TITLE:
Evaluation of Clinical Utility of the Personal KinetiGraph® in the Management of Parkinson Disease
AUTHORS:
Fatta B. Nahab, Hamad Abu-Hussain, Lissette Moreno
KEYWORDS:
Parkinson’s Disease, Wearable, Objective Measurement, Clinical Management
JOURNAL NAME:
Advances in Parkinson's Disease,
Vol.8 No.3,
August
30,
2019
ABSTRACT: INTRODUCTION: Parkinson’s disease (PD) is a
disorder characterized by complex motor and non-motor symptoms that can be
difficult for patients to accurately communicate. Wearable technologies portend
improvements in assessment and monitoring of these symptoms, with their
clinical utility currently being evaluated in routine clinical care. OBJECTIVE:
To evaluate the clinical utility of the Personal
KinetiGraph? (PKG?) Movement Recording System in the routine
clinical care of persons with PD (PWP). METHODS: Clinically stable,
non-demented PWP presented for two routine clinic visits that included:
medication review, symptom review, neurological examination including the
Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS)
III/IV, and completion of a clinical management plan by a movement disorder
specialist prior to review of the PKG report. After reviewing the PKG report,
the clinician completed a modified clinical management plan taking into
consideration the findings of the PKG. This was repeated at a second visit to evaluate
various outcome measures following PKG-enhanced management. RESULTS: The PKG
improved the assessment of PD symptoms and the response to treatment, while
increasing patient activity levels and compliance. Clinical management plans
enhanced by PKG led to different recommendations in 29.4% of cases compared
with standard of care due to higher rates of bradykinesia, dyskinesia, tremor,
and fluctuations identified by PKG. Using the PKG in the clinical management
plan led to a change in medications in 75% (21/28) of patients and both a
statistically significant difference and a clinically meaningful reduction in
MDS-UPDRS III score of 4.8 (p = 0.028). Additionally, positive changes in both
the clinician (17/28; 61%) and patient-reported (13/24; 54%) Global Impression
of Improvement were reported. CONCLUSION: The PKG is a valuable tool in
augmenting clinical management when utilized along with a clinical assessment.