The progression of Parkinsons disease (PD) is unique to every person, with different early, middle, and late-stage symptoms. However, this view of PD progression may be an artifact of limited data rather than an accurate description. We need new ways of measuring PD symptoms as they change over time. We have the technology to create new devices that people can use over an extended period, across multiple settings and severity of off periods.
I see progression as a change in the intensity and duration of bad days and off periods. Many longitudinal studies investigate the progression of PD (for example, the rate of progression in exercise), but it is hard to find studies that measure changes in response to treatment. Devices discussed in this column might change that.
Better measurement of PD progression begins with a few assumptions. First, subtle, early motor symptoms will appear before more obvious symptoms, such as tremors or bradykinesia. Second, early motor symptoms will be inconsistent and episodic. Third, we have the technology to build mobile monitoring devices.
I recently read that a patient being evaluated for internal tremors showed no signs of tremor during a physical examination of his bare feet. However, once he put his socks and boots on, an astute clinician observed the left bootlace swinging in such a way that, when measured, fit the PD pattern of a tremor. In other words, while the patient didnt exhibit tremor during a visual examination of his bare feet, his shoelace reflected an underlying tremor!
A shoelace is not going to be a reliable measuring device, but it proves that slight motor changes that are difficult to detect do exist. Ive designed two possible motor symptom detection devices: a mobile swing monitor (MSM) and a fine motor skills test (FST). Both devices would record and monitor movement fluctuation over time and across settings in daily life over 10 or so days. Both devices use sensors to track and record movement through three dimensions.
The MSM uses five movement in 3D space sensors one on each wrist, one on each ankle, and one on the belt with recording hardware for all five. Worn for several days, likea Holter monitor, the MSM would map the sway of the arms, legs, and body over time and across settings. The MSM is very similar in appearance to wearable training weights, which can measure the slightest variations in body movement. Wearable training weights are used by Olympic and World Cup judges to evaluate Shaun Whites amazing snowboard flips and twists.
The FST, illustrated in the graphic below, has a 3D monitor in the soda can receptor where the block is inserted. Similar to the game Operation, the patient must remove objects from openings in the receptor without setting off the buzzer. The warning light goes off when the sensor plate is touched.
The FST will measure how the person adjusts position and control while using fine motor skills. The FST uses a 3D monitor and four independent, pressure-sensitive plates that record when the patient fails to insert the block and when the block is aligned. The plates can be positioned at different widths using an adjustable difficulty setting, making it harder to insert the block without touching the plates.
Data gathered by these two devices may provide patients and medical professionals with more accurate clinical data about motion, tremors, and fine motor skills over a greater period. They could demonstrate the progression of intensity and duration of bad days andoff periods and serve as the beginning of a database on PD progression.
Many people are excited about using technology to provide outcome measures. As we know, technology is not being utilized in offices with patients to help understand the progression of PD. But hopefully, that will change.
If these devices are already being tested in the home of PD patients, sign me up!
***
Note: Parkinsons News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinsons News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Parkinsons disease.
I am a retired professor and research scientist along with being an artist, philosopher, writer, therapist and mystic. I am also a husband, father, grandfather, master gardener and Vietnam Vet. All of these roles influence how PD interacts with my lifes journey.
