Development of a wearable system for monitoring people with Parkinson’s at home

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Sica, Marco
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University College Cork
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Parkinson's disease (PD) is a neurodegenerative disorder affecting the central nervous system. Besides impairing motor functions, PD is also characterized by a broad variety of non-motor symptoms, such as mood and cognitive disorders, hallucinations, and sleep disturbances. People with Parkinson’s (PwP) are evaluated using clinical assessments and self-administered diaries and, as a consequence, they receive the necessary pharmacological therapy to alleviate symptoms and enhance sleep quality. Tri-axial accelerometers and gyroscopes might be employed to objectively evaluate Parkinsonians’ condition and help clinicians in making decisions. PwP often have significant abnormalities in blood pressure (BP) due to comorbid age-related cardiovascular disease and orthostatic hypotension, which result in blurred vision, dizziness, syncope, and falls. Frequent BP monitoring may aid in the evaluation of such events and differentiate PD symptoms from those originated by hypotension. A number of commercially available devices designed specifically for PwP include accelerometers and gyroscopes for the estimation of main motor symptoms, gait parameters, and sleep quality; nevertheless, according to the authors' knowledge, neither commercially available systems nor published works include also photoplethysmograph (PPG) and electrocardiogram (ECG) sensors that can be used for Parkinsonians’ cardiovascular monitoring. In this work, the WESAA (Wearable Enabled Symptom Assessment Algorithm) system is introduced as a revolutionary tool for the remote monitoring of PD patients. It is comprised of two devices worn on the wrist and ankle, and its key purpose is to capture accelerations and angular velocities from these body parts, as well as PPG and ECG data. This information may be used off-line to predict common PD motor symptoms (such as tremor, bradykinesia, and dyskinesia), walking speed, sleep-wake cycles, and cuff-less BP measures. The system requirements, market overview, industrial design, hardware and firmware development, user experience, early results of the gathered inertial raw data, and validation of the PPG and ECG signals were looked at in detail in the present work. The created system fulfils all the defined user requirements, and the sensors used yielded results equivalent to gold standard technologies. This thesis also studied the PwP's viewpoints on the WESAA system which is crucial for usability and adherence, examining practical concerns such as size, design, and comfort, as well as emotional consequences, societal impact, and the significance of discretion. In addition, users discussed their data-sharing preferences and how wearable technology could enhance their lives (i.e., the necessity to give feedback, particularly on motor symptoms). The WESAA system thus presents a promising alternative for remote monitoring of PwP since it has the ability to assist physicians in decision-making in terms of medication and treatment, giving them potentially useful information about the motor symptoms and the overall health status of their patients. Future work involves the implementation of off-line solutions for the detection of PD motor symptoms, walking speed, sleep-wake cycles, and cuff-less BP; machine learning algorithms should be adopted and a broader data collection carried out.
Parkinson’s disease , Parkinson’s motor symptoms , Cuff-less blood pressure , IMU , PPG , ECG , Remote monitoring , Sensors , Telemedicine , Wearable
Sica, M. 2023. Development of a wearable system for monitoring people with Parkinson’s at home. MEngSc. Thesis, University College Cork.
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