Effect of using a wearable device on clinical decision-making and motor symptoms in patients with Parkinson's disease starting transdermal rotigotine patch: A pilot study

Stuart H. Isaacson; B. Boroojerdi; Olga Waln; Martha McGraw; David L. Kreitzman; K. Klos; Fredy J. Revilla; Dustin Heldman; Maureen Phillips; Dolors Terricabras; Michael Markowitz; F. Woltering; Stan Carson; Daniel Truong

doi:10.1016/j.parkreldis.2019.01.025

Effect of using a wearable device on clinical decision-making and motor symptoms in patients with Parkinson's disease starting transdermal rotigotine patch: A pilot study

Stuart H. Isaacson, B. Boroojerdi, Olga Waln, Martha McGraw, David L. Kreitzman, K. Klos, Fredy J. Revilla, Dustin Heldman, Maureen Phillips, Dolors Terricabras, Michael Markowitz, F. Woltering, Stan Carson, Daniel Truong

Research output: Contribution to journal › Article › peer-review

46 Scopus citations

Abstract

Background: Feedback from wearable biosensors may help assess motor function in Parkinson's disease (PD) patients and titrate medication. Kinesia 360 continuously monitors motor symptoms via wrist and ankle sensors. Methods: PD0049 was a 12-week pilot study to investigate whether using Kinesia 360 at home could improve motor symptom management in PD patients starting transdermal dopamine agonist rotigotine. Adults with PD and insufficiently controlled motor symptoms (prescribed rotigotine) were randomized 1:1 to Control Group (CG) or Experimental Group (EG) before starting rotigotine. Motor symptoms were assessed in all patients at baseline and Week 12 (W12) using Unified PD Rating Scale (UPDRS) III and Kinesia ONE, which measures standardized motor tasks via a sensor on the index finger. Between baseline and W12, EG used Kinesia 360 at home; clinicians used the data to supplement standard care in adjusting rotigotine dosage. Results: At W12, least squares mean improvements in UPDRS II (−2.1 vs 0.5, p = 0.004) and UPDRS III (−5.3 vs −1.0, p = 0.134) were clinically meaningfully greater, and mean rotigotine dosage higher (4.8 vs 3.9 mg/24 h) in EG (n = 19) vs CG (n = 20). Mean rotigotine dosage increase (+2.8 vs + 1.9 mg/24 h) and mean number of dosage changes (2.8 vs 1.8) during the study were higher in EG vs CG. Tolerability and retention rates were similar. Conclusion: Continuous, objective, motor symptom monitoring using a wearable biosensor as an adjunct to standard care may enhance clinical decision-making, and may improve outcomes in PD patients starting rotigotine.

Original language	English (US)
Pages (from-to)	132-137
Number of pages	6
Journal	Parkinsonism and Related Disorders
Volume	64
DOIs	https://doi.org/10.1016/j.parkreldis.2019.01.025
State	Published - Jul 2019

Keywords

Biosensing techniques/instrumentation
Outcomes
Parkinson's disease
Quantitative motor assessment
Wearable devices

ASJC Scopus subject areas

Neurology
Geriatrics and Gerontology
Clinical Neurology

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10.1016/j.parkreldis.2019.01.025

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Isaacson, S. H., Boroojerdi, B., Waln, O., McGraw, M., Kreitzman, D. L., Klos, K., Revilla, F. J., Heldman, D., Phillips, M., Terricabras, D., Markowitz, M., Woltering, F., Carson, S., & Truong, D. (2019). Effect of using a wearable device on clinical decision-making and motor symptoms in patients with Parkinson's disease starting transdermal rotigotine patch: A pilot study. Parkinsonism and Related Disorders, 64, 132-137. https://doi.org/10.1016/j.parkreldis.2019.01.025

