Sensors within the wearable devices will monitor the symptoms of people with Parkinson’s disease and record information about a person’s symptoms more accurately than an in-person clinical assessment. According to NICE, such information will help inform medication decisions and follow up treatment.
Parkinson's disease is an incurable neurological condition that leads to progressive loss of coordination and movement problems. It is caused by loss of the cells in the brain that are responsible for producing dopamine, which helps to control and coordinate body movements.
People with Parkinson’s disease experience a range of motor symptoms, that can include dyskinesia (involuntary movement), bradykinesia (slowness) and tremor; non-motor symptoms include sleep disturbances.
In a statement, Mark Chapman, interim director of medical technology at NICE, said: “Providing wearable technology to people with Parkinson’s disease could have a transformative effect on their care and lead to changes in their treatment taking place more quickly.
“However there is uncertainty in the evidence at present on these five promising technologies which is why the committee has conditionally recommended their use by the NHS while data is collected to eliminate these evidence gaps.
“We are committed to balancing the best care with value for money, delivering both for individuals and society as a whole, while at the same time driving innovation into the hands of health and care professionals to enable best practice.”
NICE’s independent diagnostics advisory committee has recommended the NHS collects real-world evidence on the five technologies. They include a watch that measures movement; a waist-worn inertia recorder, configured by a doctor; sensors worn on the wrist and ankle combined with a mobile phone app data recorder to monitor physical motion and muscle activity; devices worn on both wrists, ankles and the waist to acquire movement data for assessing motor symptoms; and a smartwatch and smartphone app to measure tremor, slowness and involuntary movement.
Commenting on this development, Ravinder Dahiya, IEEE fellow and professor of electronics and nanoengineering at Glasgow University, said: “While it will take some time to consider which wearable gadgets will be used for medical use, as NICE has outlined, these devices are already providing a lot of data, which allows professionals to study the large-scale transmission of diseases and manage day-to-day ailments and conditions.”
“Today, it is now possible to remotely monitor a wide range of medical conditions associated with a single patient in real-time, allowing rapid and tailored treatments and outcomes wherever relevant,” added Andrew Feeney, lecturer in ultrasonics at Glasgow University. “With the recent advancements we have seen, such as speed in communication, improved battery life, and data processing capabilities, the number of conditions which can be remotely monitored with reliability will continue to grow.”
The NHS will provide NICE with evidence on the impact on resources associated with using the technologies for people with Parkinson’s disease and their carers; the impact on symptoms or health-related quality of life and how long this lasts for; how frequently the devices are used, and under what circumstances.
The NHS has already started data collection on one of the devices and hundreds of patients have already been issued with the Personal KinetiGraph (PKG) watch in the scheme that could be rolled out across the country to around 120,000 people in England.
Five wearables used in the trial
The Personal KinetiGraph (PKG) Movement Recording System (Global Kinetics Corporation) A watch that measures movement. It is intended to quantify movement disorder symptoms, including tremor, involuntary movement, and slowness. It has event markers for medication reminders and patient acknowledgement. It is also intended to be used to monitor activity associated with movement during sleep. STAT-ON (Sense4care) A waist-worn inertia recorder, configured by a doctor. It measures motor disorders and events when worn by someone with Parkinson’s disease, but does not measure tremor. The device measures involuntary movement, how people walk (including slowness and freezing of gait), falls, energy expenditure and posture. It can also register when medication has been taken with up to 10 alarms per day to act as prompts. The user needs to wear the system for a minimum of 24 hours over five days to generate enough data. Kinesia 360 (Great Lakes Neurotechnologies) The device monitors physical motion and muscle activity to analyse how people are able to move and how their condition is progressing. Sensors worn on the wrist and ankle combined with a mobile phone app record data, including involuntary movement and tremor. The sensors record data all day and recharge overnight for extended home use. The app also includes electronic diaries for capturing patient-reported outcomes and customizable medication diaries. KinesiaU (Great Lakes Neurotechnologies) The KinesiaU measures tremor, slowness and involuntary movement using a smartwatch and smartphone app. Patients can view reports in real-time and share these with their healthcare professionals. The reports rate the severity of tremor, slowness, and involuntary movement symptoms into good, mild, moderate and severe categories. This can be measured through specific active tasks or through passive recording. The mobile app also includes customisable medication and exercise diaries, which can be added to the report. PDMonitor (PD Neurotechnology) The PDMonitor system measures activity/posture, slowness, gait disturbances, freezing of gait, wrist tremor, leg tremor, involuntary movement and on and off periods. The devices are worn on both wrists, ankles and one is worn on the waist, and acquire movement data for assessing motor symptoms. The PDMonitor SmartBox is a docking station for charging the monitoring devices, collecting, storing and processing data and uploading them to the PD Neurotechnology storage service. The device’s mobile app has a diary for medications, diet and symptoms related to Parkinson’s disease. Source: NICE
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