DE102008042373A1 - Motor parameter monitoring device for communication with e.g. neurostimulator, to treat Parkinson's disease, has transmitting unit for transmitting data detected by acceleration sensor, where device is provided in form of wrist watch - Google Patents

Abstract

The device has a transmitting unit for transmitting data detected by an acceleration sensor, where the device is provided in the form of a wrist watch. The acceleration sensor is integrated in the device. A processor unit and a transceiver communicate continuously or periodically with a remote computer center via a wireless connection or mobile communication network. A power supply unit is charged by solar cells or by connecting the device with a charging station.

Description

object The invention is a device for observation and monitoring of the motor state of living things, especially of humans and here especially of patients with diseases that affect the motor skills. This observation is typically only possible if the corresponding person is in a special environment, eg. B. staying with the doctor. The quantitative recording of motor parameters is indeed fundamental possible, can often but not performed due to lack of suitable equipment. Instead, it will be a qualitative, subjective review by doctor and patient performed. Typical statements are z. B. "Im Moment is better than last week "or" With medication is the Tremor lower, but I get problems with uncontrollable Movements. " To allow at least a rough quantification, find of question catalogs Application in which queried different aspects and the Strength the corresponding symptom in one of several areas can. As an example, here is the questionnaire "Unified Parkinson's Disease Rating Scale ".

task The invention is as long as possible and continuous monitoring relevant motor and other parameters with a timely transmission the data to z. B. the supervising physician to improve the assessment to enable the health of the patient. Furthermore, that should Device with an implant, z. B. can communicate to a neurostimulator to to control this.

One Sensor, z. B. acceleration sensor, or multiple sensors in the device integrated, with a suitable processing unit and a transmitting / receiving unit which communicates with a remote data center via a wireless data connection, e.g. B. performs a mobile network.

This Device is preferably portable. It has one own energy supply. To charge the energy storage, the Device on a suitable charging station are connected or generated the needed Energy itself, z. B. by solar cells.

A preferred embodiment of the device is the shape of a wristwatch that is used like a regular wristwatch can be, but at the same time integrated the required inventive functionality Has.

Of the Sensor measures the movement continuously or periodically or if necessary of the carrier of the device.

at Need means z. B. that the carrier of the device trigger a measurement can, for. B. by pressing a button.

The transfer The data to the remote data center is continuous or periodic or if necessary. If necessary z. B. that the sensor is a signal has recorded that is above a predetermined limit and then the transfer triggers.

Becomes the device worn on the wrist (like watch) is mainly the movement measured the arm and the hand, which is favorable for the invention.

The Device can with other devices or sensors positioned on or in the body of the wearer.

This can among others, implanted or external: a pacemaker, Defibrillator, spinal cord stimulator, Brain stimulator, stomach stimulator, blood pressure sensors, oxygen saturation of the blood, other motion sensors z. B. to the location of the hull as well as any other type of implants, stimulators, Sensors or other devices, the z. B. Vital parameters of the wearer take up. These devices can active, d. H. be provided with their own energy supply or passive, d. H. the energy to record and transmit their readings is from the outside, z. B. supplied by the inventive device.

An evaluation of the measured values of the device according to the invention and other devices cited can be carried out completely, partially or not at all in the device according to the invention:
In an embodiment of the invention ( 8a ), the measured values are not processed in the device according to the invention, but merely transmitted via the telemetry link. This method has the advantage that the raw data are also available outside the device according to the invention and can be processed as desired. The downside is the high amount of data that needs to be transferred. This costs energy and money.

the can be countered that only random, z. B. once per Hour for One minute is measured and then transfer the data become.

Such data is in 1 - 6 presented for normal conditions and various symptoms.

In a further embodiment of the invention ( 8b ), the measured values in the device according to the invention are optimized only for transmission, for. B. transmitted by data compression and filtering and then over the telemetry link. This method has the advantage that the data are also available outside the device according to the invention only with little loss of information and can be processed as desired. The downside is the reduced but still relatively high amount of data that needs to be transferred. This costs energy and money.

