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Traditional Ordinal Strategies for Establishing the Severity and Status of Movement Disorders, Such as Parkinson’s Disease and Essential Tremor

  • Robert LeMoyne
  • Timothy Mastroianni
  • Donald Whiting
  • Nestor Tomycz
Chapter
Part of the Smart Sensors, Measurement and Instrumentation book series (SSMI, volume 31)

Abstract

Ordinal scale strategies are standardly applied to diagnose the severity of neurodegenerative movement disorders, such as Parkinson’s disease and Essential tremor. A clinician is tasked with the challenge of assigning an ordinal parameter based on a series of criteria to quantify a subjectively observed interpretation. Multiple ordinal scale systems exist for evaluating movement disorder symptoms. However, the issue is the uncertainty of translating the findings of one scale to another. The Unified Parkinson’s Disease Rating Scale (UPDRS) and upgraded Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) are commonly utilized for evaluating Parkinson’s disease severity. The Fahn-Tolosa-Marin Tremor Rating Scale is prevalently applied for Essential tremor. There are issues of concern regarding the application of ordinal scale approaches for determining the state of progressive neurodegenerative movement disorders, such as Parkinson’s disease and Essential tremor. The reliability of ordinal scale systems has not been conclusively established, and interpretive disparity is apparent respective of experience. A novel resolution is the introduction of wearable and wireless inertial sensor systems to objectively quantify movement disorder tremor. The inertial signal (accelerometer and/or gyroscope) can readily record the intrinsic characteristics of tremor for both Parkinson’s disease and Essential tremor. Successful testing and evaluation have even demonstrated the efficacy of deep brain stimulation systems for Parkinson’s disease and Essential tremor using a smartphone as a wearable and wireless inertial sensor system. These findings enable the pathways for developing Network Centric Therapy, which is in essence the emergence of the Internet of Things for healthcare regarding the domains of robustly diagnosing severity of neurodegenerative movement disorders, such as Parkinson’s disease and Essential tremor.

Keywords

Ordinal scale Parkinson’s disease Essential tremor Unified Parkinson’s Disease Rating Scale (UPDRS) Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Fahn-Tolosa-Marin Tremor Rating Scale Wearable and wireless system Network Centric Therapy 

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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Robert LeMoyne
    • 1
  • Timothy Mastroianni
    • 2
  • Donald Whiting
    • 3
  • Nestor Tomycz
    • 3
  1. 1.Department of Biological Sciences and Center for Bioengineering InnovationNorthern Arizona UniversityFlagstaffUSA
  2. 2.IndependentPittsburghUSA
  3. 3.Department of Neurosurgery Allegheny General HospitalAllegheny Health Network Neuroscience InstitutePittsburghUSA

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