Follow this link:
Devices to Record the Progression of PD - Parkinson's News Today
- Tango Parkinson's Therapy (Washington U. in St. Louis) - May 7th, 2011 [May 7th, 2011]
- Parkinson's Disease Treatment-Exercise Program-Part 2 of 4 - May 14th, 2011 [May 14th, 2011]
- Parkinson's Disease Stem Cell Treatment - Part 2 - May 21st, 2011 [May 21st, 2011]
- Deep Brain Stimulation treatment for Parkinson's disease - May 22nd, 2011 [May 22nd, 2011]
- Parkinson's Disease Treatment-Exercise Program-Part 4 of 4 - May 24th, 2011 [May 24th, 2011]
- James, Parkinson's disease, after stem cell treatment at Tiantan Puhua Hospital Beijing - May 30th, 2011 [May 30th, 2011]
- Parkinson's Disease Stem Cell Treatment - Part 1 - May 30th, 2011 [May 30th, 2011]
- Parkinson's Disease Treatment -- Mayo Clinic - June 2nd, 2011 [June 2nd, 2011]
- When should I start treatment if I have Parkinson's Disease? - June 3rd, 2011 [June 3rd, 2011]
- parkinson-treatment-with-cupping-4.flv - June 3rd, 2011 [June 3rd, 2011]
- New treatment options for Parkinson's Disease feat. Nashville Predators coach Brent Peterson - June 8th, 2011 [June 8th, 2011]
- Speech Treatment in Parkinson disease: Sharon Kha's Story - June 8th, 2011 [June 8th, 2011]
- How you can help cure Parkinson's - June 9th, 2011 [June 9th, 2011]
- TV9 - LADIES CLUB : "PARKINSON DISEASE" - CAUSE, SYMPTOMS - June 9th, 2011 [June 9th, 2011]
- Parkinson's Treatment: Case #1 - June 12th, 2011 [June 12th, 2011]
- parkinsons cure - June 17th, 2011 [June 17th, 2011]
- A Parkinson Patient Finds their Miracle. FCR Treatment helps Parkinson's Disease. - July 3rd, 2011 [July 3rd, 2011]
- Parkinson's Treatment: Case #2 - July 15th, 2011 [July 15th, 2011]
- TMJ Treatment Helping with Parkinson's Symptoms Dr. Gary Demerjian Burbank, California - July 15th, 2011 [July 15th, 2011]
- Parkinson's Treatment at Ta'ir Laser Center testimonial - July 16th, 2011 [July 16th, 2011]
- Parkinson's Disease client pre and post treatment - July 17th, 2011 [July 17th, 2011]
- Parkinson's Disease: Diagnosis, Causes and Treatment. Part 2 - July 18th, 2011 [July 18th, 2011]
- Parkinson's Disease: Diagnosis, Causes and Treatment part4 - July 18th, 2011 [July 18th, 2011]
- Glutathione for Parkinson's Disease. Learn why it helps symtoms - July 18th, 2011 [July 18th, 2011]
- Parkinson's Disease: Diagnosis, Causes and Treatment. - July 19th, 2011 [July 19th, 2011]
- parkinson-treatment-with-cupping-1.flv - July 20th, 2011 [July 20th, 2011]
- 7.30 - a treatment for Parkinson's Disease can cause problem gambling - July 27th, 2011 [July 27th, 2011]
- Parkinson's Disease Symptoms Improve with Non-Surgical TMJ Treatment: Dr. Gary Demerjian - July 29th, 2011 [July 29th, 2011]
- Werth Parkinson Centre, Daniella - Treatment - August 4th, 2011 [August 4th, 2011]
- 6.30 - Parkinson's treatment - August 19th, 2011 [August 19th, 2011]
- MDTV: New Drug Treatments for Parkinson's Disease - September 10th, 2011 [September 10th, 2011]
- Pakistan Parkinson's Disease patient Treatment, in chennai Surgery hospital - DINAMALAR - September 23rd, 2011 [September 23rd, 2011]
- Parkinson's treatment gives life back - October 2nd, 2011 [October 2nd, 2011]
- Parkinson Doctor Sarasota Discusses Parkinson's Disease Treatments - Video - October 15th, 2011 [October 15th, 2011]
- New treatments for Parkinson's disease - pt 1 - Video - October 16th, 2011 [October 16th, 2011]
- Parkinson's Disease Treatment - Year and a Half Later... - Video - October 19th, 2011 [October 19th, 2011]
- Still Life: The Search for a Parkinson's Cure - Video - October 22nd, 2011 [October 22nd, 2011]
- Can Exercise Treat Parkinson's? - Video - October 30th, 2011 [October 30th, 2011]
- Parkinsons Treatments | Symptoms Parkinsons - Video - November 2nd, 2011 [November 2nd, 2011]
- Symptoms - November 3rd, 2011 [November 3rd, 2011]
- Revolutionary Treatment for Parkinson's - Video - November 4th, 2011 [November 4th, 2011]
- Herbal Treatment for Parkinsons disease and recovery - Video - November 7th, 2011 [November 7th, 2011]
