Technology-Enabled Care: Integrating Multidisciplinary Care in Parkinson's Disease Through Digital Technology

Luis-Martínez, Raquel; Monje, Mariana H.G.; Antonini, Angelo; Sánchez‐Ferro, Álvaro; Mestre, Tiago

doi:10.3389/fneur.2020.575975

Cited by 46 publications

(34 citation statements)

References 61 publications

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“…Even a patient who is comfortable with technology may be unable to interpret the information offered, visualize the interface, and/or have the dexterity to manage the app due to difficulties associated with age and more severe stages of disease (cognitive, visual, and motor dexterity impairments). When developing this type of solution, developers should keep this in mind [ 7 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

Feasibility of a Mobile-Based System for Unsupervised Monitoring in Parkinson’s Disease

Bouça‐Machado

Pona‐Ferreira²,

Leitão³

et al. 2021

Sensors

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Mobile health (mHealth) has emerged as a potential solution to providing valuable ecological information about the severity and burden of Parkinson’s disease (PD) symptoms in real-life conditions. Objective: The objective of our study was to explore the feasibility and usability of an mHealth system for continuous and objective real-life measures of patients’ health and functional mobility, in unsupervised settings. Methods: Patients with a clinical diagnosis of PD, who were able to walk unassisted, and had an Android smartphone were included. Patients were asked to answer a daily survey, to perform three weekly active tests, and to perform a monthly in-person clinical assessment. Feasibility and usability were explored as primary and secondary outcomes. An exploratory analysis was performed to investigate the correlation between data from the mKinetikos app and clinical assessments. Results: Seventeen participants (85%) completed the study. Sixteen participants (94.1%) showed a medium-to-high level of compliance with the mKinetikos system. A 6-point drop in the total score of the Post-Study System Usability Questionnaire was observed. Conclusions: Our results support the feasibility of the mKinetikos system for continuous and objective real-life measures of a patient’s health and functional mobility. The observed correlations of mKinetikos metrics with clinical data seem to suggest that this mHealth solution is a promising tool to support clinical decisions.

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Section: Discussionmentioning

confidence: 99%

Feasibility of a Mobile-Based System for Unsupervised Monitoring in Parkinson’s Disease

Bouça‐Machado

Pona‐Ferreira²,

Leitão³

et al. 2021

Sensors

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“… 3 , 4 Generally, the number of self-care-related tasks increases with the progression of the condition, and informal caregivers play an important role. Self-care “refers to the activities that people living with chronic condition (patients and carers) undertake to manage the condition outside of institutionalized or professional care and as part of their everyday life.” 5: 869 For PwPs, self-care includes the following activities: observing changes in the body, acting on symptoms, managing treatment, and dealing with the psychological, physical, and social consequences of living with PD. Patients and caregivers monitor health signs and symptoms, interpret information, and take action such as exercising, managing diet, and asking for community resources.…”

Section: Introductionmentioning

confidence: 99%

Co-designing a digital companion with people living with Parkinson's to support self-care in a personalized way: The eCARE-PD Study

et al. 2022

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eHealth technologies play a role in the development of integrated care models for people living with Parkinson disease by improving communication with their health care teams and support self-care practices in a personalized way. This article presents a co-design approach to designing an eHealth technology, the eCARE-PD platform, that addresses the needs and expectations of people living with Parkinson disease, generates tailored care tips, and recommends actions for managing care priorities at home. We use a co-design approach involving four main iterative phases: (1) preparation, (2) mapping, (3) testing and using, and (4) co-producing solutions and requirements. This approach uses several methods to engage people directly to design this technology. The study allowed us to identify design principles to be integrated in the development of the eCARE-PD platform. These principles incorporate the expectations of future users, which were expressed during the iterative phases of the co-design process: (a) six key design features based on users’ needs and expectations, (b) six main issues users raised during a test at home and key features for improving the design of the eCARE-PD platform, and (c) collective solutions to design an interactive, meaningful, tailored, empathic, and socially acceptable technology. The results of the successive phases of the co-design process allow us to underline the progressive constitution of a technology defined over successive iterations as a digital companion supporting the self-care process at home and having the capacity to generate tailored digital health communication.

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“…Similarly, myocardial scintigraphy (using 123I-metaiodobenzylguanidine) has also been successfully used to detect cardiac sympathetic denervation in early PD and in the differential diagnosis [ 228 ]. Another exciting development is in the area of digital/telemetric technologies, which can serve as an aid in detecting early neurological dysfunction, guide in patient monitoring and response to therapy [ 229 , 230 ]. Although, more scientific data and rigorous analyses on their utility are still missing, these can be useful clinical tools in the detection of sleep disorders, gastrointestinal problems (i.e., dysphagia, salivation, constipation) and tremor.…”

Section: Future Prospects and Opportunitiesmentioning

confidence: 99%

The Prion-Like Spreading of Alpha-Synuclein in Parkinson’s Disease: Update on Models and Hypotheses

Jan

Gonçalves

Vægter

et al. 2021

IJMS

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The pathological aggregation of the presynaptic protein α-synuclein (α-syn) and propagation through synaptically coupled neuroanatomical tracts is increasingly thought to underlie the pathophysiological progression of Parkinson’s disease (PD) and related synucleinopathies. Although the precise molecular mechanisms responsible for the spreading of pathological α-syn accumulation in the CNS are not fully understood, growing evidence suggests that de novo α-syn misfolding and/or neuronal internalization of aggregated α-syn facilitates conformational templating of endogenous α-syn monomers in a mechanism reminiscent of prions. A refined understanding of the biochemical and cellular factors mediating the pathological neuron-to-neuron propagation of misfolded α-syn will potentially elucidate the etiology of PD and unravel novel targets for therapeutic intervention. Here, we discuss recent developments on the hypothesis regarding trans-synaptic propagation of α-syn pathology in the context of neuronal vulnerability and highlight the potential utility of novel experimental models of synucleinopathies.

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Technology-Enabled Care: Integrating Multidisciplinary Care in Parkinson's Disease Through Digital Technology

Cited by 46 publications

References 61 publications

Feasibility of a Mobile-Based System for Unsupervised Monitoring in Parkinson’s Disease

Feasibility of a Mobile-Based System for Unsupervised Monitoring in Parkinson’s Disease

Co-designing a digital companion with people living with Parkinson's to support self-care in a personalized way: The eCARE-PD Study

The Prion-Like Spreading of Alpha-Synuclein in Parkinson’s Disease: Update on Models and Hypotheses

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