User Experiences of Limb-Worn Wearable Devices for Monitoring Parkinson Disease Motor Function and Blood Pressure: Usability Study.

backgroundWearable devices have the potential to provide reliable and objective assessment and monitoring of Parkinson disease (PD). During design, there is often a focus on technical performance, accuracy, and reliability, with less emphasis on the user experience.

objectiveThis study explored the user experience of a novel prototype wearable device (wrist- and ankle-worn) to record limb movements (accelerations and angular velocities), and physiological data (eg, photoplethysmography and heart rate information for estimation of blood pressure).

methodsThis qualitative study used internet-based semistructured interviews with people with PD, following wearing prototype devices for 24 hours at home. Interviews were audio-recorded and transcripts analyzed using a hybrid deductive and inductive approach.

resultsSix people with PD, 3 male and 3 female, aged 52-83 years, with mild-to-moderate PD (Hoehn and Yahr scale score ≤3; median MDS-UPDRS [Movement Disorder Society - Unified Parkinson's Disease Rating Scale] score of 72/199) and cognition within normal limits (6-item Cognitive Impairment Test median score 0), with an average disease duration of 8 years took part in the study. Participants were overall positive toward the device, finding it generally comfortable, light in weight and noninvasive. Five out of 6 participants reported minor problems related to strap adjustability and challenges specific to PD. The prototype was comfortable, but this was a lesser priority than robustness, the device not hindering their usual clothing choices (device size or outward projection, or both), and adjustability for fit, including the need to switch to an elasticated strap. In particular, a discreet design was important, as some individuals may feel self-conscious about wearing visible condition-specific products, due to stigma. The ankle-worn device was perceived as unfamiliar and nondiscreet, with some participants likening it to a prisoner tracking system and dressing specifically to conceal it. The wrist-worn device was considered more user-friendly, especially if designed discreetly and resembling more familiar devices. Five of the 6 participants believed their health care teams should have access to the data, particularly relating to their symptoms, fluctuations, and medication. Three also wished to access these data for self-management. One participant was hesitant regarding the potential benefits of technology to support PD management, preferring to use feedback data personally and relying on their health care team's usual assessment to guide decisions. Across the group, desirable device technical features included symptom prediction, reminder prompts, and support for medication management. Despite concerns about stigma, most participants were willing to wear PD-specific devices, believing that they could aid better symptom management.

conclusionsIn summary, wearable devices must be discreet, robust, comfortable, and easily applied to promote adherence regardless of technical specifications.