- Early Diagnosis and Treatment of Parkinson's Disease - Video - November 10th, 2011 [November 10th, 2011]
- Parkinson's Disease Treatment (part 1 of 4) at Penn Medicine - Video - November 15th, 2011 [November 15th, 2011]
- Parkinson's Disease Treatment - Video - November 18th, 2011 [November 18th, 2011]
- MDTV: Parkinson's Disease: Treating Off Times - Video - November 20th, 2011 [November 20th, 2011]
- parkinson-treatment-with-hijamah-therapy.3gp - Video - November 24th, 2011 [November 24th, 2011]
- parkinson-treatment-with-cupping-2.flv - Video - December 3rd, 2011 [December 3rd, 2011]
- Parkinsons Antioxident treatment before with Dr. Offutt.MOV - Video - December 7th, 2011 [December 7th, 2011]
- Teva Presenting Data on MS and Parkinson's Disease Treatments - Video - December 7th, 2011 [December 7th, 2011]
- LSVT® LOUD Treatment Benefits Parkinson's Disease Patient -- Hendricks Regional Health - Video - December 14th, 2011 [December 14th, 2011]
- Parkinson's Cure - Dating - Video - December 21st, 2011 [December 21st, 2011]
- Parkinson's Treatment part-2 - Video - December 29th, 2011 [December 29th, 2011]
- Parkinson's Treatment - Video - January 1st, 2012 [January 1st, 2012]
- Parkinson's Treatment - Deep Brain Stimulation - Video - January 2nd, 2012 [January 2nd, 2012]
- Parkinson's cure with out medicine - Video - January 10th, 2012 [January 10th, 2012]
- Parkinson's Disease and The Argentine Tango - Video - January 11th, 2012 [January 11th, 2012]
- Parkinson treatment shows positive results in clinical testing - Video - January 15th, 2012 [January 15th, 2012]
- Parkinson's Disease Treatment - Patient Testimony "Lad" - Video - January 27th, 2012 [January 27th, 2012]
- Parkinson - Video - January 27th, 2012 [January 27th, 2012]
- parkinson-treatment-with-cupping-3.flv - Video - January 28th, 2012 [January 28th, 2012]
- Parkinson's Disease: Balance, Gait (Walk) and Tremors Improve with New Non-Surgical Treatment Part 2 - Video - January 29th, 2012 [January 29th, 2012]
- Researchers visualize the development of Parkinson's cells - January 31st, 2012 [January 31st, 2012]
- NPH diagnosis in San Tan Valley man returns him to normal life - January 31st, 2012 [January 31st, 2012]
- Laser targeting could help fight Parkinson's - February 1st, 2012 [February 1st, 2012]
- Study of live human neurons reveals Parkinson's origins - February 7th, 2012 [February 7th, 2012]
- Lauren Sciences LLC awarded MJFF grant to develop a V-SmartTM therapeutic for Parkinson's disease - February 7th, 2012 [February 7th, 2012]
- "Biochemistry", Advances in Parkinson's Disease Treatment - Video - February 7th, 2012 [February 7th, 2012]
- Parkinson's Disease Symptoms Improve with Non-Surgical TMJ Treatment: Part 2 - Video - February 7th, 2012 [February 7th, 2012]
- Treatment of Parkinson's Disease Symptoms - Video - February 7th, 2012 [February 7th, 2012]
- Parkinson Disease - Surgical Treatment - Video - February 8th, 2012 [February 8th, 2012]
- MediGait Announces: GaitAid Device for Parkinson's Disease Shows Significant Step-initiation Improvement in New Trial ... - February 14th, 2012 [February 14th, 2012]
- Tai Chi Makes Parkinson’s Patients Steadier on Feet, Study Says - February 14th, 2012 [February 14th, 2012]
- Cleveland Clinic Joins 23andMe in the Search for Genetic Clues to Parkinson's Disease - February 14th, 2012 [February 14th, 2012]
- Cleveland Clinic to Recruit Parkinson's Patients for 23andMe - February 14th, 2012 [February 14th, 2012]
- Fairhope Parkinson's patient enters film in contest to awareness of disease - February 15th, 2012 [February 15th, 2012]
- Tai Chi may help Parkinson's patients regain balance - February 16th, 2012 [February 16th, 2012]
- Weight Training May Help Parkinson's Patients Retain Function - February 17th, 2012 [February 17th, 2012]
- Parkinson's Disease and Exercise: How Much Is Beneficial? - February 17th, 2012 [February 17th, 2012]
- Study shows exercise may help Parkinson's patients - February 17th, 2012 [February 17th, 2012]