Also could be here it may be that only random, z. B. once per hour for one minute is measured and the data is then transmitted.

In a further embodiment of the invention ( 8c ), the measured values are processed in such a way that an index value results for certain aspects of the measured movement of interest. So z. B. a value for the current strength of a symptom can be determined, for. B. as a value between 0 and 100. Thus, for a given time for each symptom the corresponding strength can be determined and transmitted. The advantage is the small amount of data that has to be transferred. It is disadvantageous that the raw data outside the device according to the invention are no longer available in order to make further evaluations.

Here could z. B. once a minute for be measured for a few seconds. The calculated values are collected and Z. B. transmitted once an hour.

Such an index is in 7 shown for different symptoms.

In a further embodiment of the invention ( 8d ), the measured values are processed in such a way that a marker results for certain aspects of the measured movement of interest. For this purpose, as described above, first an index value can be determined. By applying appropriate thresholds, a marker can be set or deleted that indicates the presence of a particular symptom. Such information could be space-saving coded and transmitted by the nature of the symptom and the time of onset and disappearance of the symptom.

Here could z. B. once a minute for be measured for a few seconds. The calculated values are collected and Z. B. transmitted once a day.

Such a marker is in 7 shown for different symptoms.

The invention Device can also supportive for the Be patient, z. B. when taking medication. The inventive device provides for example, based on the evaluation of the measured values, that the patient becomes hypomotor and develops a tremor. Thereupon reports the inventive Device that Patient z. B. over the

In a further stage of development, the inventive device is not only record, process and send measurements to a remote data center It can also communicate with one or more devices. Such a device may for example be an implanted electrostimulator, which has a Electrode delivers electrical impulses to the brain of the patient. For one thing, this device can Information, such as B. send stimulation parameters to the device according to the invention, this then z. B. evaluates and transmits further to the data center.

About these Communication can control the device according to the invention but also the implant. So lets there is a feedback loop (feedback) for the Realize control of the stimulator.

The invention Device provides for example, based on the evaluation of the measured values, that the patient becomes hypomotor and develops a tremor. Thereon towards the invention sends Device one Command to the stimulator to turn on or if already the case is to adjust the pacing parameters accordingly.

Should a communication with the implant may not be possible, for. B. because that Implant and the invention Device due technical incompatibility can not communicate with each other, so the inventive device information about the Take up the condition of the implant differently.

So can Information from the patient in the inventive device can be entered, such. B. "Stimulator switched on "," stimulator switched off".

About attached to the inventive device Electrodes can be a surface signal the electrical activity in the body to be recorded. In this signal, the inventive device, the stimulation pulses recognize and measure the implant. The information gained from it added to the data of the motion sensor. So can be z. B. recognize whether the stimulator is on or at what frequency is stimulated becomes.

The patient can on the device according to the invention also further information z. B. on the one Enter the medication taken.

• – Gerät kann problemlos ständig vom Patienten mitgeführt werden.
• – Erstmals sind engmaschige Überwachungen motorischer Parameter eines Patienten möglich
• – Zusätzliche Vitalinformationen können ermittelt und übertragen werden.
• – Gerät kann Implant steuern und Feedback liefern.

The solution according to the invention offers the following advantages:

• - Device can be easily carried by the patient constantly.
• - For the first time, close monitoring of motor parameters of a patient is possible
• - Additional vital information can be determined and transmitted.
• - Device can control implant and provide feedback.

One Use of the inventive Solution is Here the example of the disease Parkinson's disease, commonly referred to shaking palsy.

Crohn's Parkinson's is a disorder underlying the central nervous system, whose cause in the disorder of the Production of the neurotransmitter dopamine is.

