Co-Interpreting Movement With Sensors: Assessing Parkinson’s Patients’ Deep Brain Stimulation Programming

Abstract

Movement sensors have been touted as providing the next generation of health care through objective measurements that will replace “subjective” health assessments and remove the fallible memory of patients from health decision making. However, assessing the level of disability and assessing the efficacy of treatment are iterative and constructive acts reliant on an alignment of shared perceptions between clinician and patient. The challenge then is to utilize movement sensors as a resource for this co-interpretation as opposed to a replacement. The examples presented in this article are from fieldwork of Parkinson’s patients’ deep brain stimulation programming sessions. We employed a design research study that included observations of the noninstrumented movement assessment in 10 naturally occurring deep brain stimulation clinical programming sessions, design explorations of a sensor for evaluating upper limb movement, and the resulting uptake of the system in the assessment and co-interpretation practices by clinicians and patients through a deployment of this sensor in eight naturally occurring clinical assessments. Our findings highlight how sensors can provide much needed co-interpreted assessment of movement but sensors can also intrude on this process through clinician or sensor authority.

Additional information

Notes on contributors

Helena M. Mentis

Helena M. Mentis ([email protected]) is an information scientist with an interest in systems for movement sensing and perceiving in health decision making; she is an Assistant Professor in the Department of Information Systems of the University of Maryland, Baltimore County. Rita Shewbridge ([email protected]) is interested in Personal Health Informatics and the design and use of embedded systems for health and wellness; she is a Ph.D. student in the Department of Information Systems of the University of Maryland, Baltimore County. Sharon Powell ([email protected]) is a registered nurse with a master’s in Public Health; she is the Nurse Educator and the Deep Brain Stimulation Coordinator for the University of Maryland Medical Center’s Parkinson’s Disease and Related Movement Disorders Center. Melissa Armstrong ([email protected]) is a neurologist with an interest in memory and thinking problems that develop in Parkinson’s disease; she is an Assistant Professor in the Department of Neurology of the University of Maryland School of Medicine. Paul Fishman ([email protected]) is a neurologist who cofounded the Deep Brain Stimulation program at the University of Maryland Medical Center; he is a Professor in the Department of Neurology of the University of Maryland School of Medicine. Lisa Shulman ([email protected]) is a neurologist with an interest in Alzheimer’s and Parkinson’s disease; she holds the Eugenia Brin Professorship in Parkinson’s Disease and Movement Disorders in the Department of Neurology of the University of Maryland School of Medicine.