Multiple Wearable Sensors in Parkinson and Huntington Disease Individuals: A Pilot Study in Clinic and at Home

Abstract

Background: Clinician rating scales and patient-reported outcomes are the principal means of assessing motor symptoms in Parkinson disease and Huntington disease. However, these assessments are subjective and generally limited to episodic in-person visits. Wearable sensors can objectively and continuously measure motor features and could be valuable in clinical research and care.

Methods: We recruited participants with Parkinson disease, Huntington disease, and prodromal Huntington disease (individuals who carry the genetic marker but do not yet exhibit symptoms of the disease), and controls to wear 5 accelerometer-based sensors on their chest and limbs for standardized in-clinic assessments and for 2 days at home. The study's aims were to assess the feasibility of use of wearable sensors, to determine the activity (lying, sitting, standing, walking) of participants, and to survey participants on their experience.

Results: Fifty-six individuals (16 with Parkinson disease, 15 with Huntington disease, 5 with prodromal Huntington disease, and 20 controls) were enrolled in the study. Data were successfully obtained from 99.3% (278/280) of sensors dispatched. On average, individuals with Huntington disease spent over 50% of the total time lying down, substantially more than individuals with prodromal Huntington disease (33%, p = 0.003), Parkinson disease (38%, p = 0.01), and controls (34%; p < 0.001). Most (86%) participants were "willing" or "very willing" to wear the sensors again.

Conclusions: Among individuals with movement disorders, the use of wearable sensors in clinic and at home was feasible and well-received. These sensors can identify statistically significant differences in activity profiles between individuals with movement disorders and those without. In addition, continuous, objective monitoring can reveal disease characteristics not observed in clinic.

Keywords: Ambulatory patients; Clinical study; Gait; Huntington disease; Monitoring; Movement disorders; Parkinson disease; Remote sensing technology; Technology.

Fig. 1

Study participant wearing chest, thigh, and forearm sensors.

Fig. 2

24-h sample intervals for representative individuals from each group. a Control participant from day 1, 3 p.m. until day 2, 3 p.m. b Participant with Parkinson disease from day 1, 10 a.m. until day 2, 10 a.m. c Participant with Huntington disease from day 1, 11 a.m. until day 2, 11 a.m. d Participant with prodromal Huntington disease from day 1, 12 p.m. until day 2, 12 p.m. Std, stand; St, sit.

Fig. 3

Proportion of the day participants spent lying down, sitting, standing, and walking. * One participant with Huntington disease lost the chest sensor and could not be included.

Fig. 4

Number of sleep transitions per hour, including changes in lying position and transitions from lying to sitting or standing. * One participant with Huntington disease lost the chest sensor and could not be included. Red lines denote medians.

Fig. 5

Participant responses to end-of-study survey.