• – Verlangsamte Bewegungen (Bradykinese), zu kleine Bewegungen (Hypokinese), bis hin zur Bewegungslosigkeit (Akinese)
• – Zittern der Extremitäten (Tremor)
• – Steifigkeit der Gliedmassen (Rigor)
• – Gleichgewichtsstörungen
• – Schluckstörungen
• – Sprechstörungen bei der Modulation von Sprache
• – Augenbewegungsstörungen

The typical motor symptoms of the disease are:

• - slowed movements (bradykinesis), too small movements (hypokinesia), even to immobility (akinesia)
• - tremors of the extremities (tremor)
• - Rigidity of the limbs
• - balance disorders
• - swallowing disorders
• - Speech disorders in the modulation of speech
• - Eye movement disorders

These Symptoms can also superimpose and other symptoms. So a rigor can be superimposed with a tremor with load on the extremity, z. B. when lifting loads to jerky movements, de, so mentioned gear phenomenon to lead.

Of the Use of medication leads, In addition to alleviating the symptoms often too strong side effects. Here, as a motor side effect, the occurrence is overshooting Movements (hypermotorics), the u. a. cause the patients too in peace constantly typically screw more slowly.

at Parkinson's disease is feedback for one closed control loop. Through the movement sensor built into the watch should tremors be detected. Previous neurostimulators have no feedback to the patient's condition and need therefore be operated manually. The watch on the wrist can be at one optimal location to detect tremors with motion sensors and transmitted to the neurostimulator via MICS interface. It can thus be a Control loop to be built over which the implant is capable of, the pulse shape, duration and strength itself within the limits prescribed by the physician. The patient will not be permanent anymore with full power stimulates the implant, but as needed with the right one pulse strengths provided. It is conceivable that the implant is performed "self-learning" and thus already recognizes slight tremors and with a gentle Stimulation early treated. this leads to to a better compatibility the therapy. In addition, you can Data about sent the course of therapy for evaluation purposes to the service center become.

following the use of the invention is exemplified by bradykinesis, hypokinesia, Akinese, tremor and the gear phenomenon are shown. But also the use for other symptoms are conceivable.

For example, the sensor can measure the position [m], the velocity [m / s], the acceleration [m / s ² ], the derivative of the acceleration ([m / s ³ ] "jerk") or higher derivatives ([m / s ⁴ ] = "Snap", [m / s ⁵ ] = "Crackle", [m / s ⁶ ] = "Pop") or measure the force acting on it F or any other relevant quantity in one or more dimensions.

The measured signals are filtered, compressed and according to the different Processed symptoms. This processing allows the determination of indices for each a symptom. These indices can in turn set or delete markers.

Description of the figures

The 1 to 6 prototypically show acceleration values of an acceleration sensor, the z. B. is positioned on the wrist of the patient.

shown are respectively the time course and the spectral acceleration density for a section the time course. Alternatively, you can also find the others above mentioned sizes being represented. The signal shown may be in one or more Dimensions be included.

1a shows the typical acceleration signal on a free-floating wrist of a healthy person. Small signals are caused by small movements, so to speak, the noise of the biological system.

1b shows the typical spectral acceleration density spectrum. The spectrum is equally distributed in the range of approx. 0.1 Hz-10 Hz.

2a shows the typical acceleration signal of the gripping motion of the hand of a healthy adult human. A quick start movement is followed by a slower, but steady, hand-to-goal advance.

2 B shows the typical spectral acceleration density spectrum. The movement has frequency components mainly in the range is in the range of about 0.1 Hz-30 Hz.

3a shows the typical acceleration signal of a tremor of a patient's hand. The frequency is typically in the range of 4-6 Hz.

3b shows the typical spectral acceleration density spectrum. The spectrum is particularly pronounced in the range of 4-6 Hz.

4a shows the typical acceleration signal of the gripping movement of a patient with a slowed and less scaled motor skills (hypomotricity). Towards the end of the gripping movement, the in 3 shown tremor as a so-called intentional tremor.

4b shows the typical spectral acceleration density spectrum. The spectrum shows an emphasis on slow movements up to about 1 Hz and the tremor at about 4-6 Hz.

