Quantification of symptoms of movement disorders - towards support of clinical monitoring and diagnosis

Evaluation of symptoms in patients with movement disorders generally implies subjective assessment based on observation. Furthermore, time-limited clinical observation provides only a glimpse of the condition of the patient. To reduce subjectivity researchers have developed clinical assessment protocols, but even with these protocols, proper evaluation of movement disorders patients remains a challenge.
In this thesis, we tried to improve upon two issues: subjectivity in the assessment of symptoms and the limited duration of observation. By using inertial sensors, we expected that both the clinical diagnostic work-up and long-term monitoring at home could be supported.
For diagnostic purposes, we improved upon the distinction between children with early onset ataxia or developmental coordination disorder and healthy children, by combining information from three kinetic upper limb tests (finger to nose, finger chasing and fast alternating movements) and by using information from normal and tandem gait.
For long term monitoring, we investigated the use of accelerometry for long term tremor recordings. We determined the optimal number of days needed to obtain reliable estimates of tremor percentage, tremor frequency variability and tremor intensity. Furthermore, we explored the hypothesis that functional tremor patients overestimate tremor presence compared to organic tremor patients.
We concluded that the results obtained in this thesis provide evidence that movement sensors can be used as a support tool for the monitoring and diagnosis of movement disorder patients.