Isaacson, SH, Boroojerdi, B, Waln, O, McGraw, M, Kreitzman, DL, Klos, K, Revilla, FJ, Heldman, D, Phillips, M, Terricabras, D, Markowitz, M, Woltering, F, Carson, S & Truong, D 2019, 'Effect of using a wearable device on clinical decision-making and motor symptoms in patients with Parkinson's disease starting transdermal rotigotine patch: A pilot study', Parkinsonism and Related Disorders, vol. 64, pp. 132-137. https://doi.org/10.1016/j.parkreldis.2019.01.025

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title = "Effect of using a wearable device on clinical decision-making and motor symptoms in patients with Parkinson's disease starting transdermal rotigotine patch: A pilot study",

abstract = "Background: Feedback from wearable biosensors may help assess motor function in Parkinson's disease (PD) patients and titrate medication. Kinesia 360 continuously monitors motor symptoms via wrist and ankle sensors. Methods: PD0049 was a 12-week pilot study to investigate whether using Kinesia 360 at home could improve motor symptom management in PD patients starting transdermal dopamine agonist rotigotine. Adults with PD and insufficiently controlled motor symptoms (prescribed rotigotine) were randomized 1:1 to Control Group (CG) or Experimental Group (EG) before starting rotigotine. Motor symptoms were assessed in all patients at baseline and Week 12 (W12) using Unified PD Rating Scale (UPDRS) III and Kinesia ONE, which measures standardized motor tasks via a sensor on the index finger. Between baseline and W12, EG used Kinesia 360 at home; clinicians used the data to supplement standard care in adjusting rotigotine dosage. Results: At W12, least squares mean improvements in UPDRS II (−2.1 vs 0.5, p = 0.004) and UPDRS III (−5.3 vs −1.0, p = 0.134) were clinically meaningfully greater, and mean rotigotine dosage higher (4.8 vs 3.9 mg/24 h) in EG (n = 19) vs CG (n = 20). Mean rotigotine dosage increase (+2.8 vs + 1.9 mg/24 h) and mean number of dosage changes (2.8 vs 1.8) during the study were higher in EG vs CG. Tolerability and retention rates were similar. Conclusion: Continuous, objective, motor symptom monitoring using a wearable biosensor as an adjunct to standard care may enhance clinical decision-making, and may improve outcomes in PD patients starting rotigotine.",

keywords = "Biosensing techniques/instrumentation, Outcomes, Parkinson's disease, Quantitative motor assessment, Wearable devices",

author = "Isaacson, \{Stuart H.\} and B. Boroojerdi and Olga Waln and Martha McGraw and Kreitzman, \{David L.\} and K. Klos and Revilla, \{Fredy J.\} and Dustin Heldman and Maureen Phillips and Dolors Terricabras and Michael Markowitz and F. Woltering and Stan Carson and Daniel Truong",

note = "Funding Information: This study was funded by UCB Pharma (Brussels, Belgium). The authors thank the patients and their caregivers who contributed to the study. The authors acknowledge Rajesh Pahwa, MD (University of Kansas Medical Center, Kansas City, KS, USA) for the collection of data, Erin Brown, BSN (UCB Pharma, Raleigh, NC, USA), Katie Melton, BS (UCB Pharma, Raleigh, NC, USA) for study management support, Elisabeth Dohin, MD (UCB Pharma, Brussels, Belgium) for scientific and medical input into the data analyses and interpretation, Emily Chu, PhD (Evidence Scientific Solutions, London, UK) for writing assistance, funded by UCB Pharma (Brussels, Belgium), and Nicole Meinel, PhD, CMPP (Evidence Scientific Solutions, London, UK) for publication coordination.This study was funded by UCB Pharma. Authors employed by UCB Pharma (Babak Boroojerdi, Stan Carson, Michael Markowitz, Dolors Terricabras, and Franz Woltering) were involved in conduct of the research; in study design; in the collection, analysis, and interpretation of data; in writing the report; and in preparation of the article and the decision to submit the article for publication. Funding Information: This study was funded by UCB Pharma (Brussels, Belgium). The authors thank the patients and their caregivers who contributed to the study. The authors acknowledge Rajesh Pahwa, MD (University of Kansas Medical Center, Kansas City, KS, USA) for the collection of data, Erin Brown, BSN (UCB Pharma, Raleigh, NC, USA), Katie Melton, BS (UCB Pharma, Raleigh, NC, USA) for study management support, Elisabeth Dohin, MD (UCB Pharma, Brussels, Belgium) for scientific and medical input into the data analyses and interpretation, Emily Chu, PhD (Evidence Scientific Solutions, London, UK) for writing assistance, funded by UCB Pharma (Brussels, Belgium), and Nicole Meinel, PhD, CMPP (Evidence Scientific Solutions, London, UK) for publication coordination. Publisher Copyright: {\textcopyright} 2019 Elsevier Ltd",

