Role of an electronic armband in motor function monitoring in patients with Parkinson's disease.
OBJECTIVE
Levodopa replacement still is the gold standard for the management of Parkinson's disease (PD). Long-term treatment with levodopa is frequently associated with motor fluctuations. A low-protein (LP) dietary regimen has proved to be effective in reducing this adverse effect, but has been associated with weight loss, probably due to increased energy expenditure. A new wearable device (SenseWear Armband [SWA]) has recently been introduced into clinical practice. It is designed to monitor physical activity continuously and provide estimates of energy consumption. We assessed its role in measuring the effects of dietary regimens on motor function in PD.


METHODS
Six patients with levodopa-treated PD and motor fluctuations were asked to follow a balanced diet (protein 1g x kg(-1) x d(-1)) for 7 d and then to cross over to a isocaloric LP (protein 0.7 g x kg(-1) x d(-1)) dietary regimen. Total daily energy expenditures, physical activity, number of steps, and metabolic rate were assessed continuously (14 d) by the SWA. Motor control was evaluated by daily diaries.


RESULTS
The SWA proved that, during the LP diet, mean total daily energy expenditure was higher (P<0.05) and so were physical activity (P=0.05) and average metabolic rate (P=0.01), despite no change in the number of steps. The duration of periods with dyskinesias was also increased (P<0.05). These data support the role of upper-extremity involuntary movements in increasing total daily energy expenditure during an LP diet.


CONCLUSIONS
The SWA may help in monitoring patients with PD because it can assist in evaluating motor response to treatment and changes in physical activity and daily calorie needs.
Cereda
Emanuele
E
International Center for the Assessment of Nutritional Status (ICANS), Dipartimento di Scienze e Tecnologie Alimentari e Microbiologiche (DISTAM), Università degli Studi di Milano, Milan, Italy. emanuele.cereda@virgilio.it
Pezzoli
Gianni
G
Barichella
Michela
M
D001132:Arm; D001481:Basal Metabolism; D018753:Diet, Protein-Restricted; D004409:Dyskinesia, Drug-Induced / Q000178:diet therapy*; D004581:Electronics; D004734:Energy Metabolism; D006801:Humans; D007980:Levodopa / Q000009:adverse effects / Q000627:therapeutic use; D018670:Monitoring, Ambulatory / Q000295:instrumentation / Q000379:methods*; D009043:Motor Activity; D009068:Movement; D010300:Parkinson Disease / Q000178:diet therapy / Q000188:drug therapy / Q000378:metabolism*
D007980:Levodopa