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Towards the integration of body-worn sensors in the management of Parkinson’s disease : perspectives on new paradigms of follow-up

Abstract : Parkinson's disease (PD) treatment is adjusted according to the severity of symptoms. At the stage of fluctuations, therapeutic adjustments become complex. Current assessment tools do not provide a complete picture of the patient's condition. The interviews are subjective, the clinical scales are ad hoc, and the agendas are binding. Body-Worn Sensors (BWS) allow an objective and continuous measurement of PD motor symptoms in real life. The hypothesis of this work is based on the perspective of new patient monitoring strategies and the emergence of closed-loop systems that would automate the control of treatment by apomorphine pump from BWS results. The first study showed that assessment of PD symptoms based on usual scale contributed little to the therapeutic adjustments in a cohort of PD patients treated with a pump. The second study highlighted a good user experience and a positive perception of BWS monitoring by patients and healthcare professionals. The third work suggested that the reading of BWS results was equivocal, and that some parameters could predict therapeutic adjustments. According to this work, a standardization of BWS would facilitate the interpretation of the results and would allow defining precise rules of therapeutic decisions. The automatic control of the pump from BWS must be specifically studied before considering its inclusion in a closed-loop. An intermediate step would be a hybrid loop based on expert decisions to customize therapeutic adaptations.
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https://tel.archives-ouvertes.fr/tel-03467730
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Submitted on : Monday, December 6, 2021 - 4:37:43 PM
Last modification on : Saturday, June 4, 2022 - 3:33:25 AM
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  • HAL Id : tel-03467730, version 1

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Clara Fleischman. Towards the integration of body-worn sensors in the management of Parkinson’s disease : perspectives on new paradigms of follow-up. Human health and pathology. Sorbonne Université, 2021. English. ⟨NNT : 2021SORUS118⟩. ⟨tel-03467730⟩

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