OBJECTIVE MOVEMENT DISORDER MEASUREMENT SYSTEM 2.0
The new Objective Movement Disorder Measurement (OMDM) System 2.0 is comprised of both Dexterity and Mobility measurement test. The Dexterity test is taken online via any web browser, the Mobility test is a smartphone app download. Test results, historical graphs, etc. are all available online. Already in use in human trials, the OMDM System is paving the way for objective measurement of Parkinson’s and other Diseases.
OMDM—Dexterity 1.0 is a self contained device with built-in video instruction. It is suitable for in-clinic or in-home use. Several trials have been conducted at leading centers to determine the most sensitive and effective measures of disease state. This has led to a five minute motor assessment on the
OMDM—Dexterity 1.0 device, which consists of a digitography (keyboard) test and a pegboard test.
An objective motor score has been developed from an extensive analysis of data collected from over 200 people with Parkinson’s and over 50 controls. The OMDM—Score is designed to be used as a single endpoint in a clinical trial and is calibrated to the UPDRS motor score. This test has a 0.73 correlation with Motor UPDRS and an ICC (Intraclass Correlation Coefficient) of 0.94.
COLLECTING DATA AT HOME
Perhaps the most exciting attribute of the OMDM—Dexterity 1.0 device is that it allows for in home measurements of patients. Many clinicians have expressed concern that patients behave differently in the clinic, and that patients’ disease state can vary during the course of the day. This makes it difficult to accurately assess a patient’s state and their responsiveness to treatment. The OMDM—Dexterity 1.0 allows for frequent measurements in the home which can average out daily fluctuations and provide a clearer picture of the patient’s actual state.
In addition, only minimal training is needed for the OMDM—Dexterity 1.0 device. Training videos guide the patient through the test, and training games and feedback scores ensure the patient takes the test properly and consistently. When used with an internet connected computer the device automatically uploads data to a server where it can be tracked for compliance and scoring.
OMDM—Mobility 1.0 was designed to be easily and inexpensively deployed in a clinical setting, providing capabilities that were previously only available in very expensive laboratories. It consists of six wearable movement monitors to precisely measure movement during the Timed Up and Go (TUG) Test and the Postural Sway Test. Each movement monitor includes accelerometers, gyroscopes, and magnetometers all of which stream the data to a laptop that pre-processes and uploads the data to the OMDM-Server.
The movement monitors are placed on the sternum, wrists, ankles, and sacrum. During the TUG Test, the subject stands, walks 7 meters, turns back, returns to the chair, and sits. The test is repeated three times. During the Postural Sway Test the patient stands with their arms folded, looking at a picture on the wall for 30 seconds. The test is repeated three times. The tests require approximately 15 minutes to administer, including the placement and removal of movement monitors.
Measuring patient mobility
OMDM—Mobility 1.0 has been used in many trials at Oregon Health & Science University and other centers. These studies have shown that OMDM—Mobility 1.0 can track functional progression, and distinguish between controls and people with PD better than clinical rating scales.
A composite score has been created which combines measurements from the Timed Up and Go Test and the Postural Sway Test. This composite score correlates very well with the Postural Instability and Gait Disability (PIGD) Subscore of the UPDRS with an ICC (Intraclass Correlation Coefficient) of 0.9. Training videos are provided which guide both the administrator and the patient through the tests. While a test administrator is required, this administrator does not need any special certifications.
OMDM—Server provides a secure data store, with a browser interface, performs quality assurance checks on incoming data, provides electronic records for legacy rating scales (e.g. UPDRS, PDQ-39), and provides an easy way to store video of patients taking UPDRS or other tests.
The data from the Dexterity and Mobility devices are uploaded to the OMDM—Server, where scores and quality assurance reports are generated. Investigators can quickly see the effect of treatment and, if desired, use the raw data to perform their own analysis.
Study administration is greatly simplified by the server. A dashboard is used to verify all incoming data and assign it to the appropriate patient. Patient data from different tests are easily grouped together. Other dashboards are also available that allow for tracking existing studies, adding new studies, and easy administration of security settings.
For researcher convenience, the OMDM—Server can provide UPDRS, MoCA, PDQ-39, MSWS-12, ABC Scale, and EDSS forms that allow for convenient electronic tracking of patients’ data. The scores only allow the operator to use accepted values, prompt the user with the description of the test, and allow for notes to be easily added.