Diagnosis of orthostatic tremor using smartphone accelerometry

Abstract Background Primary orthostatic tremor (OT) is a rare movement disorder characterized by a 13–18 Hz leg tremor, which arises when standing and is relieved by walking/sitting. Those affected generally do not fall, but experience fear of falling, lessened by ambulation. Because of its low ampl...

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Autores principales:	Nicholas E. Calvo, Joseph M. Ferrara
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Accelerometry Movement disorders Neurology Orthostatic tremor Smartphone Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/6c2cae974c9d41928c715f6e5c807456
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spelling	oai:doaj.org-article:6c2cae974c9d41928c715f6e5c8074562021-11-28T12:11:27ZDiagnosis of orthostatic tremor using smartphone accelerometry10.1186/s12883-021-02486-01471-2377https://doaj.org/article/6c2cae974c9d41928c715f6e5c8074562021-11-01T00:00:00Zhttps://doi.org/10.1186/s12883-021-02486-0https://doaj.org/toc/1471-2377Abstract Background Primary orthostatic tremor (OT) is a rare movement disorder characterized by a 13–18 Hz leg tremor, which arises when standing and is relieved by walking/sitting. Those affected generally do not fall, but experience fear of falling, lessened by ambulation. Because of its low amplitude, the tremor is not readily visible, and diagnosis requires confirmation with surface electromyography (sEMG). Recently, applications using the accelerometer feature of smartphones have been used to detect and quantify tremors, including OT, though the accuracy of smartphone accelerometry (SPA) in diagnosing OT is unknown. Methods We completed SPA in consecutive adults (18+ years), who presented to our neurology clinic with either subjective leg shakiness upon standing or unsteadiness when standing that lessened with ambulation, which comprised 59 of 2578 patients. We assessed tremor using the StudyMyTremor application on an iPhone 6 s adhered with tape to the patient’s tibialis anterior. Surface electromyography was completed on the same muscle. The primary outcome of this study was to determine SPA’s sensitivity and specificity in detecting OT compared with surface electromyography. Results Fifty-nine patients with the following diagnoses were included: OT (6), Parkinson’s disease, Hereditary Spastic Paraplegia, orthostatic hypotension, essential tremor, spinal cerebellar ataxia, sensory ataxia and functional movement disorder. Smartphone accelerometry detected a 13–18 Hz tremor in 5 of 6 patients diagnosed with OT by sEMG with no false positives in other conditions, yielding a sensitivity of 83%, specificity of 100% in the cohort we studied. Conclusions Though a larger sample size is desirable, preliminary data suggest that smartphone accelerometry is an alternative to surface electromyography in diagnosing OT.Nicholas E. CalvoJoseph M. FerraraBMCarticleAccelerometryMovement disordersNeurologyOrthostatic tremorSmartphoneNeurology. Diseases of the nervous systemRC346-429ENBMC Neurology, Vol 21, Iss 1, Pp 1-4 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Accelerometry Movement disorders Neurology Orthostatic tremor Smartphone Neurology. Diseases of the nervous system RC346-429
spellingShingle	Accelerometry Movement disorders Neurology Orthostatic tremor Smartphone Neurology. Diseases of the nervous system RC346-429 Nicholas E. Calvo Joseph M. Ferrara Diagnosis of orthostatic tremor using smartphone accelerometry
description	Abstract Background Primary orthostatic tremor (OT) is a rare movement disorder characterized by a 13–18 Hz leg tremor, which arises when standing and is relieved by walking/sitting. Those affected generally do not fall, but experience fear of falling, lessened by ambulation. Because of its low amplitude, the tremor is not readily visible, and diagnosis requires confirmation with surface electromyography (sEMG). Recently, applications using the accelerometer feature of smartphones have been used to detect and quantify tremors, including OT, though the accuracy of smartphone accelerometry (SPA) in diagnosing OT is unknown. Methods We completed SPA in consecutive adults (18+ years), who presented to our neurology clinic with either subjective leg shakiness upon standing or unsteadiness when standing that lessened with ambulation, which comprised 59 of 2578 patients. We assessed tremor using the StudyMyTremor application on an iPhone 6 s adhered with tape to the patient’s tibialis anterior. Surface electromyography was completed on the same muscle. The primary outcome of this study was to determine SPA’s sensitivity and specificity in detecting OT compared with surface electromyography. Results Fifty-nine patients with the following diagnoses were included: OT (6), Parkinson’s disease, Hereditary Spastic Paraplegia, orthostatic hypotension, essential tremor, spinal cerebellar ataxia, sensory ataxia and functional movement disorder. Smartphone accelerometry detected a 13–18 Hz tremor in 5 of 6 patients diagnosed with OT by sEMG with no false positives in other conditions, yielding a sensitivity of 83%, specificity of 100% in the cohort we studied. Conclusions Though a larger sample size is desirable, preliminary data suggest that smartphone accelerometry is an alternative to surface electromyography in diagnosing OT.
format	article
author	Nicholas E. Calvo Joseph M. Ferrara
author_facet	Nicholas E. Calvo Joseph M. Ferrara
author_sort	Nicholas E. Calvo
title	Diagnosis of orthostatic tremor using smartphone accelerometry
title_short	Diagnosis of orthostatic tremor using smartphone accelerometry
title_full	Diagnosis of orthostatic tremor using smartphone accelerometry
title_fullStr	Diagnosis of orthostatic tremor using smartphone accelerometry
title_full_unstemmed	Diagnosis of orthostatic tremor using smartphone accelerometry
title_sort	diagnosis of orthostatic tremor using smartphone accelerometry
publisher	BMC
publishDate	2021
url	https://doaj.org/article/6c2cae974c9d41928c715f6e5c807456
work_keys_str_mv	AT nicholasecalvo diagnosisoforthostatictremorusingsmartphoneaccelerometry AT josephmferrara diagnosisoforthostatictremorusingsmartphoneaccelerometry
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Diagnosis of orthostatic tremor using smartphone accelerometry

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