Patent Application
20190206566
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The present invention relates to a movement disorder monitoring and treatment support system, and a method of measuring and quantifying symptoms of movement disorders. More particularly, the present invention relates to a monitoring and treatment support system to monitor motion symptoms of tremor, bradykinesia and/or dyskinesia.
Movement disorders include, but are not limited to, Parkinson's disease (PD), dystonia, Tourette's syndrome and essential tremor. People with movement disorders usually present syndromes with an excess of movement or a paucity of voluntary and involuntary movements. The symptoms include tremor, bradykinesia, rigidity, dyskinesia, and the like. Take Parkinson's disease as an example, tremor, bradykinesia and dyskinesia are some of the major symptoms that affect the quality of life of the elderly. Movement disorders are especially prevalent in the elderly. The prevalence of all common categories of movement disorders in men and women aged 50-89 years was 28%, and the proportions were sharply increased with age.
Tremors are unintentional and uncontrollable rhythmic movements of the body part of the elderly. They are the result of a problem in part of the brain that controls muscular movement. Tremors can occur in any part of the body at any time. Bradykinesia is characterized by slow movement and an impaired ability to move the body swiftly on commands. It is the most common symptom of Parkinson's disease. Dyskinesia is a kind of involuntary movements. The severity of dyskinesia differs with the elderly, affecting normal daily activities of the elderly. Its symptoms can occur at any frequency or at any time of day.
To monitor and track the frequency and the severity that the elderly suffered from symptoms of movement disorders, a diary is mainly used as a tool to monitor the symptoms of movement disorders at present. However, a traditional diary relies heavily on the elderly's motivations and self-discipline to fill out the diary. This kind of self-report is subjected to bias that the elderly who are not medical professionals may not be able to distinguish one symptom from other symptoms. The reliability of the traditional diary would also be hindered due to the subjective experience and subjective observation by the elderlies. Moreover, the traditional diary requires only filling out the ON and OFF states of the symptoms. The ON and OFF states are inadequate for measuring and monitoring the severity of the symptoms. As the result, records from the traditional diary may not be sufficient for medical professionals, include but are not limited to, a physician and clinician, when assessing the severity of movement disorders and making important clinical decisions such as writing up and adjusting prescriptions.
Recently, some efforts have been made to quantify symptoms of movement disorders using digitized monitoring system such as a digital diary to replace the use of a traditional handwritten diary to refrain from the problems arising from the elderly's motivations and self-discipline. However, these digitized monitoring systems require continuous monitoring of movement disorders during everyday activities, over a 24-hour period. The continuous monitoring during daily activities risks the possibility of containing errors in the measurement. The movements in daily activities are easily messed up with motions of movement disorders. Although there are prior arts suggested methods for distinguishing symptoms of movement disorders from activities of daily living, errors occurred in the measurement during activities can never be eliminated. Also, the day and night wearing of the measuring device throughout the day put the elderly to great inconvenience.
Moreover, the existing digitized monitoring and measuring systems are designed to quantify symptoms of movement disorders individually. The digitized monitoring and measuring system processes and analyzes data from the elderly and hence computes various scores separately. Each individual score is an indicator of one symptom of movement disorders. For example, the existing digitized monitoring system obtains data from the elderly and utilizes the captured data to compute one score for tremor symptom, one score for bradykinesia symptom and/or one score for dyskinesia symptom. These individual scores of various symptoms are presented to medical professionals and the elderly to have a review. However, providing scores of various symptoms of movement disorders exclusively may create difficulty for the elderly to understand their own health conditions and to know more about the status of their treatment in the home environment. The nonlinearity in inter- and intra-test score becomes the main difficulty to interpret the treatment status without medical professionals. It may also influence the judgment and the clinical decisions made by a medical professional. Medical professionals may solely focus on one symptom of movement disorders while neglecting the general situation of the elderly when assessing the severity of movement disorders and making up a prescription for the elderly. Medications for treating movement disorders are not given depending on only a symptom of movement disorders. Medical professionals should take an overview and understand the general conditions of the elderly when prescribing them medications. Movement disorders are characterized by ranges of symptoms include, but are not limited to, tremor, bradykinesia, rigidity and/or dyskinesia. Suffering from severe tremor does not necessarily means that the elderly are having a severe movement disorder. To make precise judgements when assessing the severity of movement disorders, a whole picture should be presented to medical professionals by integrating the results of various symptoms of movement disorders.
Furthermore, the existing digitized monitoring and measuring systems concentrate their design merely on the method of carrying out the measurement, while paying less attention to the target users of the invention. As a monitoring and measuring system for reference to medical professionals, the invention should put more emphasis on the elderlies themselves. Therefore, it is important to have a personalized system for monitoring and measuring symptoms of movement disorders.
More importantly, the existing digitized monitoring and measuring systems are developed for the elderlies already diagnosed with movement disorders to have further monitoring in the home environment to facilitate treatment procedures by medical professionals. However, providing systems only for those who have already diagnosed with movement disorders is not the most effective way to treat movement disorders. Instead, a system should be provided to the general public, even the elderly or persons without movement disorders, to allow regular monitoring and early detection of movement disorders of the elderly or persons.
