Remote smartphone gait monitoring and fall prediction in Parkinson’s disease during the COVID-19 lockdown

Abstract

Background Falls could be serious events in Parkinson's disease (PD). Patient remote monitoring strategies are on the raise and may be an additional aid in identifying patients who are at risk of falling. The aim of the study was to evaluate if balance and timed-up-and-go data obtained by a smartphone application during COVID-19 lockdown were able to predict falls in PD patients. Methods A cohort of PD patients were monitored for 4 weeks during the COVID-19 lockdown with an application measuring static balance and timed-up-and-go test. The main outcome was the occurrence of falls (UPDRS-II item 13) during the observation period. Results Thirty-three patients completed the study, and 4 (12%) reported falls in the observation period. The rate of falls was reduced with respect to patient previous falls history (24%). The stand-up time and the mediolateral sway, acquired through the application, differed between "fallers" and "non-fallers" and related to the occurrence of new falls (OR 1.7 and 1.6 respectively, p < 0.05), together with previous falling (OR 7.5, p < 0.01). In a multivariate model, the stand-up time and the history of falling independently related to the outcome (p < 0.01). ConclusionsOur study provides new data on falls in Parkinson's disease during the lockdown. The reduction of falling events and the relationship with the stand-up time might suggest that a different quality of falls occurs when patient is forced to stay home -hence, clinicians should point their attention also on monitoring patients' sit-to-stand body transition other than more acknowledged features based on step quality.

Transcutaneous Auricular Vagus Stimulation Improves Gait and Reaction Time in Parkinson's Disease

“…The flanker is an acknowledged VNSresponsive parameter, 4 while the 10mTUG provides data on total time (stand, rotation, sit, and gait time), gait speed, stride length, number of steps, mediolateral sway, and swing amplitude. 5 The experiments took place in the morning while all of the patients were on levodopa. The patients' awareness about the condition (i.e., whether real or control) was verified with a questionnaire (Supporting Information Materials).…”

A smart-device based secondary prevention program for cerebrovascular disease patients: a randomized trial

“…In our study, the vast majority of patients took at least one ECG per day (>90%) and more than two-thirds of the recorded ECGs were of su cient quality to be analyzed by the in-built smartwatch algorithm. Considering the variegate nature of our cohort in terms of age and instruction, it is reasonable to say that the current intellectual resources are enough for implementing new technologies in clinical practice, as also shown by other similar experiences 32,33 . Indeed, the recent Coronavirus Disease 2019 pandemic had the unexpected twist of prompting the implementation of remote monitoring and telemedicine programs around the world and the number of papers on this topic has skyrocketed in the last two years 34 .…”

A smart devices based secondary prevention program for cerebrovascular disease patients

“…Considering the variegate nature of our cohort in terms of age and instruction, it is reasonable to say that the current intellectual resources are enough for implementing new technologies in clinical practice, as also shown by other similar experiences (32,33). Indeed, the recent Coronavirus Disease 2019 pandemic had the unexpected twist of prompting the implementation of remote monitoring and telemedicine programs around the world and the number of papers on this topic has skyrocketed in the last 2 years (34).…”