When optimizing Parkinson’s therapy, the patient is in the middle of a complex system where drug types, doses, and times interact to create fluctuating patterns of motor symptoms and side effects. Determining an optimal therapy regimen can take years of repeated office visits, as symptoms can vary throughout the day and across multiple days. Clinical rating scales provide a limited snapshot of symptom severity in the clinic. Likewise, handwritten diaries can be burdensome, leading to inaccurate entries and poor compliance. These limitations can make decisions about medication adjustments challenging and require a costly trial-and-error process. Even after an appropriate therapy regimen is determined, the optimization process will continue as the disease progresses.
Wearable technology has shown great promise for providing an objective evidence base for clinical decision making. Objective home-based assessment can empower patients with PD to become more involved in their disease management and allow a personalized approach to treatment, ultimately improving symptomatic control and quality of life.
KinesiaU benefits caregivers too
The KinesiaU motor assessment system is a validated, low-cost medical app for patients to measure their Parkinson’s disease and other movement disorder symptoms their smartwatch. KinesiaU objectively tracks tremor, slowness, and dyskinesia in response to medication and exercise. In addition to tracking symptoms, the KinesiaU app provides user-friendly reports for patients and clinicians to assist in making therapy adjustments to dosing and timing without having to come into the office. This creates better access for patients outside of a clinical setting, which can lead to a higher quality of care, decreased costs, and improved compliance for patients.
Clinicians in the US can bill CPT codes for using KinesiaU as part of RPM and the National Institute for Care Excellence (NICE) in the UK has recommended the KinesiaU for remote monitoring of Parkinson’s disease in their National Health Service (NHS).
Remote monitoring using Kinesia technology has been shown to aid in clinical decision making in several clinical studies:
Clinical Study 1
KinesiaU successfully captured temporal trends in symptom scores following application of new therapy on hourly, daily, and weekly timescales, suggesting that validated smartwatch-based PD monitoring can provide clinically relevant information and may reduce the need for traditional office visits for therapy adjustment. https://pubmed.ncbi.nlm.nih.gov/34703975/
Clinical Study 2
KinesiaU measured significant differences in Parkinson’s patients recommended for DBS compared to patients not recommended for DBS. The system also captured significant improvements in patients after they received DBS. The results suggest that sensors in commercial smartwatches and AI can help identify DBS candidates and detect improvements resulting from the therapy. This type of remote patient monitoring could expand access to patients who might not otherwise have considered DBS. https://www.mdsabstracts.org/abstract/smartwatch-based-screening-to-identify-candidates-for-deep-brain-stimulation-in-parkinsons-disease/
Clinical Study 3
The advanced Parkinson’s therapy (deep brain stimulation or drug pump) referral rate was significantly higher for patients when a clinician had access to Kinesia remote monitoring reports compared to standard care alone. https://pubmed.ncbi.nlm.nih.gov/27392872/
Clinical Study 4
Kinesia reports enabled clinicians to make therapy decisions and observe the symptomatic response to changes in therapy regimens without patients returning to the clinic. https://pubmed.ncbi.nlm.nih.gov/29725667/
Clinical Study 5
Parkinson’s patients who used Kinesia at home over 12-weeks when starting transdermal dopamine agonist rotigotine were titrated to higher dosages, had more dose changes, and experienced improved UPSRS II and UPDRS III scores compared to patients receiving standard care. https://pubmed.ncbi.nlm.nih.gov/30948242/