year = "2019",

month = jul,

doi = "10.1016/j.parkreldis.2019.01.025",

language = "English (US)",

volume = "64",

pages = "132--137",

journal = "Parkinsonism and Related Disorders",

issn = "1353-8020",

publisher = "Elsevier Ltd",

}

TY - JOUR

T1 - Effect of using a wearable device on clinical decision-making and motor symptoms in patients with Parkinson's disease starting transdermal rotigotine patch

T2 - A pilot study

AU - Isaacson, Stuart H.

AU - Boroojerdi, B.

AU - Waln, Olga

AU - McGraw, Martha

AU - Kreitzman, David L.

AU - Klos, K.

AU - Revilla, Fredy J.

AU - Heldman, Dustin

AU - Phillips, Maureen

AU - Terricabras, Dolors

AU - Markowitz, Michael

AU - Woltering, F.

AU - Carson, Stan

AU - Truong, Daniel

N1 - Funding Information: This study was funded by UCB Pharma (Brussels, Belgium). The authors thank the patients and their caregivers who contributed to the study. The authors acknowledge Rajesh Pahwa, MD (University of Kansas Medical Center, Kansas City, KS, USA) for the collection of data, Erin Brown, BSN (UCB Pharma, Raleigh, NC, USA), Katie Melton, BS (UCB Pharma, Raleigh, NC, USA) for study management support, Elisabeth Dohin, MD (UCB Pharma, Brussels, Belgium) for scientific and medical input into the data analyses and interpretation, Emily Chu, PhD (Evidence Scientific Solutions, London, UK) for writing assistance, funded by UCB Pharma (Brussels, Belgium), and Nicole Meinel, PhD, CMPP (Evidence Scientific Solutions, London, UK) for publication coordination.This study was funded by UCB Pharma. Authors employed by UCB Pharma (Babak Boroojerdi, Stan Carson, Michael Markowitz, Dolors Terricabras, and Franz Woltering) were involved in conduct of the research; in study design; in the collection, analysis, and interpretation of data; in writing the report; and in preparation of the article and the decision to submit the article for publication. Funding Information: This study was funded by UCB Pharma (Brussels, Belgium). The authors thank the patients and their caregivers who contributed to the study. The authors acknowledge Rajesh Pahwa, MD (University of Kansas Medical Center, Kansas City, KS, USA) for the collection of data, Erin Brown, BSN (UCB Pharma, Raleigh, NC, USA), Katie Melton, BS (UCB Pharma, Raleigh, NC, USA) for study management support, Elisabeth Dohin, MD (UCB Pharma, Brussels, Belgium) for scientific and medical input into the data analyses and interpretation, Emily Chu, PhD (Evidence Scientific Solutions, London, UK) for writing assistance, funded by UCB Pharma (Brussels, Belgium), and Nicole Meinel, PhD, CMPP (Evidence Scientific Solutions, London, UK) for publication coordination. Publisher Copyright: © 2019 Elsevier Ltd

