Evaluating Parkinson's disease patients at home: Utility of self‐videotaping for objective motor, dyskinesia, and ON–OFF assessments

Abstract

The objective is to test feasibility and utility of home-based videos for assessing Parkinson's disease (PD) patients. As part of a clinical trial, patients opted between coming to the study sites or learning to videotape assessments at home. Those opting for at-home filming completed training on videotape techniques. Ten-minute films were taken at 30-minute intervals over 8.5 hours, 2 and 4 weeks after study entry using a protocol covering most items of the UDPRS motor examination and all Rush Dyskinesia Rating Scale items. After each filming, patients marked their ON/OFF status, based on prior training. We determined the number of patients who elected self-taping and the quality of video segments obtained. To assess ON/OFF patient accuracy, we compared the rater's and patient's assessment of ON/OFF at each time point. Of 12 participants, 10 elected self-videotaping and only 1 time point was missed (99.5% taping compliance). All self-recorded video segments were clear with all protocol elements included. With the exception of one missed ON/OFF rating, patient-based self-ratings occurred on time. Rating ON/OFF, UPDRS, and RDRS assessments for 8.5 hours required 170 minutes by the blinded rater. In spite of patient training, mean ON/OFF concordance between rater and patients was only 64%. At home video-based self-recordings are feasible and allow accurate rater-based ON/OFF assessments. In this group of patients with no or mild fluctuations, in spite of pretrial training, patients were inaccurate in separating ON vs. OFF status.

Testing objective measures of motor impairment in early Parkinson's disease: Feasibility study of an at‐home testing device

“…Some of the current authors (CGG and GTS) have experience with the use of a modified UPDRS that can be performed by a patient and caregiver at home and self‐videotaped. This technique allowed for monitoring of parkinsonism, dyskinesia, and fluctuation status (ON/OFF) 13. The AHTD gathers information on overall behavior, and we have not tested the impact of motor fluctuations or dyskinesias on outcome measures.…”

“…This technique allowed for monitoring of parkinsonism, dyskinesia, and fluctuation status (ON/OFF). 13 The AHTD gathers information on overall behavior, and we have not tested the impact of motor fluctuations or dyskinesias on outcome measures. At this point, one technique cannot be favored over the other and, in our view, both deserve further study.…”

WiiPD—Objective Home Assessment of Parkinson's Disease Using the Nintendo Wii Remote

“…As patients have been shown to have trouble distinguishing between medication states and identifying the presence of medication complications even after training [27], it was decided that a simple five-point scale would be used for patients to record their perceived severity of symptoms. Rather than being asked to classify their current state, this scale requires users to intuitively compare the current severity of symptoms to that of a typical day.…”

Une étude du système de jeux de savoirs dans la théorie de l'action conjointe en didactique. Le cas de l'usage des modèles concrets en géologie au Cours Moyen

“…Nous ne connaissons pas d'autres recherches en éducation basées sur des auto-filmages qui auraient pu nous servir de comparaison. Cependant, nous retrouvons les résultats de Goetz et al (2008) dans leur étude clinique, en neurosciences, sur un suivi de patients parkinsoniens à partir d'autoilmages au domicile. Goetz et al constatent un taux élevé de conformation au dispositif et de réussite des enregistrements, ce qui est également notre cas.…”