Proposta de avaliação motora multidimensional em portadores de doença de Parkinson usando smartphones

Abstract

Parkinson's disease is a highly prevalent disease worldwide, with motor and non-motor symptoms in its spectrum. The cardinal motor signs of Parkinson's disease are tremor, bradykinesia, postural instability and the strain of movement. The correct identification of these signs is classically clinical and subjective. Some clinical scales and equipment may allow the assessment of these signs. However, most equipment is still restricted to clinical research and difficult for most people to access. The presence of multiple sensors in mobile cell phones (smartphones) opens the possibility of evaluating these motor signs and symptoms to a larger number of people. The present work carried out an evaluation of hand tremor, static and dynamic balance and hand mobility in patients with Parkinson's disease in order to construct a motor functional indicator for these patients. For this, applications for mobile devices developed at the Universidade Federal do Pará were used. Through these applications, the readings of the inertial sensors and the touch screen were obtained. The assessment was carried out in 4 stages: assessment of hand tremor at rest, assessment of static balance, assessment of dynamic balance during the Timed Up and Go test and assessment of the Finger Tapping Test. We evaluated 9 patients with Parkinson's disease and 8 participants as controls without Parkinson's disease. The results of each test were compared by statistical tests for comparing two independent samples. A multivariate analysis with Linear Discriminant Analysis was also performed to identify the distance between the groups of study participants. During the evaluation of motor cardinal signs, we observed a great variability of presentation among patients with Parkinson's disease, as these showed non-uniform impairments between the evaluated domains. For the evaluation of tremor in both the dominant and non-dominant hand, there was a significant difference between the control group and the Parkinson's group, with the non-dominant hand having the worst functionality between groups. The worst functionality in the assessment of both static and motor balance was seen in patients with Parkinson's disease, but in the Time up and go Test, no significant difference was seen between groups. Smartphones are equipped with accelerometers and triaxial gyroscopes where applications that can more assertively assess motor impairments can be used, we conclude that they can be used as a multidimensional assessment tool in patients with Parkinson's disease