背景:可穿戴传感器技术具有改善多发性硬化症(MS)患者的监测并及时告知疾病管理决策的潜力。在MS患者中使用可穿戴传感器技术的证据正在积累,但通常仅限于特定的患者亚组。临床或实验室设置,和功能域。
目的:这篇综述旨在全面概述所有使用可穿戴传感器进行评估的研究,监视器,并量化MS患者在日常活动或受控实验室环境中的运动功能,并阐明过去几十年的技术进步。
方法:我们系统地回顾了可穿戴传感器的研究,以评估患有MS的人的运动表现。我们扫描了PubMed,Scopus,Embase,和WebofScience数据库,直到2022年12月31日,考虑搜索术语“多发性硬化症”以及与可穿戴技术相关的术语,并包括所有评估运动功能的研究。将相关研究的结果类型系统地映射到9个预定义类别中(与临床评分或其他指标的关联;测试重测可靠性;组差异,3种类型;对变化或干预的反应能力;以及对研究参与者的可接受性),通过9个问题确定报告质量。我们遵循PRISMA(系统审查和荟萃分析的首选报告项目)报告指南。
结果:在1251个确定的出版物中,308人被包括:176人(57.1%)在现实世界中,107(34.7%)在实验室环境中,和25(8.1%)在混合背景下。大多数出版物研究了身体活动(196/308,63.6%),其次是步态(81/308,26.3%),灵巧或震颤(38/308,12.3%),和余额(34/308,11%)。在实验室环境中,结果指标包括(除临床严重程度评分外)2分钟和6分钟步行测试,定时25英尺步行测试,超时,走,爬楼梯,平衡测试,手指到鼻子的测试,在其他人中。可穿戴放置的最受欢迎的解剖学标志是腰部,手腕,下背部。三轴加速度计是最常用的(229/308,74.4%)。已经观察到嵌入在智能手机和智能手表中的传感器数量激增。总的来说,报告质量很好。
结论:使用可穿戴传感器进行持续监测可以优化MS患者的管理,但是在临床上完全采用数字监测仍然存在一些障碍。尽管报告的结果可能存在发表偏倚和巨大的异质性,我们的综述概述了用于MS患者的可穿戴传感器技术的当前文献,并强调了缺点,例如缺乏协调,报告方法和结果的透明度,和有限的数据可用性的研究社区。在临床常规和临床试验中越来越多地实施可穿戴传感器技术,需要解决这些限制。这对于MS患者的临床研究和日常管理的进一步进展至关重要。
背景:PROSPEROCRD42021243249;https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=243249。
Wearable sensor technologies have the potential to improve monitoring in people with multiple
sclerosis (MS) and inform timely disease management decisions. Evidence of the utility of wearable sensor technologies in people with MS is accumulating but is generally limited to specific subgroups of patients, clinical or laboratory settings, and functional domains.
This
review aims to provide a comprehensive overview of all studies that have used wearable sensors to assess, monitor, and quantify motor function in people with MS during daily activities or in a controlled laboratory setting and to shed light on the technological advances over the past decades.
We systematically reviewed studies on wearable sensors to assess the motor performance of people with MS. We scanned PubMed, Scopus, Embase, and Web of Science databases until December 31, 2022, considering search terms \"multiple
sclerosis\" and those associated with wearable technologies and included all studies assessing motor functions. The types of results from relevant studies were systematically mapped into 9 predefined categories (association with clinical scores or other measures; test-retest reliability; group differences, 3 types; responsiveness to change or intervention; and acceptability to study participants), and the reporting quality was determined through 9 questions. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) reporting guidelines.
Of the 1251 identified publications, 308 were included: 176 (57.1%) in a real-world context, 107 (34.7%) in a laboratory context, and 25 (8.1%) in a mixed context. Most publications studied physical activity (196/308, 63.6%), followed by gait (81/308, 26.3%), dexterity or tremor (38/308, 12.3%), and balance (34/308, 11%). In the laboratory setting, outcome measures included (in addition to clinical severity scores) 2- and 6-minute walking tests, timed 25-foot walking test, timed up and go, stair climbing, balance tests, and finger-to-nose test, among others. The most popular anatomical landmarks for wearable placement were the waist, wrist, and lower back. Triaxial accelerometers were most commonly used (229/308, 74.4%). A surge in the number of sensors embedded in smartphones and smartwatches has been observed. Overall, the reporting quality was good.
Continuous monitoring with wearable sensors could optimize the management of people with MS, but some hurdles still exist to full clinical adoption of digital monitoring. Despite a possible publication bias and vast heterogeneity in the outcomes reported, our
review provides an overview of the current literature on wearable sensor technologies used for people with MS and highlights shortcomings, such as the lack of harmonization, transparency in reporting methods and results, and limited data availability for the research community. These limitations need to be addressed for the growing implementation of wearable sensor technologies in clinical routine and clinical trials, which is of utmost importance for further progress in clinical research and daily management of people with MS.
PROSPERO CRD42021243249; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=243249.