The overall aim of this thesis was to develop and evaluate new data-driven methods for supporting treatment and providing information for better management of Parkinson’s disease (PD).
This disease is complex and progressive. There is a large amount of inter- and intra-variability in motor symptoms of patients with PD (PwPD). Current evaluation of motor symptoms which is done at clinics by using clinical rating scales provides limited and only part of the health status of PwPD. PD requires an accurate assessment that is approved by clinics. Therefore frequent evaluation of symptoms at micro-level is required.
Sensor systems including smartphone and motion sensors were employed to collect data from PwPD and the recruited healthy controls. Repeated measures consisting of subjective assessment of symptoms and objective assessment of motor functions were collected.
First, the smartphone-based data-driven methods were developed to quantify the dexterity presented in fine motor tests of spiral drawing and alternate tapping. The upper extremities temporal irregularity measure presented in spiral drawing tests of PwPD was further analyzed by the approximate entropy (ApEn) method. Second, tri-axial motion sensor data were collected from various tests like leg agility, walking, and rapid alternating movements of hands of PwPD during a full cycled levodopa challenge. Data driven methods for quantification of leg agility tests and a combination of multiple motor tests were developed. The clinimetric properties of the methods such as reliability, validity, and responsiveness were evaluated. In addition, the feasibility of using smartphone inertial measurement unit (IMU) sensors in comparison to motion sensors for quantifying the motor states in PD during rapid alternating movements of hands tests was investigated.
Results of the developed methods for quantification of PD motor symptoms via dexterity tests in a smartphone can be used for measuring treatment related changes in PwPD. Investigation of the ApEn method showed good sensitivity and test-retest reliability indicating that this method is useful in measuring upper limb temporal irregularity at micro-level. High convergence validity resulted from using motion sensors during leg agility tests which led to valid and reliable objective measures of PD motor symptoms. The results of fusion of sensor data gathered during standardized motor tests were promising and led to highly valid, reliable and sensitive objective measures of PD motor symptoms. The results of the analyzing acceleration IMU data showed that smartphone IMU is capable of capturing symptom information from hand rotation tests. It can provide sufficient data for quantification of the motor states.
The findings from the data-driven methodology in this thesis can be used in development of systems for follow up of the effects of treatment and individualizing treatments in PD.