Objective: To investigate the use of a novel tele-health system to remotely monitor physical activity and falls in patients with Huntington’s disease.

Background: Increased physical activity has been shown to improve motor function in individuals with HD [1]. Furthermore, falls are common in patients with HD [2] and the social and economic impact of falls can be devastating. Current assessment of treatment typically requires in person visits, which may be challenging for patients with limited mobility. Wearable sensors can be used to remotely monitor physical activity and detect falls, which can provide healthcare providers with continuous at-home assessment.

Method: 44 participants were enrolled in the study and 41 (mean age=49.8±14.4 years old) were included in the analysis (3 were excluded due to missing data). 8 participants were classified by investigators as prodromal HD, 21 as manifest HD (UHDRS-motor=41.8±14.7), and 12 were controls. 8 participants with HD were also on anti-chorea medication. Participants were asked to visit the clinic every 3 months for 1 year and were given an accelerometer-based wearable platform that is capable of measuring step counts and detecting falls. Patients performed standard in clinic assessments (e.g. UHDRS) and were directed to wear the sensors for 1 week following each visit. The average step count per day and the number falls were calculated. Univariate analysis was used to compare across groups while adjusting for age, sex and BMI. Significant level was set at alpha=0.05 and Cohen’s coefficient (d) was used to measure effect size.

Results: Analysis of data thus far showed that HD participants on anti-chorea medication were more active as compared to HD participants not on anti-chorea medication (8295 vs 6272 steps/day, p=0.143, d=0.69). While the result is not statistically significant; it has a medium effect size. During the remote monitoring period, a total of 43 falls occurred. HD participants not on anti-chorea medication experienced more falls (n=21) than HD participants on anti-chorea medication (n=15, p=0.094, d=0.12).

Conclusion: This novel tele-health system based on wearable sensors could potentially be used to remotely monitor falls and physical activity in patients with HD. Furthermore, preliminary data suggest that anti-chorea medication could enable increased activity and reduce falls in HD patients.

References: [1] Mueller SM, Petersen JA, Jung HH. Exercise in Huntington’s Disease: Current State and Clinical Significance. Tremor Other Hyperkinet Mov (N Y). 2019 Feb 4;9:601. [2] Busse ME, Wiles CM, Rosser AE. Mobility and falls in people with Huntington’s disease. Journal of Neurology, Neurosurgery & Psychiatry 2009;80:88-90.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/remote-monitoring-of-physical-activity-and-falls-in-patients-with-huntingtons-disease-using-wearable-sensors/