5a shows the typical acceleration signal of a patient with excessive movements (hypermotoric) at rest. Because of the hypermotoric the patient is constantly in motion even when desired rest. This can be seen on the signal shown.

5b shows the typical spectral acceleration density spectrum. Since the hypermotorics "at rest" rather slow movements generated, the spectral signal is in the range up to about 1 Hz.

6a shows the typical acceleration signal when the gear phenomenon occurs.

6b shows the typical spectrum of the spectral acceleration density in the gear phenomenon. The spectrum has maxima around the tremor (4-6 Hz) and higher frequencies resulting from the jerky movement of the arm.

7 shows by way of example the calculated indices for the occurring symptoms and the markers generated therefrom.

8th shows the exemplary preparation of the measured values for data transmission.

9 shows the exemplary embodiment of the inventive device.

10 shows a patient with brain stimulator with the inventive device.

11 shows, by way of example, an electrical surface derivation, the detection of an activated brain stimulator from this signal and the markers generated therefrom.

UNIFIED ASSESSMENT SCHEME FOR MORBUS PARKINSON

I. THINKING, BEHAVIOR AND MOOD SITUATION

1. mental impairment

• 0

  = None

  1

  = Easy. Consistent forgetfulness with partial resistance to remembering events; but no other difficulties.

  2

  = Moderate memory loss, being disoriented and moderately difficult in coping complex problems occur. Low but recognizable impairment coping domestic Tasks, with occasional help.

  3

  = Strong memory loss with temporal and often also local Disorientation. Strong impairment in coping of problems.

  4

  = Strong memory loss, where the orientation is limited to one's own person. Unable, Make decisions or solve problems. Requires intensive help with the Personal hygiene. Can at all not to be left alone.

2nd thought disorder (due to dementia or Arzneimittelintoxikation)

• 0

  = None.

  1

  = Lively dreams.

  2

  = "Benign" hallucinations on receipt the insight.

  3

  = Occasional until frequent Hallucinations or delusions; without insight; These can interfere with everyday activities.

  4

  = Persistent hallucinations, Delusions or pronounced Psychosis. Can not take care of himself

3. Depression

• 1

  = Longer than normal lasting periods of sadness or guilt, the never over Lasting for days or weeks.

  2

  = Persistent depression (a week or more)

  3

  = Persistent depression with vegetative symptoms (insomnia, loss of appetite, weight loss, Loss of interest).

  4

  = Persistent depression with vegetative symptoms and suicidal thoughts or intent.

4. Motivation / drive

• 0

  = Normal.

  1

  = Less energetic than usual; rather passive.

  2

  = Drive loss or disinterestedness in relation to voluntary (non-routine) activities.

  3

  = Drive loss or disinterestedness in everyday (routine) activities.

  4

  = Retired, complete loss of motivation

II. ACTIVITIES OF EVERYDAY LIFE (for "on" as well as "off" periods)

5. Language

• 0

  = Normal.

  1

  = Slightly affected. No communication difficulties.

  2

  = Moderately impaired. Is sometimes asked to repeat what has been said.

  3

  = Severely impaired. Becomes common asked to repeat what was said.

  4

  = Mostly incomprehensible.

6. Salivation

• 0

  = Normal.

  1

  = Low, but unique increased saliva in the mouth; occasionally saliva leakage at night.

  2

  = Moderately increased saliva; possibly minimal saliva leakage.

  3

  = Significantly increased Saliva secretion with slight saliva leakage.

  4

  = Pronounced salivation, Must be constantly paper towel or use a handkerchief.

7. Swallow

• 0

  = Normal.

  1

  = Rare ingestion.

  2

  = Occasional ingestion.

  3

  = Requires soft Food.

  4

  = Must via nasal probe or gastrotomy become.

8. Manuscript

• 0

  = Normal.

  1

  = Something slow or small.

  2

  = Moderately slow or small; all words are legible.

