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- Wearable Health Technology to Quantify the Functional Impact of Peripheral Neuropathy on Mobility in Parkinson’s Disease: A Systematic ReviewPublication . Corrà, Marta; Warmerdam, Elke; Vila-Chã, Nuno; Maetzler, Walter; Maia, LuisThe occurrence of peripheral neuropathy (PNP) is often observed in Parkinson's disease (PD) patients with a prevalence up to 55%, leading to more prominent functional deficits. Motor assessment with mobile health technologies allows high sensitivity and accuracy and is widely adopted in PD, but scarcely used for PNP assessments. This review provides a comprehensive overview of the methodologies and the most relevant features to investigate PNP and PD motor deficits with wearables. Because of the lack of studies investigating motor impairments in this specific subset of PNP-PD patients, Pubmed, Scopus, and Web of Science electronic databases were used to summarize the state of the art on PNP motor assessment with wearable technology and compare it with the existing evidence on PD. A total of 24 papers on PNP and 13 on PD were selected for data extraction: The main characteristics were described, highlighting major findings, clinical applications, and the most relevant features. The information from both groups (PNP and PD) was merged for defining future directions for the assessment of PNP-PD patients with wearable technology. We established suggestions on the assessment protocol aiming at accurate patient monitoring, targeting personalized treatments and strategies to prevent falls and to investigate PD and PNP motor characteristics.
- Gait speed in clinical and daily living assessments in Parkinson’s disease patients: performance versus capacityPublication . Atrsaei, Arash; Corrà, Marta; Dadashi, Farzin; Vila Cha, Nuno; Maia, Luis; Mariani, Benoit; Maetzler, Walter; Aminian, KamiarGait speed often referred as the sixth vital sign is the most powerful biomarker of mobility. While a clinical setting allows the estimation of gait speed under controlled conditions that present functional capacity, gait speed in real-life conditions provides the actual performance of the patient. The goal of this study was to investigate objectively under what conditions during daily activities, patients perform as well as or better than in the clinic. To this end, we recruited 27 Parkinson's disease (PD) patients and measured their gait speed by inertial measurement units through several walking tests in the clinic as well as their daily activities at home. By fitting a bimodal Gaussian model to their gait speed distribution, we found that on average, patients had similar modes in the clinic and during daily activities. Furthermore, we observed that the number of medication doses taken throughout the day had a moderate correlation with the difference between clinic and home. Performing a cycle-by-cycle analysis on gait speed during the home assessment, overall only about 3% of the strides had equal or greater gait speeds than the patients' capacity in the clinic. These strides were during long walking bouts (>1 min) and happened before noon, around 26 min after medication intake, reaching their maximum occurrence probability 3 h after Levodopa intake. These results open the possibility of better control of medication intake in PD by considering both functional capacity and continuous monitoring of gait speed during real-life conditions.
- Motor, cognitive and mobility deficits in 1000 geriatric patients: protocol of a quantitative observational study before and after routine clinical geriatric treatment - the ComOn-studyPublication . Geritz, Johanna; Maetzold, Sara; Steffen, Maren; Pilotto, Andrea; Corrà, Marta; Moscovich, Mariana; Rizzetti, Maria C; Borroni, Barbara; Padovani, Alessandro; Alpes, Annekathrin; Bang, Corinna; Barcellos, Igor; Baron, Ralf; Bartsch, Thorsten; Becktepe, Jos S; Berg, Daniela; Bergeest, Lu M; Bergmann, Philipp; Bouça-Machado, Raquel; Drey, Michael; Elshehabi, Morad; Farahmandi, Susan; Ferreira, Joaquim J; Franke, Andre; Friederich, Anja; Geisler, Corinna; Hüllemann, Philipp; Gierthmühlen, Janne; Granert, Oliver; Heinzel, Sebastian; Heller, Maren K; Hobert, Markus A; Hofmann, Marc; Jemlich, Björn; Kerkmann, Laura; Knüpfer, Stephanie; Krause, Katharina; Kress, Maximilian; Krupp, Sonja; Kudelka, Jennifer; Kuhlenbäumer, Gregor; Kurth, Roland; Leypoldt, Frank; Maetzler, Corina; Maia, Luis; Moewius, Andreas; Neumann, Patricia; Niemann, Katharina; Ortlieb, Christian T; Paschen, Steffen; Pham, Minh H; Puehler, Thomas; Radloff, Franziska; Riedel, Christian; Rogalski, Marten; Sablowsky, Simone; Schanz, Elena M; Schebesta, Linda; Schicketmüller, Andreas; Studt, Simone; Thieves, Martina; Tönges, Lars; Ullrich, Sebastian; Urban, Peter P; Vila-Chã, Nuno; Wiegard, Anna; Warmerdam, Elke; Warnecke, Tobias; Weiss, Michael; Welzel, Julius; Hansen, Clint; Maetzler, WalterBackground: Motor and cognitive deficits and consequently mobility problems are common in geriatric patients. The currently available methods for diagnosis and for the evaluation of treatment in this vulnerable cohort are limited. The aims of the ComOn (COgnitive and Motor interactions in the Older populatioN) study are (i) to define quantitative markers with clinical relevance for motor and cognitive deficits, (ii) to investigate the interaction between both motor and cognitive deficits and (iii) to assess health status as well as treatment outcome of 1000 geriatric inpatients in hospitals of Kiel (Germany), Brescia (Italy), Porto (Portugal), Curitiba (Brazil) and Bochum (Germany). Methods: This is a prospective, explorative observational multi-center study. In addition to the comprehensive geriatric assessment, quantitative measures of reduced mobility and motor and cognitive deficits are performed before and after a two week's inpatient stay. Components of the assessment are mobile technology-based assessments of gait, balance and transfer performance, neuropsychological tests, frailty, sarcopenia, autonomic dysfunction and sensation, and questionnaires to assess behavioral deficits, activities of daily living, quality of life, fear of falling and dysphagia. Structural MRI and an unsupervised 24/7 home assessment of mobility are performed in a subgroup of participants. The study will also investigate the minimal clinically relevant change of the investigated parameters. Discussion: This study will help form a better understanding of symptoms and their complex interactions and treatment effects in a large geriatric cohort.