It is therefore an object of the present invention to provide a system for quantifying accurately symptoms of movement disorders. It is another object of the present invention to provide a system that quantifies symptoms accurately utilizing measuring devices which are easy to use for the elderly and convenient enough for home monitoring. It is another object of the present invention to provide a system that allows early detection of movement disorders. It is still another object of the present invention to provide a system that can be worn and/or used upon reminders to monitor and quantify symptoms and provide information to be analyzed as needed by medical professionals include, but are not limited to, a physician and clinician. It is further another object of the present invention to provide a system that is capable of automatically and immediately retrieving data from measuring devices and providing the data for further analysis and evaluation. It is still further another object of the present invention to provide a system that is capable of computing an overall motor performance score from records derived from various motion tests of symptoms of movement disorders for medical professionals. It is still further an object of the present invention to provide a system with clinical video instruction to act as a guide for the elderly in home monitoring. It is further an object of the present invention to provide a personalized system for the elderly to monitor and quantify symptoms of movement disorders so that medical professionals can give directions specifically to the elderly to accommodate conditions of different elder persons. Finally, it is the object of the present invention to provide remote access to medical professionals for quantifying, monitoring and recording the motion-related symptoms of the elderly with movement disorders.
The present invention relates to a system and method for monitoring and quantifying symptoms of movement disorders. The present invention overcomes the shortcomings in technology to provide a system and method which can monitor and quantify multiple symptoms of movement disorders at a scheduled time as assigned by medical professionals. Medical professionals arrange personalized schedules for the elderly to accommodate conditions of different elder persons. A timer in the mobile application alerts the elderly at the scheduled time. Therefore, the elderly do not have to wear or carry the measuring devices over 24 hours. The present invention further provides a system and method for early detection of movement disorders.
The present invention still further provides a system and method for providing data from multiple measuring devices to be analyzed as needed by medical professionals, determining the severity of the elderly's movement disorders. The present invention yet further provides a system and method for providing the captured movement data from measuring devices to be computed as an overall motor performance score by scores from tremor test, finger tapping test and/or spiral drawing test using a weighting algorithm. Medical professionals can then refer to the overall motor performance score to have an overview of the general conditions of the elderly's movement disorders, instead of focusing entirely on one symptom of movement disorders.
The present invention further provides a system and method for presenting the overall motor performance score in form of comprehensive figures as needed by medical professionals for their review and analysis. The overall motor performance score is presented in graphs, and it is compared with the treatment plan to the elderly, and hence supporting medical professionals in the treatment process such as writing up and/or adjusting prescriptions.
The present invention relates to a movement disorder monitoring and treatment support system, and a method of measuring and quantifying symptoms of movement disorders. The present invention additionally relates to a monitoring and treatment support system to monitor motion symptoms of tremor, bradykinesia and/or dyskinesia. The devices, systems and methods of the various embodiments of the present invention are used to quantify, analyze and score various symptoms of movement disorders. Movement disorders in the present application, include but are not limited to, Parkinson's disease (PD).
The devices of the various embodiments of the present invention are preferably portable. Further, it is relatively easy for the device to be carried by a single elder person. Furthermore, the device preferably should be relatively light-weight. By being light-weight, the device should gain greater acceptance for use by the elderly.
Another advantage of the system and method of the present invention is the ability to monitor and track the severity of the elderly's symptoms of movement disorders accurately without the necessity of continuous monitoring. Monitoring symptoms of movement disorders of the elderly continuously would decrease the accuracy of the measurement due to the confusion between symptoms of movement disorders and activities of daily living. Daily activities include but are not limited to handwriting, eating, dressing, and the like. To eliminate errors made during continuous monitoring, the present invention preferably involves a timer in a digital diary to perform a reminder function to remind the elderly at the scheduled time. The time is scheduled by medical professionals depending on the health conditions of the elderly. With regular measurement on symptoms of movement disorders, a medical professional could maintain the consistency of the movement data collected and ensure the accuracy of the measurement in a more convenient way without carrying bulky external measuring devices include but are not limited to external sensor modules 200 at all time.
Another advantage of the system and method of the present invention is the ability to have early detection of movement disorders. Movement abnormality of the elderly is detected and quantified to compare with the healthy elderlies to provide an advantage of detecting movement disorders in an earlier stage.
Another advantage of the system and method of the present invention is the ability to determine and calculate the severity of the elderly's movement disorders. Preferably, two or more symptoms are quantified. The symptoms include but are not limited to tremor, bradykinesia and dyskinesia. The results of the two or more symptoms are weighted using a weighting algorithm 116 and computed as an overall motor performance score 118 for medical professionals to take references and determine the severity of the elderly's movement disorders.
The devices of the various embodiments of the present invention can form part of a system for use by a medical professional, includes but are not limited to, a physician and a clinician for analyzing and assessing of the elderly's movement disorders. Other elements of the present system may include but are not limited to a computing device 202, a wireless transmission unit 318, a processing unit 306, a cloud 204, algorithms, and the like, some of which are described further in various embodiments described in more detail below.