  3

  = Severely impaired, not all words are legible.

  4

  = The majority of words is not legible.

9. Cutting food and handling of cutlery

• 0

  = Normal.

  1

  = Something slow and awkward, but no help needed.

  2

  = Can most Cutting food, albeit awkwardly and slowly; something Help required.

  3

  = Food must from but can still eat slowly.

  4

  = Must be fed.

10. Wear

• 0

  = Normal.

  1

  = Somewhat slow, but no help needed.

  2

  = Occasional assistance when buttoning and during insertion arms in the sleeves.

  3

  = Significant help required, but can do some things alone.

  4

  = Helpless.

11. Body Care

• 0

  = Normal.

  1

  = Somewhat slow, but no help needed.

  2

  = Need help with Showering or bathing; or is very slow in personal hygiene.

  3

  = Need help with Washing, brushing, combing and when going to the bathroom.

  4

  = Foley catheter or other mechanical aids.

12. Turning over in bed and straightening the sheets

• 0

  = Normal.

  1

  = Something slow and awkward, but no help needed.

  2

  = Can alone turn around or the sheets judge, but with big ones Difficulties.

  3

  = Can start, but Do not turn around alone or straighten the sheets.

  4

  = Helpless.

13. traps (not related to solidification)

• 0

  = No.

  1

  = Seldom falls.

  2

  = Occasionally, less than once a day.

  3

  = Falls on average once a day.

  4

  = Falls more as once a day.

14. Freezing while walking

• 0

  = No.

  1

  = Rare solidification while walking; possibly Starting difficulties.

  2

  = Occasional solidification while walking.

  3

  = Frequent solidification. Occasionally due to the solidification.

  4

  = Often falls due of solidification.

15. Go

• 0

  = Normal.

  1

  = Little difficulty. Eventual lack of sympathy of the arms or tendency, a leg follow suit.

  2

  = Moderate difficulties, but little or no help needed.

  3

  = Severe disorder, needs help.

  4

  = Can at all not going, not even with support.

16. tremor (symptomatic tremor disorders in a body part)

• 0

  = Not available.

  1

  = Light and rare.

  2

  = Moderate; annoying for the patient.

  3

  = Strong; in many activities hindrance.

  4

  = Pronounced; at most activities hindrance.

17. Sensory complaints as a result of parkinsonism

• 0

  = None.

  1

  = Occasional numbness, tingling or light pain.

  2

  = Frequent numbness, tingling or pain; not disturbing.

  3

  = Frequent pain sensations.

  4

  = Unbearable pain.

III. MOTOR TEST

18. Language

• 0

  = Normal.

  1

  = Slight decrease in expression, diction and / or volume.

  2

  = Monotone, washed out, but understandable; moderately impaired.

  3

  = Significant impairment; hard to understand.

  4

  = Incomprehensible.

19. facial expression

• 0

  = Normal

  1

  = Minimal hypomnia, could normal "poker face".

  2

  = Light but recognizable abnormal reduction of facial expression.

  3

  = Moderate hypomnia; Lips open at times.

  4

  = Masked or rigid expression with a strong or complete lack of facial expression; Lips are half an inch or wider open.

20. Ruhememor (head, upper and lower Extremities)

• 0

  = Not available.

  1

  = Light and rare available.

  2

  = Weak amplitudes and persistently. Or moderate amplitude, but only with interruptions available.

  3

  = Moderate amplitude and most of the time.

  4

  = Pronounced amplitude and most of the time.

21. Movement or posture tremor hands

• 0

  = Not available.

  1

  = Easy; during exercise available.

  2

  = Moderate amplitude, with movement available.

  3

  = Moderate amplitude, while keeping a posture as well as moving.

  4

  = Pronounced amplitude; disturbs the Eat.

22. Rigidity (Checked with passive movement of the main joints, with the patient in an ent cocked sitting position. Do not observe the gear phenomenon.)

• 0

  = Not available.

