title: Motion sensor dyskinesia assessment during activities of daily living.
abstract: BACKGROUND
  Dyskinesia throughout the levodopa dose cycle has been previously measured in patients with Parkinson's disease (PD) using a wrist-worn motion sensor during the stationary tasks of arms resting and extended. Quantifying dyskinesia during unconstrained activities poses a unique challenge since these involuntary movements are kinematically similar to voluntary movement.
  
  
  OBJECTIVE
  To determine the feasibility of using motion sensors to measure dyskinesia during activities of daily living.
  
  
  METHODS
  Fifteen PD subjects performed scripted activities of daily living while wearing motion sensors on bilateral hands, thighs, and ankles over the course of a levodopa dose cycle. Videos were scored by clinicians using the modified Abnormal Involuntary Movement Scale to rate dyskinesia severity in separate body regions, with the total score used as an overall measure. Kinematic features were extracted from the motion data and algorithms were generated to output severity scores.
  
  
  RESULTS
  Movements when subjects were experiencing dyskinesia were less smooth than when they were not experiencing dyskinesia. Dyskinesia scores predicted by the model using all sensors were highly correlated with clinician scores, with a correlation coefficient of 0.86 and normalized root-mean-square-error of 7.4%. Accurate predictions were maintained when two sensors on the most affected side of the body (one on the upper extremity and one on the lower extremity) were used.
  
  
  CONCLUSIONS
  A system with motion sensors may provide an accurate measure of overall dyskinesia that can be used to monitor patients as they complete typical activities, and thus provide insight on symptom fluctuation in the context of daily life.
authors.affiliation: Great Lakes NeuroTechnologies, Cleveland, OH, USA.
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Pulliam
authors.affiliation: Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Burack
authors.affiliation: Great Lakes NeuroTechnologies, Cleveland, OH, USA.
authors.forename: Dustin A
authors.initials: DA
authors.lastname: Heldman
authors.affiliation: Great Lakes NeuroTechnologies, Cleveland, OH, USA.
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Giuffrida
authors.affiliation: Great Lakes NeuroTechnologies, Cleveland, OH, USA.
authors.forename: Thomas O
authors.initials: TO
authors.lastname: Mera
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000465:Algorithms; D000978:Antiparkinson Agents / Q000009:adverse effects; D020820:Dyskinesias / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006225:Hand / Q000503:physiopathology; D006801:Humans; D007980:Levodopa / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009039:Motion Perception / Q000502:physiology*; D009068:Movement; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy; D012720:Severity of Illness Index
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa
keywords: Parkinson's disease; accelerometer; dyskinesia; gyroscope