PY - 2019/7

Y1 - 2019/7

N2 - Background: Feedback from wearable biosensors may help assess motor function in Parkinson's disease (PD) patients and titrate medication. Kinesia 360 continuously monitors motor symptoms via wrist and ankle sensors. Methods: PD0049 was a 12-week pilot study to investigate whether using Kinesia 360 at home could improve motor symptom management in PD patients starting transdermal dopamine agonist rotigotine. Adults with PD and insufficiently controlled motor symptoms (prescribed rotigotine) were randomized 1:1 to Control Group (CG) or Experimental Group (EG) before starting rotigotine. Motor symptoms were assessed in all patients at baseline and Week 12 (W12) using Unified PD Rating Scale (UPDRS) III and Kinesia ONE, which measures standardized motor tasks via a sensor on the index finger. Between baseline and W12, EG used Kinesia 360 at home; clinicians used the data to supplement standard care in adjusting rotigotine dosage. Results: At W12, least squares mean improvements in UPDRS II (−2.1 vs 0.5, p = 0.004) and UPDRS III (−5.3 vs −1.0, p = 0.134) were clinically meaningfully greater, and mean rotigotine dosage higher (4.8 vs 3.9 mg/24 h) in EG (n = 19) vs CG (n = 20). Mean rotigotine dosage increase (+2.8 vs + 1.9 mg/24 h) and mean number of dosage changes (2.8 vs 1.8) during the study were higher in EG vs CG. Tolerability and retention rates were similar. Conclusion: Continuous, objective, motor symptom monitoring using a wearable biosensor as an adjunct to standard care may enhance clinical decision-making, and may improve outcomes in PD patients starting rotigotine.

AB - Background: Feedback from wearable biosensors may help assess motor function in Parkinson's disease (PD) patients and titrate medication. Kinesia 360 continuously monitors motor symptoms via wrist and ankle sensors. Methods: PD0049 was a 12-week pilot study to investigate whether using Kinesia 360 at home could improve motor symptom management in PD patients starting transdermal dopamine agonist rotigotine. Adults with PD and insufficiently controlled motor symptoms (prescribed rotigotine) were randomized 1:1 to Control Group (CG) or Experimental Group (EG) before starting rotigotine. Motor symptoms were assessed in all patients at baseline and Week 12 (W12) using Unified PD Rating Scale (UPDRS) III and Kinesia ONE, which measures standardized motor tasks via a sensor on the index finger. Between baseline and W12, EG used Kinesia 360 at home; clinicians used the data to supplement standard care in adjusting rotigotine dosage. Results: At W12, least squares mean improvements in UPDRS II (−2.1 vs 0.5, p = 0.004) and UPDRS III (−5.3 vs −1.0, p = 0.134) were clinically meaningfully greater, and mean rotigotine dosage higher (4.8 vs 3.9 mg/24 h) in EG (n = 19) vs CG (n = 20). Mean rotigotine dosage increase (+2.8 vs + 1.9 mg/24 h) and mean number of dosage changes (2.8 vs 1.8) during the study were higher in EG vs CG. Tolerability and retention rates were similar. Conclusion: Continuous, objective, motor symptom monitoring using a wearable biosensor as an adjunct to standard care may enhance clinical decision-making, and may improve outcomes in PD patients starting rotigotine.

KW - Biosensing techniques/instrumentation

KW - Outcomes

KW - Parkinson's disease

KW - Quantitative motor assessment

KW - Wearable devices

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U2 - 10.1016/j.parkreldis.2019.01.025

DO - 10.1016/j.parkreldis.2019.01.025

M3 - Article

C2 - 30948242

AN - SCOPUS:85063620859

SN - 1353-8020

VL - 64

SP - 132

EP - 137

JO - Parkinsonism and Related Disorders

JF - Parkinsonism and Related Disorders

ER -

Effect of using a wearable device on clinical decision-making and motor symptoms in patients with Parkinson's disease starting transdermal rotigotine patch: A pilot study

Abstract

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