  1

  = Minor or only detectable if by mirror image or other movements triggered.

  2

  = Light to moderate.

  3

  = Pronounced, but full range of motion is easily achieved.

  4

  = Strong, range of motion is achieved with difficulty.

23. Fingerklopfen (patient knocks in faster Follow with your index finger on the thumb.)

• 0

  = Normal.

  1

  = Slight slowdown and / or reduction in amplitude.

  2

  = Moderately restricted. significant and early Fatigue. possibly occasional break in the movement.

  3

  = Severely restricted. Frequent hesitation when initiating the movement or stopping in the middle of the movement.

  4

  = Can the task barely perform.

24. Hand movements (patient opens and includes hands in quick succession.)

• 0

  = Normal

  1

  = Slight slowdown and / or reduction in amplitude.

  2

  = Moderately restricted. significant and early Fatigue. possibly occasional break in the movement.

  3

  = Severely restricted. Frequent hesitation when initiating the movement or stopping in the middle of the movement.

  4

  = Can the task barely perform.

25. Quick change in the hand movement (Pronation-supination movements of the hands, vertical and horizontal, with the greatest possible Amplitude, both hands at the same time.)

• 0

  = Normal.

  1

  = Slight slowdown and / or reduction in amplitude.

  2

  = Moderately restricted. significant and early Fatigue. possibly occasional break in the movement.

  3

  = Severely restricted. Frequent hesitation when initiating the movement or stopping in the middle of the movement.

  4

  = Can the task barely perform.

26. Agility of the legs (patient knocks with the heel in rapid succession on the floor and lifts the whole Leg on. The amplitude should be at least 7.5 cm.)

• 0

  = Normal.

  1

  = Slight slowdown and / or reduction in amplitude.

  2

  = Moderately restricted. significant and early Fatigue. possibly occasional break in the movement.

  3

  = Severely restricted. Frequent hesitation when initiating the movement or stopping in the middle of the movement.

  4

  = Can the task barely perform.

27. Getting up from a chair (The patient trying to get up from a chair with a straight backrest, taking his arms over the breast are crossed.)

• 0

  = Normal.

  1

  = Slow; or can need more than a try.

  2

  = Presses up on the armrests.

  3

  = Tends to fall back and needed possibly need several attempts but can get up without help.

  4

  = Can without help do not get up.

28. Attitude

• 0

  = Normal upright.

  1

  = Not quite upright, slightly bent position; could with an older one People be normal.

  2

  = Moderately bent Attitude; clearly abnormal; could easily tilted to one side.

  3

  = Heavily bent Attitude; could moderately to one Be inclined.

  4

  = Strong bending with extreme abnormal posture.

29th gear

• 0

  = Normal.

  1

  = Goes slow, can Shuffle with small steps. No festination or propulsion.

  2

  = Goes with difficulties, but needs little or no help. Maybe some degree of Festination, small steps or propulsion.

  3

  = Strong disturbance of the Vintage. Needs support.

  4

  = Can at all not going, not even with support.

30. Postural stability (response to sudden backward movement by pulling on the shoulders, with the patient standing upright with the foot slightly open) and opened his eyes. The patient is prepared for it.)

• 0

  = Normal.

  1

  = Retropulsion, gets caught but without help.

  2

  = No postural reaction. Would fall, if he was not caught by the investigator.

  3

  = Very unstable. tends to spontaneous loss of balance.

  4

  = Can not do without Help stand.

31. bradykinesia and hypokinesia of the body (combination of slowness, hesitation, reduced swinging of the arms, low amplitude of movement and general sedentary lifestyle.)

• 0

  = None.

  1

  = Minimum slowness, whereby the movement appears intentionally. Could be normal for some people. possibly reduced amplitude.

  2

  = Low level of slowness and sedentary, which is clearly abnormal. Alternatively a certain Measure Reduction of the amplitude.

  3

  = Moderate slowness, Low movement or low amplitude.

