title: A systematic review of the characteristics and validity of monitoring technologies to assess Parkinson's disease.
abstract: BACKGROUND
  There is growing interest in having objective assessment of health-related outcomes using technology-based devices that provide unbiased measurements which can be used in clinical practice and scientific research. Many studies have investigated the clinical manifestations of Parkinson's disease using such devices. However, clinimetric properties and clinical validation vary among the different devices.
  
  
  METHODS
  Given such heterogeneity, we sought to perform a systematic review in order to (i) list, (ii) compare and (iii) classify technological-based devices used to measure motor function in individuals with Parkinson's disease into three groups, namely wearable, non-wearable and hybrid devices. A systematic literature search of the PubMed database resulted in the inclusion of 168 studies. These studies were grouped based on the type of device used. For each device we reviewed availability, use, reliability, validity, and sensitivity to change. The devices were then classified as (i) 'recommended', (ii) 'suggested' or (iii) 'listed' based on the following criteria: (1) used in the assessment of Parkinson's disease (yes/no), (2) used in published studies by people other than the developers (yes/no), and (3) successful clinimetric testing (yes/no).
  
  
  RESULTS
  Seventy-three devices were identified, 22 were wearable, 38 were non-wearable, and 13 were hybrid devices. In accordance with our classification method, 9 devices were 'recommended', 34 devices were 'suggested', and 30 devices were classified as 'listed'. Within the wearable devices group, the Mobility Lab sensors from Ambulatory Parkinson's Disease Monitoring (APDM), Physilog®, StepWatch 3, TriTrac RT3 Triaxial accelerometer, McRoberts DynaPort, and Axivity (AX3) were classified as 'recommended'. Within the non-wearable devices group, the Nintendo Wii Balance Board and GAITRite® gait analysis system were classified as 'recommended'. Within the hybrid devices group only the Kinesia® system was classified as 'recommended'.
authors.affiliation: Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal.|Center for Interdisciplinary Research Egas Moniz (CiiEM), Instituto Superior de Ciências da Saúde Egas Moniz, Monte de Caparica, Portugal.|CNS-Campus Neurológico Sénior, Torres Vedras, Portugal.
authors.forename: Catarina
authors.initials: C
authors.lastname: Godinho
authors.affiliation: Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal.|CNS-Campus Neurológico Sénior, Torres Vedras, Portugal.
authors.forename: Josefa
authors.initials: J
authors.lastname: Domingos
authors.affiliation: Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
authors.forename: Guilherme
authors.initials: G
authors.lastname: Cunha
authors.affiliation: Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal.
authors.forename: Ana T
authors.initials: AT
authors.lastname: Santos
authors.affiliation: Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal.|Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
authors.forename: Ricardo M
authors.initials: RM
authors.lastname: Fernandes
authors.affiliation: Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal.
authors.forename: Daisy
authors.initials: D
authors.lastname: Abreu
authors.affiliation: Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal.
authors.forename: Nilza
authors.initials: N
authors.lastname: Gonçalves
authors.affiliation: The Cure Parkinson's Trust, London, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Matthews
authors.affiliation: The Cure Parkinson's Trust, London, UK.
authors.forename: Tom
authors.initials: T
authors.lastname: Isaacs
authors.affiliation: The Cure Parkinson's Trust, London, UK.
authors.forename: Joy
authors.initials: J
authors.lastname: Duffen
authors.affiliation: HSG-IMIT, Villingen-Schwenningen, Germany.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Al-Jawad
authors.affiliation: Norwegian Centre for Telemedicine, Tromso, Norway.
authors.forename: Frank
authors.initials: F
authors.lastname: Larsen
authors.affiliation: Norwegian Centre for Telemedicine, Tromso, Norway.
authors.forename: Artur
authors.initials: A
authors.lastname: Serrano
authors.affiliation: Hasomed GmbH, Magdeburg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Weber
authors.affiliation: Hasomed GmbH, Magdeburg, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Thoms
authors.affiliation: AbilityNet, London, UK.
authors.forename: Stefan
authors.initials: S
authors.lastname: Sollinger
authors.affiliation: Institute for Medical Genetics and Applied Genomics, University of Tuebingen, Tuebingen, Germany.
authors.forename: Holm
authors.initials: H
authors.lastname: Graessner
authors.affiliation: Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, Center of Neurology, University of Tuebingen, Tuebingen, Germany.
authors.forename: Walter
authors.initials: W
authors.lastname: Maetzler
authors.affiliation: Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal. joaquimjferreira@gmail.com.|Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal. joaquimjferreira@gmail.com.|CNS-Campus Neurológico Sénior, Torres Vedras, Portugal. joaquimjferreira@gmail.com.
authors.forename: Joaquim J
authors.initials: JJ
authors.lastname: Ferreira
mesh_terms: D061725:Accelerometry / Q000295:instrumentation*; D006801:Humans; D018670:Monitoring, Ambulatory / Q000295:instrumentation*; D010300:Parkinson Disease / Q000503:physiopathology* / Q000534:rehabilitation; D015203:Reproducibility of Results
keywords: Monitoring technologies; Outcomes; Parkinson’s disease; Quantitative assessment; Wearable devices