Beyond center-based testing: Understanding and improving functioning with wearable technology in MS

Abstract

Wearable sensors are designed to be worn on the body or embedded into portable devices (e.g. smartphones and smartwatches), allowing continuous patient-based monitoring, objective outcomes measuring, and feedback delivering on daily-life activities. Within the medicine domain, there has been a rapid increase in the development, testing, and use of wearable technologies especially in the context of neurological diseases. Although wearables represent promising tools also in multiple sclerosis (MS), the research on their application in MS is still ongoing, and further studies are required to assess their reliability and accuracy to monitor body functions and disability in people with MS (pwMS). Here, we provided a comprehensive overview of the opportunities, potential challenges, and limitations of the wearable technology use in MS. In particular, we classified previous findings within this field into macro-categories, considered crucial for disease management: assessment, monitoring, intervention, advice, and education. Given the increasing pivotal role played by wearables, current literature suggests that for pwMS, the time is right to shift from a center-based traditional therapeutic paradigm toward a personalized patient-based disease self-management. On this way, we present two ongoing initiatives aimed at implementing a continuous monitoring of pwMS and, consequently, providing timely and appropriate care interventions.

Prioritizing progressive MS rehabilitation research: A call from the International Progressive MS Alliance

“…Wearables and new data processing techniques to analyze data flows, such as artificial intelligence, can be leveraged to collect and monitor quantitative and continuous data in real-life circumstances, and potentially facilitate function. 101 Progress in symptom management for other chronic illnesses provide hope and guidance. Successful efforts such as those achieved in cardiac rehabilitation, which is now an accepted method to reduce heart failure symptoms and prevent worsening, provide a powerful example of how rehabilitation can produce improved quality of life and be supported by diverse payers and stakeholders.…”

Data Collection in Multiple Sclerosis: The MSDS Approach

“…PROs are collected using standardized questionnaires and provide valuable information on the effectiveness of interventions and therapies (20,(38)(39)(40)(41). The patients' symptoms and physical impairments remain unexplored by the healthcare providers, especially in the intervals between clinic visits (42)(43)(44)(45). In addition, pwMS are often affected by varying degrees of cognitive impairment and may forget what they felt a week or two before planned visits (46)(47)(48).…”

Sensorized Tip for Monitoring People with Multiple Sclerosis that Require Assistive Devices for Walking

“…To overcome these aforementioned issues, recent studies [15] have proposed to include sensors in passive, daily-use Assistive Devices for Walking, such as canes or crutches, as they can provide more reliable monitoring data. Most of the works in this area [16][17][18][19][20][21][22][23][24] propose devices capable of measuring the load applied, as well as their motion, which can be used to define indicators that could provide relevant information regarding the modality of use of the ADW.…”