Characterizing Orthostatic Tremor Using a Smartphone Application

Balachandar, Arjun; Fasano, Alfonso

doi:10.5334/tohm.385

Cited by 6 publications

(4 citation statements)

References 2 publications

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“…75 Many of these devices can be used to record different types of tremor, with higher accuracy compared with clinical observation. [76][77][78][79] Also, wearable sensors are reliable and record tremor severity with a moderate degree of correlation when compared with clinical scales commonly used to assess tremor. 80 Recent studies have explored the feasibility of using customized smartphone applications to record not only tremor but also other parameters as gait and balance, voice, and bradykinesia to aid with investigation of etiology (Axis 2 of the tremor classification).…”

Section: Role Of Neurophysiology and Innovative Technologiesmentioning

confidence: 99%

Diagnostic Uncertainties in Tremor

2023

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The approach and diagnosis of patients with tremor may be challenging for clinicians. According to the most recent consensus statement by the Task Force on Tremor of the International Parkinson Movement Disorder Society, the differentiation between action (i.e., kinetic, postural, intention), resting, and other task- and position-specific tremors is crucial to this goal. In addition, patients with tremor must be carefully examined for other relevant features, including the topography of the tremor, since it can involve different body areas and possibly associate with neurological signs of uncertain significance. Following the characterization of major clinical features, it may be useful to define, whenever possible, a particular tremor syndrome and to narrow down the spectrum of possible etiologies. First, it is important to distinguish between physiological and pathological tremor, and, in the latter case, to differentiate between the underlying pathological conditions. A correct approach to tremor is particularly relevant for appropriate referral, counseling, prognosis definition, and therapeutic management of patients. The purpose of this review is to outline the possible diagnostic uncertainties that may be encountered in clinical practice in the approach to patients with tremor. In addition to an emphasis on a clinical approach, this review discusses the important ancillary role of neurophysiology and innovative technologies, neuroimaging, and genetics in the diagnostic process.

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Section: Role Of Neurophysiology and Innovative Technologiesmentioning

confidence: 99%

Diagnostic Uncertainties in Tremor

2023

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“…Accelerometer- [72][73][74][75], gyroscope- [76,77], EMG- (72)(73)(74)78), kinematic- [72], and tabletbased [79] measurements were used to capture key phenomenological characteristics of tremor, namely frequency, amplitude, and variability under different testing conditions. TOMs effectively differentiated between parkinsonian, essential [76,77,79], and functional (psychogenic) tremors [78], and provided objective measurements of tremor severity in real-life condition using both wearable devices [74] and smartphone applications [75,80].…”

Section: Tremormentioning

confidence: 99%

Technology-based assessment of motor and nonmotor phenomena in Parkinson disease

Merola

Sturchio

Hacker

et al. 2018

Expert Review of Neurotherapeutics

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Introduction:The increasing development and availability of portable and wearable technologies is rapidly expanding the field of technology-based objective measures (TOMs) in neurological disorders, including Parkinson disease (PD). Substantial challenges remain in the recognition of disease phenomena relevant to patients and clinicians, as well as in the identification of the most appropriate devices to carry out these measurements. Areas Covered: The authors systematically reviewed PubMed for studies employing technology as outcome measures in the assessment of PD-associated motor and non-motor abnormalities. Expert Commentary: TOMs minimize intra-and inter-rater variability in clinical assessments of motor and non-motor phenomena in PD, improving the accuracy of clinical endpoints. Critical unmet needs for the integration of TOMs into clinical and research practice are the identification and validation of relevant endpoints for individual patients, the capture of motor and non-motor activities from an ecologically-valid environment, the integration of various sensor data into an open-access, common-language platforms, and the definition of a regulatory pathway for approval of TOMs. The current lack of multi-domain, multi-sensor, smart technologies to measure in real time a wide scope of relevant changes remain a significant limitation for the integration of technology into the assessment of PD motor and non-motor functional disability.

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“…Recently, applications using the accelerometer within smartphones (SPA) have been used to detect and quantify tremors, including OT [ 3 , 4 ], though the accuracy of SPA in distinguishing OT from alternate causes of instability is unknown. In our study, we assessed the sensitivity and specificity of SPAs in detecting OT, when compared with sEMG, with the goal of facilitating diagnostic options for the primary care provider.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of orthostatic tremor using smartphone accelerometry

Calvo

Ferrara

2021

BMC Neurol

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Background Primary orthostatic tremor (OT) is a rare movement disorder characterized by a 13–18 Hz leg tremor, which arises when standing and is relieved by walking/sitting. Those affected generally do not fall, but experience fear of falling, lessened by ambulation. Because of its low amplitude, the tremor is not readily visible, and diagnosis requires confirmation with surface electromyography (sEMG). Recently, applications using the accelerometer feature of smartphones have been used to detect and quantify tremors, including OT, though the accuracy of smartphone accelerometry (SPA) in diagnosing OT is unknown. Methods We completed SPA in consecutive adults (18+ years), who presented to our neurology clinic with either subjective leg shakiness upon standing or unsteadiness when standing that lessened with ambulation, which comprised 59 of 2578 patients. We assessed tremor using the StudyMyTremor application on an iPhone 6 s adhered with tape to the patient’s tibialis anterior. Surface electromyography was completed on the same muscle. The primary outcome of this study was to determine SPA’s sensitivity and specificity in detecting OT compared with surface electromyography. Results Fifty-nine patients with the following diagnoses were included: OT (6), Parkinson’s disease, Hereditary Spastic Paraplegia, orthostatic hypotension, essential tremor, spinal cerebellar ataxia, sensory ataxia and functional movement disorder. Smartphone accelerometry detected a 13–18 Hz tremor in 5 of 6 patients diagnosed with OT by sEMG with no false positives in other conditions, yielding a sensitivity of 83%, specificity of 100% in the cohort we studied. Conclusions Though a larger sample size is desirable, preliminary data suggest that smartphone accelerometry is an alternative to surface electromyography in diagnosing OT.

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Characterizing Orthostatic Tremor Using a Smartphone Application

Cited by 6 publications

References 2 publications

Diagnostic Uncertainties in Tremor

Diagnostic Uncertainties in Tremor

Technology-based assessment of motor and nonmotor phenomena in Parkinson disease

Diagnosis of orthostatic tremor using smartphone accelerometry

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