: oai:DiVA.org:oru-20552DiVA: diva2:464165
Presentation
2011-12-15, Örebro universitet, Teknikhuset, rum T131, Fakultetsgatan1, Örebro, 13:15 (English)
Opponent
Supervisors
Available from: 2011-12-12 Created: 2011-12-12 Last updated: 2017-10-18Bibliographically approved
List of papers
1. Methods for detection of handwriting/drawing impairment using inputs from touch screens
Open this publication in new window or tab >>Methods for detection of handwriting/drawing impairment using inputs from touch screens
2011 (English)In: Recent Patents on Signal Processing, ISSN 1877-6124, Vol. 1, no 2, 156-162 p.Article in journal (Refereed) Published
Abstract [en]

Fine motor dysfunction in patients with movement disorders, such as Parkinson’s disease, is characterized by slowness of movements, decrease of reaction time and involuntary movements. In this article, recent patents on detecting and assessing the said dysfunction are reviewed; their implementation in telemedicine settings, design considerations and ability to assist in dose and time adjustments are discussed. These patents explain application of signal processing techniques in analysis and interpretation of digitized handwriting/drawing information of individuals based on data gathered using touch screens. The study reveals that measures concerning forces, accelerations and radial displacements are the most relevant measurements to detect fine movement anomalies. These findings demonstrate that digitized analysis of handwriting/drawing movements may be useful in clinical trials evaluating fine motor control. This review further depicts the role of employing event-based data acquisition and signal processing techniques suitable for nonstationary signals, such as Wavelet transform, in systems for patient home-monitoring.

Place, publisher, year, edition, pages
Bussum: Bentham Science Publishers, 2011
Keyword
Drawing, fine motor impairment, Fourier transform, handwriting, home monitoring, Parkinson’s disease, touch screens, Wavelet transform
National Category
Signal Processing
Research subject
Signal Processing
Identifiers
urn:nbn:se:oru:diva-20463 (URN)10.2174/2210686311101020156 (DOI)
Available from: 2011-12-02 Created: 2011-12-02 Last updated: 2017-10-18Bibliographically approved
2. A new computer method for assessing drawing impairment in Parkinson's disease
Open this publication in new window or tab >>A new computer method for assessing drawing impairment in Parkinson's disease
Show others...
2010 (English)In: Journal of Neuroscience Methods, ISSN 0165-0270, E-ISSN 1872-678X, Vol. 190, no 1, 143-148 p.Article in journal (Refereed) Published
Abstract [en]

A test battery, consisting of self-assessments and motor tests (tapping and spiral drawing tasks) was used on 9482 test occasions by 62 patients with advanced Parkinson's disease (PD) in a telemedicine setting. On each test occasion, three Archimedes spirals were traced. A new computer method, using wavelet transforms and principal component analysis processed the spiral drawings to generate a spiral score. In a web interface, two PD specialists rated drawing impairment in spiral drawings from three random test occasions per patient, using a modification of the Bain & Findley 10-category scale. A standardised manual rating was defined as the mean of the two raters’ assessments. Bland-Altman analysis was used to evaluate agreement between the spiral score and the standardised manual rating. Another selection of spiral drawings was used to estimate the Spearman rank correlations between the raters (r = 0.87), and between the mean rating and the spiral score (r = 0.89). The 95% confidence interval for the method's prediction errors was ±1.5 scale units, which was similar to the differences between the human raters. In conclusion, the method could assess PD-related drawing impairments well comparable to trained raters.

Place, publisher, year, edition, pages
Amsterdam: Elsevier, 2010
Keyword
Test battery, Home environment, Motor test, Tremor, Dyskinesia, Spiral drawing, Drawing impairment, Wavelet transform, Principal component analysis, Involuntary movement, Movement disorders, Motor fluctuations, Parkinson's disease, Telemedicine
National Category
Neurosciences Biochemistry and Molecular Biology
Research subject
Biochemistry
Identifiers
urn:nbn:se:oru:diva-20464 (URN)10.1016/j.jneumeth.2010.04.027 (DOI)000279888800019 ()20438759 (PubMedID)2-s2.0-77953725166 (Scopus ID)
Available from: 2011-12-02 Created: 2011-12-02 Last updated: 2017-12-08Bibliographically approved
3. A web application for follow-up of results from a mobile device test battery for Parkinson's disease patients
Open this publication in new window or tab >>A web application for follow-up of results from a mobile device test battery for Parkinson's disease patients
Show others...
2011 (English)In: Computer Methods and Programs in Biomedicine, ISSN 0169-2607, E-ISSN 1872-7565, Vol. 104, no 2, 219-226 p.Article in journal (Refereed) Published
Abstract [en]

This paper describes a web-based system for enabling remote monitoring of patients with Parkinson's disease (PD) and supporting clinicians in treating their patients. The system consists of a patient node for subjective and objective data collection based on a handheld computer, a service node for data storage and processing, and a web application for data presentation. Using statistical and machine learning methods, time series of raw data are summarized into scores for conceptual symptom dimensions and an “overall test score” providing a comprehensive profile of patient's health during a test period of about one week. The handheld unit was used quarterly or biannually by 65 patients with advanced PD for up to four years at nine clinics in Sweden. The IBM Computer System Usability Questionnaire was administered to assess nurses’ satisfaction with the web application. Results showed that a majority of the nurses were quite satisfied with the usability although a sizeable minority were not. Our findings support that this system can become an efficient tool to easily access relevant symptom information from the home environment of PD patients.

Place, publisher, year, edition, pages
Amsterdam: Elsevier, 2011
Keyword
Parkinson's disease, Test battery, Web application, Decision support, Remote patient monitoring, Telemedicine, Principal component analysis
National Category
Information Science
Research subject
Computer and Systems Science
Identifiers
urn:nbn:se:oru:diva-20469 (URN)10.1016/j.cmpb.2011.07.017 (DOI)000296945100024 ()21872355 (PubMedID)2-s2.0-80054120422 (Scopus ID)
Note

7th IFAC Symposium on Modelling and Control in Biomedical Systems

Available from: 2011-12-02 Created: 2011-12-02 Last updated: 2017-12-08Bibliographically approved

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Citation style
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Output format
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