‘Sensory’ dot on the horizon

Taking the step in transforming public health, the Maastricht University Medical Center+ started a ‘telemonitoring’ pilot project in the summer of 2017 and collection of big data with wearable sensors. The pilot project, called “Dot on the Horizon” is focused on patients with Essential tremor and Parkinson’s disease. This posed many challenging questions: How can sensors be deployed for measuring people with Essential tremor and Parkinson’s disease?; How can successful quantitative measurements be made in a way that is representative of the symptoms in the home environment?; What is the battery life of the sensor?; Where is the all the big data stored in one telemonitoring system? Pieter Kubben, a neurosurgeon and coordinator for e-Health at Maastricht UMC + clarified: “Slowness in people with ET or PD is commonly measured with an accelerometer. This is cheap and energy-efficient. However, people with this condition also suffer from tremors, which are measured with a gyroscope in combination to an accelerometer. However, this technique requires a lot of energy. Thus we are looking for a sensor that can perform both measurements and is economical.” There are various institutes involved to make this possible, including specialists from the neurology and neurosurgery department, the prototyping department at Instrument Development Engineering & Evaluation (IDEE), together with Maastricht Instruments (MI) that support the development of an inertial measurement unit (accelerometer & gyroscope) prototype and a secured data collection platform. The project is also in collaboration with Radboud UMC in Nijmegen.

Our purpose is to collect medical data for better treatment of the patient." - Pieter Kubben

Filling the gaps in research

Currently, there is no research on the movement patterns or level of activity in people with Essential tremor and Parkinson’s disease in the home environment. Studies on physical activity levels have been mainly focused on the general population. Furthermore, research on Essential tremor and Parkinson’s disease is generally done in controlled laboratory settings or has been mostly focused on neurological changes.

Multiple purposes

If detection of movement patterns in people with Essential tremor and Parkinson’s disease are successful, this technology could be applied to study other conditions of movement disorder, for example people with epilepsy, or people with a risk of falling. “Patients not only have PD. They are often the elderly who may also have chronic obstructive pulmonary disease or a hip replacement. The pulmonologist wants know if the patient is moving enough; the orthopedic wants to know if the patient with a hip replacement is walking well.”, explained Pieter Kubben. With the appropriate sensor technology and algorithms, better distinctions could be made between types of movement patterns and activity which could be used to interpret health risk and wellbeing. This information could be of particular relevance across several medical specializations to compute a next course of action for the patient.

Wearable sensors in healthcare

For diagnostics and therapy, objective measurement of a patient’s movement pattern in the home environment would be useful in evaluating the management of a medical condition as well as the response to an intervention or treatment. Wearable sensors can be used to improve the precision and accuracy of measuring a patient’s movement pattern during activities of daily living. In addition, big data collected from sensors can be translated to provide valuable healthcare insights. A better understanding of the management of a medical condition in a home environment is important in prolonging independence and quality of life of the patient.

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  1. Rombout, B., ‘Sensorische’ stip aan de horizon. 2018, ICT&health: The Netherlands. p. 48 & 49.