Remote Physical Activity Monitoring in Neurological Disease: A Systematic Review

Abstract

Objective: To perform a systematic review of studies using remote physical activity monitoring in neurological diseases, highlighting advances and determining gaps.

Methods: Studies were systematically identified in PubMed/MEDLINE, CINAHL and SCOPUS from January 2004 to December 2014 that monitored physical activity for ≥24 hours in adults with neurological diseases. Studies that measured only involuntary motor activity (tremor, seizures), energy expenditure or sleep were excluded. Feasibility, findings, and protocols were examined.

Results: 137 studies met inclusion criteria in multiple sclerosis (MS) (61 studies); stroke (41); Parkinson's Disease (PD) (20); dementia (11); traumatic brain injury (2) and ataxia (1). Physical activity levels measured by remote monitoring are consistently low in people with MS, stroke and dementia, and patterns of physical activity are altered in PD. In MS, decreased ambulatory activity assessed via remote monitoring is associated with greater disability and lower quality of life. In stroke, remote measures of upper limb function and ambulation are associated with functional recovery following rehabilitation and goal-directed interventions. In PD, remote monitoring may help to predict falls. In dementia, remote physical activity measures correlate with disease severity and can detect wandering.

Conclusions: These studies show that remote physical activity monitoring is feasible in neurological diseases, including in people with moderate to severe neurological disability. Remote monitoring can be a psychometrically sound and responsive way to assess physical activity in neurological disease. Further research is needed to ensure these tools provide meaningful information in the context of specific neurological disorders and patterns of neurological disability.

Conflict of interest statement

Competing Interests: The authors have read the journal's policy and have the following competing interests: VAJB and PT have no disclosures. EP has received compensation for teaching continuing education for Summit Professional Education. BACC has received personal compensation for consulting from Abbvie, Biogen, EMD Serono, MedImmune, Novartis, Genzyme/sanofi aventis, Teva and has received contracted research support (including clinical trials) from Acorda, Biogen, EMD Serono, Hoffman La Roche, MedImmune, Novartis and Teva. DDA has received compensation as an instructor for the Neurologic Physical Therapy Residency Program at Kaiser Redwood City. She has also received compensation for co-developing an online continuing education course in rehabilitation for people with multiple sclerosis for Western Schools. JMG has served as a consultant on a scientific advisory board for MedImmune; has received research support from Quest Diagnostics through UCSF on a dementia care pathway; and has received compensation for medical legal consulting related to CNS inflammatory disorders. This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1. PRISMA Flow Diagram.

Notes: * 1 Article includes multiple groups of neurological diagnosis—MS, Parkinson’s and neuromuscular disease—(Busse et al, 2004) α 1 Article includes TBI and Stroke (Fulk et al, 2014)

Fig 2. Checklist for Standardization of Reporting for Remote Physical Activity Monitoring in Neurological Disease.

From: Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6(6): e1000097. doi:10.1371/journal.pmed1000097 For more information, visit: www.prisma-statement.org.