  4

  = Pronounced slowness, Lack of exercise or low movement amplitude.

IV. COMPLICATIONS OF THERAPY (in the last weeks)

A. DYSKINESIA

32. Duration: To what extent occur while wakefulness in one day Dyskinesia? (Medical information)

• 0

  = None.

  1

  = 1-25% of the day

  2

  = 26-50% of the day

  3

  = 51-75% of the day

  4

  = 76-100% of the day

33. Disability: How much are they hampering Dyskinesias? (Medical information, can by the investigation supplemented in practice become)

• 0

  = No disability

  1

  = Low disability

  2

  = Moderate disability

  3

  = Severe disability

  4

  = Complete disability

34. Painful dyskinesias: how painful the dyskinesia?

• 0

  = No painful dyskinesias

  1

  = Easy

  2

  = Moderate

  3

  = Strong

  4

  = Pronounced

35. Onset of early morning dystonia (Medical information)

• 0

  = No

  1

  = Yes

B. CLINICAL FLUCTUATIONS

36. Are "off" periods predictable?

• 0

  = No

  1

  = Yes

37. Are "off" periods unpredictable?

• 0

  = No

  1

  = Yes

38. If "off" periods suddenly occur, z. Within a few seconds?

• 0

  = No

  1

  = Yes

39. For What is the average duration of an off-day during the day?

• 0

  = None

  1

  = 1-25% of the day

  2

  = 26-50% of the day

  3

  = 51-75% of the day

  4

  = 76-100% of the day

C. OTHER COMPLICATIONS

40. Does the patient suffer from loss of appetite, nausea, or or vomiting?

• 0

  = No

  1

  = Yes

41. Does the patient have sleep disturbances, z. Eg insomnia or drowsiness?

• 0

  = No

  1

  = Yes

42. Does the patient show orthostatic symptoms?

• 0

  = No

  1

  = Yes

V. MODIFIED STADIUM DETERMINATION BY HOEHN AND YAHR

• Stage 0

  = No signs a disease.

  Stage 1

  = Unilateral disease.

  Stage 1.5

  = Unilateral and axial Participation.

  Stage 2

  = Bilateral disease without balance disorder.

  Stage 2.5

  = Lightweight bilateral Disease with compensation in the tensile test.

  Stage 3

  = Light to moderate bilateral Disease: mild posture instability; physically independent.

  Stage 4

  = Severe disability; can still walk or stand without help.

  Stage 5

  = Without help to the Wheelchair bound or bedridden.

VI. MODIFIED SWAB AND ENGLAND SCALE THE ACTIVITIES THE DAILY LIFE

• 100%

  = Completely independent. can all Activities without slowing down, difficulties or disability To run. Essentially healthy. No difficulties perceived.

  90%

  = Completely independent. can all Low deceleration, difficulty and disability operations To run. It may take twice as long. Difficulties become aware.

  80%

  = For most Performances completely independently. Need for it twice as much time. Is the difficulty and slowdown deliberately.

  70%

  = Not completely independent. at some difficulties greater difficulties. need for some three to four times as long. Must spend a large part of the day on the Use activities.

  60%

  = Slight dependence. Can do most things, but very slowly and with much effort; Error; sometimes impossible.

  50%

  = More dependent. Help at half performance, slower, etc. Difficulty in everything.

  40%

  = Very dependent. can in all Works help, but only a few alone.

  30%

  = Can with effort Doing or starting some activities here and there by yourself. Needs a lot Help.

  20%

  = Can not do it alone do. Can help with some activities. Heavily handicapped.

  10%

  = Completely dependent, helpless. Completely with special needs.

  0%

  = Vegetative functions such as swallowing, bladder and stool emptying have failed. Bedridden.

Claims (3)

device for monitoring motor parameter comprising at least one sensor and a transmitting unit to send the data collected by the sensor. device according to claim 1, characterized in that the at least one Sensor is an acceleration sensor, device according to claim 1 or 2, characterized in that the device is portable is.