Comprehensive real time remote monitoring for Parkinson's disease using Quantitative DigitoGraphy.

People with Parkinson's disease (PWP) face critical challenges, including lack of access to neurological care, inadequate measurement and communication of motor symptoms, and suboptimal medication management and compliance. We have developed QDG-Care: a comprehensive connected care platform for Parkinson's disease (PD) that delivers validated, quantitative metrics of all motor signs in PD in real time, monitors the effects of adjusting therapy and medication adherence and is accessible in the electronic health record. In this article, we describe the design and engineering of all components of QDG-Care, including the development and utility of the QDG Mobility and Tremor Severity Scores.

Quantitative DigitoGraphy: a Comprehensive Real-Time Remote Monitoring System for Parkinson's Disease.

People with Parkinson's disease (PWP) face critical challenges, including lack of access to neurological care, inadequate measurement and communication of motor symptoms, and suboptimal medication management and compliance. We have developed QDG-Care: a comprehensive connected care platform for Parkinson's disease (PD) that delivers validated, quantitative metrics of all motor signs in PD in real time, monitors the effects of adjusting therapy and medication adherence and is accessible in the electronic health record. In this article, we describe the design and engineering of all components of QDG-Care, including the development and utility of the QDG Mobility and Tremor Severity Scores.

Differential Effects of Pathological Beta Burst Dynamics Between Parkinson's Disease Phenotypes Across Different Movements.

Resting state beta band (13-30 Hz) oscillations represent pathological neural activity in Parkinson's disease (PD). It is unknown how the peak frequency or dynamics of beta oscillations may change among fine, limb, and axial movements and different disease phenotypes. This will be critical for the development of personalized closed loop deep brain stimulation (DBS) algorithms during different activity states.

Perspective: Evolution of Control Variables and Policies for Closed-Loop Deep Brain Stimulation for Parkinson's Disease Using Bidirectional Deep-Brain-Computer Interfaces.

A deep brain stimulation system capable of closed-loop neuromodulation is a type of bidirectional deep brain-computer interface (dBCI), in which neural signals are recorded, decoded, and then used as the input commands for neuromodulation at the same site in the brain. The challenge in assuring successful implementation of bidirectional dBCIs in Parkinson's disease (PD) is to discover and decode stable, robust and reliable neural inputs that can be tracked during stimulation, and to optimize neurostimulation patterns and parameters (control policies) for motor behaviors at the brain interface, which are customized to the individual. In this perspective, we will outline the work done in our lab regarding the evolution of the discovery of neural and behavioral control variables relevant to PD, the development of a novel personalized dual-threshold control policy relevant to the individual's therapeutic window and the application of these to investigations of closed-loop STN DBS driven by neural or kinematic inputs, using the first generation of bidirectional dBCIs.

Gender Differences in Modifying Lumbopelvic Motion during Hip Medial Rotation in People with Low Back Pain.

Reducing increased or early lumbopelvic motion during trunk or limb movements may be an important component of low back pain treatment. The ability to reduce lumbopelvic motion may be influenced by gender. The purpose of the current study was to examine the effect of gender on the ability of people with low back pain to reduce lumbopelvic motion during hip medial rotation following physical therapy treatment.

Differences in end-range lumbar flexion during slumped sitting and forward bending between low back pain subgroups and genders.

Patterns of lumbar posture and motion are associated with low back pain (LBP). Research suggests LBP subgroups demonstrate different patterns during common tasks. This study assessed differences in end-range lumbar flexion during two tasks between two LBP subgroups classified according to the Movement System Impairment model.

Clinical examination procedures to determine the effect of axial decompression on low back pain symptoms in people with chronic low back pain.

Study Design: Observational.

Objective: To assess the effects of spinal decompression procedures performed during a clinical exam on low back pain (LBP) symptoms.

Background: Not all patients report an immediate or complete improvement in symptoms when the direction of lumbar motion or alignment is corrected according to principles of the movement system impairment (MSI) model.

Sex differences in lumbopelvic movement patterns during hip medial rotation in people with chronic low back pain.

Objective: To examine sex differences in lumbopelvic motion and symptom behavior during hip medial rotation in people with low back pain (LBP). We hypothesized that men would demonstrate greater and earlier lumbopelvic motion and would be more likely to report increased symptoms compared with women.

Design: Cross-sectional observational study.

Low interrater reliability of examiners performing the prone instability test: a clinical test for lumbar shear instability.

Objective: To test the interrater reliability of examiners performing the prone instability test (PIT), a clinical test proposed to identify lumbar shear instability.

Design: Cross-sectional test-retest design examining individuals with mechanical low back pain (LBP).

Setting: University-based musculoskeletal analysis laboratory.

Effect of classification-specific treatment on lumbopelvic motion during hip rotation in people with low back pain.

Increased and early lumbopelvic motion during trunk and limb movements is thought to contribute to low back pain (LBP). Therefore, reducing lumbopelvic motion could be an important component of physical therapy treatment. Our purpose was to examine the effects of classification-specific physical therapy treatment (Specific) based on the Movement System Impairment (MSI) model and non-specific treatment (Non-Specific) on lumbopelvic movement patterns during hip rotation in people with chronic LBP.

Differences in activity limitation between 2 low back pain subgroups based on the movement system impairment model.

Objective: To examine if activity limitation differs between 2 low back pain (LBP) subgroups in the Movement System Impairment (MSI) model.

Design: Cross-sectional observational study.

Setting: University medical center musculoskeletal analysis laboratory.

Effect of metatarsal phalangeal joint extension on plantar soft tissue stiffness and thickness.

Background: Plantar soft tissue stiffness and thickness are important biomechanical variables to understand stress concentrations that may contribute to tissue injury.

Objective: The purpose of this study was to determine the effects of passive metatarsal phalangeal joint (MPJ) extension on plantar soft tissue stiffness and thickness.

Methods: Seventeen healthy participants (7 male, 10 female, mean age 25.