Various embodiments of the present invention may include an external sensor module 200 for measuring the elderly's external body movement. Many types of external sensor modules 200 are known by those skilled in the art for measuring external body movement. These external sensor modules 200 include but are not limited to accelerometers and gyroscopes, combinations thereof, and the like. The part of the body wearing the external sensor module 200 and being measured for movement may be a limb, such as a wrist, ankle, heel, or finger or the trunk of the body, such as a shoulder, or a waist. In most embodiments, the use of a combination of 3D accelerometer and 3D gyroscope is preferably being used at the wrist of the elderly.
To start using the digital diary 100, the elderly are required to input basic personal information such as Name, Age, Contact, Identity Card Number, Address, and the like, and as well as past clinical records such as the number of suffered years from movement disorders and the severity of the movement disorders, based on the standard clinical evaluation. The standard in evaluating the severity of movement disorders symptoms in Parkinson's disease is the Unified Parkinson's Disease Rating Scale (UPDRS). With the completion of all information as required in the digital diary, the elderly can therefore get registered and log in to the digital diary 102.
With registration to the digital diary, information will be stored in a cloud 204. The medical professional in charge can therefore assess the information provided by the elderly from the cloud 204 using the mobile application 206 which acts as a monitoring and treatment support platform. Medical professionals can also make up and give the elderly prescriptions through the monitoring and treatment support platform 104. To write out prescriptions for the elderly, the medical professionals can select the medicines from a medicine list in the monitoring and treatment support platform. Medical professionals can then adjust the quantity and the frequency of taking each medicine. Medical professionals can further set the start date and the end date of the prescriptions so that the elderly can directly refer to the digital diary of the details of their medications 104. Medical professionals can also arrange a schedule for the elderly to take medicines and carry out various motion tests 104. The schedule of motion tests varies with the elderlies, depending on their health conditions and the severity as assessed by medical professionals. The prescriptions and the schedule of the motion tests are stored in the cloud 204 of the system.
Whenever a scheduled time is reached 106, a timer in the digital diary would remind the elderly by sending notifications 108. The timer provides two types of reminders, medication reminder and test reminder. For medication reminder, the elderly need to follow the instructions and take medicines according to the quantity of the medicines as shown on the screen of the personal computing device 202 such as a digitized tablet. For test reminder, the elderly are required to complete the scheduled tests. The motion tests are scheduled for monitoring and quantifying symptoms of movement disorders. They are also scheduled for early detection of movement disorders. The motion tests are designed for symptoms include, but are not limited to, tremor, bradykinesia, rigidity, balance and dyskinesia. Preferably, motion tests developed in the present invention include tremor test 110, finger tapping test 112 and spiral drawing test 114 for quantifying symptoms of tremor, bradykinesia and dyskinesia respectively.
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With the completion of two or more motion tests to quantify symptoms of movement disorders, two or more scores from two or more motion tests will be further processed. In a preferred embodiment, scores from tremors test 110, finger tapping test 112 and spiral drawing test 114 are further processed using a weighting algorithm 116.
In the weighting algorithm 116, different weights are assigned to the scores derived from the tremor test 110, finger tapping test 112 and spiral drawing tests 114. Coefficients regarding the respective weights are applied to various scores from motion tests to generate an overall motor performance score 118. The weighting coefficients are with respect to the number motion test scheduled to be completed each day. Referring to
where,
In this way, the motor performance index 162 can reflect the general condition of the elderly with movement disorders with only one indicator, instead of the performance on one specific motion test. The elderly also find the overall motor performance score 118 easier to understand as compared to the nonlinearity in inter- and intra-test scores. An overall motor performance score 118 can better demonstrate the severity of the elderly's movement disorders by weighting and by combining various motion tests that quantify symptoms of movement disorders into a single indicator.
The overall motor performance score 118 obtained from the weighting algorithm 116 is stored in a cloud 204. The cloud 204 is capable of storing more than one computed scores from more than one motion tests. In a preferred embodiment of the present invention, the cloud 204 can store the computed scores from tremor test 110, finger tapping test 112 and/or spiral drawing test 114. The cloud 204 of the present invention is also capable of storing trained models for analyzing and computing scores based on the movement data acquired from the motion tests. Whenever movement data is captured from the motion tests, the computing device 202 such as a digitized tablet will retrieve trained models from the cloud 204 and automatically select the particular trained model for calculating the respective feature vectors and hence deriving a score to reflect the severity of a symptom.
The overall motor performance score 118 stored in the cloud 204 is further analyzed. For the elderly who are classified mild movement disorders, they are not required to see a medical professional. They then keep following the schedule as arranged by a medical professional. The timer in the digital diary will remind the elderly at the scheduled time to perform the motion tests or to take medicines by sending notifications. For the elderly who reach a score indicating severe movement disorders, the elderly are recommended to see a medical professional. The medical professional in charge can therefore retrieve the elderly's information such as personal information and movement data related to movement disorders from the cloud 204 through the monitoring and treatment support platform.
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