Signal processing of quantitative continuous measurement of movements in the extremities
A protocol for a low-cost quantitative continuous measurement of movements in the extremities of people with Parkinson’s disease (PD) (McKay, et al., 2019) modified from the Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) (Goetz, et al., 2008) was administered by trained raters certified in the MDS-UPDRS once to ten participants with PD and again a month later to ten people with PD and eight age- and sex-matched healthy controls (HCs) (Brasic, et al., 2020). Raters certified in the MDS-UPDRS administered and scored the protocol live in person while signals from accelerometers on the extremities were recorded. Signals from the five repetitive activities were processed to generate fast Fourier transforms (FFTs) and continuous wavelet transforms (CWTs) (Harrigan, et al., Data Brief, Mendeley, 2020), Of the 40 raters recruited for the project, 38 obtained certification in the MDS-UPDRS and 32 completed the ratings of several sets of transforms of the repetitive movements. The rating scale for live ratings (McKay, et al., 2019) was modified for the assessment of signals and FFTs and CWTs by visual observation. The instructions were presented to raters to consult for the rating of representations of signals and transforms. The laterality of the representations was not stated.Raters were asked to complete ratings independently at convenient times during the week. Pilot Study Raters were presented two sets of 40 quizzes containing five representations of the ratings of participants with PD with single sessions for scoring of (A) output signals and FFTs and (B) CWTs (Pilot Test and Retest). Each quiz contained the panels of the x, y, and z representations of the finger and wrist or the toe and ankle of the five repetitive tasks. Each panel to be scored included six images corresponding to the signals of the three dimensions of the two accelerometers on a single extremity.Raters were presented five sets of six images of the original signal and the fast Fourier transform (FFT) or the continuous wavelet transforms (CWTs). Raters were presented either five panels of output signals and FFTs or CWTs. Panels did not include output signals and FFTs and CWTs simultaneously. Raters were instructed to score (A) output signals and FFTs and (B) CWTs analogously to the clinical coding forms as indicated the the instructions in the data. The raters also completed the output of the ten participants with PD and eight HCs who completed a two test session (CWT Test and Retest). Raters were presented two sets of 72 quizzes containing five representations for scoring of CWTs (Pilot Test and Retest). Each quiz contained the panels of averaged signals of the x, y, and z representations of the finger and wrist or the toe and ankle of the five repetitive tasks. Each panel to be scored included two images corresponding to the signals of the three dimensions of the two accelerometers on a single extremity.
Steps to reproduce
Please complete the ratings independently without collaboration. The transforms correspond to the visual observation of a single extremity. The rating of each representation corresponds to the rating of an extremity by visual observation. Base the rating on the panel with the optimal representation. There may be 20 to 60 repetitions on each transform. Use all for the scoring.This differs from the instructions for the MDS-UPDRS for ten repetitions (Goetz, et al., 2008). The live ratings were administered by examiners who gave the instructions on the coding form (MdKay, et al., 2019) modified from the MDS-UPDRS (Goetz, et al., 2008). For each repetitive item the examiner presented the instructions to the participant, demonstrated the activity at approximately 6 Hz, asked the participant to begin, and then encouraged the participant to perform the movement as fast and fully as possible. In order to obtain the minimal data for signal processing, examiners asked participants to continue the activites for up to 40,50, or 60 repetitions. Use all repetitions for the scoring. Score only abnormalities observed. If there are none, score 0. Abnormalities to be scores are in three groups a) interruptions, b) slowing, and c) amplitude re- ductions. Score each abnormality. a) Interruptions or freezing a) 1 to 2 interruptions, score 1a. b) 3 to 5 interruptions, score 2a. c) 5 or more interruptions or a freeze, a sustained absence of repetitions, score 3a. d) Worse, score 4 a. b) Slowing a) Minimal slowing, score 1b. b) Mild slowing, score 2b. c) Moderate slowing, score 3b. d) Worse slowing, score 4b c) Amplitude reductions a) End of sequence, score 1c. b) Middle of sequence, score 2c. c) Beginning of sequence, score 3c d) Worse, score 4c. Item b merits a score if there is slowing throughout the trace or midway during the trace. Score 0 or 4 for an overall rating without any indicated abnormalities. If the individual cannot perform the desired movement and there is no or negligible evidence of any movement in any of the six panels of transforms, or if the transforms exhibit bizarre patterns that do not represent any of the usual features, then an overall score of 4 is merited even if there is no score of 4a, 4b, or 4c. Do not score 0a, 0b, or 0c because a, b, and c refer to abnormalities. For each rating score 1a, 2a, 3a, 4a, 1b, 2b, 3b, 4b, 1c, 2c, 3c, and 4c independently. Some categories (a, b, c) may not be scored if the corresponding abnormality is absent. The overall rating then corresponds to the highest individual score with the exception of the absence of rat- ings in all categories. When there are no individual abnormalities, then the overall score is 0 or 4. The overall score is 4 when the transform reflects negligible movement or bizarre movements that do not correspond to the indicated categories corresponding to the individual who cannot perform the desired movements. You may take as much time as you like to complete the project.