Neuroscience Department, The Alfred Hospital, Melbourne, VIC, Australia
Van Cleef Roet Centre for Nervous Diseases, Monash University, The Alfred Hospital, Melbourne, VIC, Australia
Neurology Department, The Royal Melbourne Hospital, Parkville, VIC, Australia
Correspondence to: Will Lee, Van Cleef Roet Centre for Nervous Diseases, Monash University, The Alfred Hospital,Melbourne, Victoria 3004, Australia. Tel.: +61 3 9076 2059; E-mail: [email protected].
Abstract: Background: Measurement of motor function is critical to the assessment and management of Parkinson’s disease. Ambulatory motor assessment has the potential to provide a glimpse of the patient’s clinical state beyond the consultation. We custom-designed a smartphone application that quantitatively measures hand dexterity and hypothesized that this can give an indication of a patient’s overall motor function. Objective: The aims of this study were to (i) validate this smartphone application against MDS-UPDRS motor assessment (MDS-UPDRS-III) and the two-target tapping test; (ii) generate a prediction model for MDS-UPDRS-III; (iii) assess repeatability of our smartphone application and (iv) examine compliance and user-satisfaction of this application. Methods: 103 patients with Parkinson’s disease were recruited from two movement disorders clinics. After initial assessment, a group of patients underwent repeat assessment within two weeks. Patients were invited to use the smartphone application at home over three days, followed by a survey to assess their experience. Results: Significant correlation between key smartphone application test parameters and MDS-UPDRS-III (r = 0.281–0.608, p < 0.0001) was demonstrated. A prediction model based on these parameters accounted for 52.3% of variation in MDS-UPDRS-III (R2 = 0.523, F(4,93) = 25.48, p < 0.0001). Forty-eight patients underwent repeat assessment under identical clinical conditions. Repeatability of key smartphone application tests parameters and predicted MDS-UPDRS-III was moderate to strong (intraclass correlation coefficient 0.584–0.763, p < 0.0001). The follow-up survey identified that our patients were very comfortable with the smartphone application and mobile technology. Conclusions: Our smartphone application demonstrated satisfactory repeatability and validity when measured against MDS-UPDRS-III. Its performance is acceptable considering our smartphone application measures hand dexterity only.