The relationships between three-axis accelerometer measures of physical activity and motor symptoms in patients with Parkinson’s disease: a single-center pilot study

Abstract

Background Various wearable devices for objectively evaluating motor symptoms of patients with Parkinson’s disease (PD) have been developed. Importantly, previous studies have suggested protective effects of physical activity in PD. However, the relationships between conventional clinical ratings for PD and three-axis accelerometer measures of physical activity (e.g., daily physical activity levels [PAL] or metabolic equivalents of task [METs]) are still unclear, particularly for METs. In the current study, we sought to elucidate these relationships on a daily basis, and to clarify optimal predictors for clinical states on a 30-min basis. Methods Patients who were hospitalized for adjustment of drugs or deep brain stimulation were enrolled. Using waist-worn three-axis accelerometers, PAL and METs parameter data were obtained and compared with UPDRS-3[On] and symptom diary data. We extracted data from the patients’ best and worst days, defined by the best and worst UPDRS-3[On] scores, respectively. Thus, 22 data sets from 11 patients were extracted. We examined the correlations and produced scatter plots to represent the relationships, then investigated which METs parameters and activity patterns were the best predictors for “On” and “dyskinesia”. Results The parameter “mean METs value within the 95–92.5 percentile range on a day (95–92.5 percentile value)” exhibited the strongest correlation with conventional daily clinical ratings (Rho: − 0.799 for UPDRS-3[On], 0.803 for On hours [p < 0.001]). Scatter plots suggested that PAL tended to have higher values in patients with involuntary movement. However, METs parameters focusing on higher METs seemed to alleviate this tendency. We clarified that “time over 2.0 METs” and “time over 1.5 METs” could be predictors for “On” and “dyskinesia” on a 30-min basis, respectively (AUROC: 0.779 and 0.959, 95% CI: 0.733–0.824 and 0.918–1.000). The specificity and sensitivity of the optimal activity pattern for “On” were 0.858 and 0.621. Conclusions This study suggested feasible activity patterns and METs parameters for objective evaluation of motor symptoms on a 30-min or daily basis. Three-axis accelerometer measures focusing on higher METs may be appropriate for evaluating physical activity. Further larger-scale studies are necessary to clarify the validity, reliability, and clinical utility of these objective measures.

Body-Worn Sensors for Remote Monitoring of Parkinson’s Disease Motor Symptoms: Vision, State of the Art, and Challenges Ahead

“…Commercial devices are widely utilized in PD for quantifying physical activity [ 40–42 ]. Although people with PD have lower levels of physical activity compared to older adults (discriminant validity), construct validity provides contrasting results with either no [ 42 ], moderate [ 43 ] or strong [ 44 ] relationships with clinical scales (e.g., UPDRS, Hoehn and Yahr staging) [ 40 ]. Criterion validity was again limited to laboratory-based tests (e.g., MET) rather than real-world environments [ 44 ], where the use of self-report diaries limit validity assessment due to subjectivity and recall issues [ 42 ].…”

The Role of Wearable Sensors to Monitor Physical Activity and Sleep Patterns in Older Adult Inpatients: A Structured Review

“…Studies were conducted across 20 countries ( Appendix A ; Table A1 and Table A2 ), the majority were in the United States of America (n = 19) followed by Denmark (n = 10) and Japan (n = 9). Studies included 40 emergency admissions [ 4 , 9 , 10 , 22 , 33 , 46 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 ], 18 elective [ 37 , 38 , 39 , 41 , 44 , 47 , 89 , 90 , 91 , 92 ...…”

Perioperative Administration of Cystine and Theanine Suppresses Inflammation and Facilitates Early Rehabilitation and Recovery after Esophagectomy: A Randomized, Double-Blind, Controlled Clinical Trial

“…It is used to quantify the activity characterized by sedentary behavior (1.0–1.5 METs), light intensity (1.6–2.9 METs), moderate intensity (3–5.9 METs), and vigorous intensity (≥6 METs) [ 13 ]. It has been widely used in several fields, including rehabilitation [ 14 ]. Exercise (Ex) is the value obtained by multiplying MET and the activity time (hour) when the physical activity intensity is 3 METs or more.…”