Abstract
Background
Performing motor evaluations using videoconferencing for patients with Parkinson’s disease (PD) is safe and feasible. However, the feasibility of these evaluations is not adequately studied in resource-limited settings.
Objective
To evaluate the feasibility of performing motor evaluations for patients with PD in a resource-limited setting.
Methods
The examiners rated motor aspects of parkinsonism of 34 patients with PD from the Brazilian public healthcare system through telemedicine with the patient’s own means by using the Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) rating scale. Quality measures of the video meeting were also obtained. The feasibility of rating the motor aspects was the primary outcome whereas the rating of individual motor aspects, video meeting quality and predictors of a complete evaluation served as secondary outcomes.
Results
The least assessable parameters were freezing of gait (52.9%), gait (70.6%), leg agility, and rest tremor (both 76.5%). Complete MDS-UPDRS part III was possible in 41.2% of patients and 62 out of 374 motor aspects evaluated (16.6%) were missed. Available physical space for a video evaluation was the worst quality measure. Incomplete evaluations were directly associated with disability (p = 0.048, r = 0.34) and inversely with available physical space (p = 0.003, r = 0.55).
Conclusion
A significant portion of the MDS-UPDRS part III is unable to be performed during telemedicine-based evaluations in a real-life scenario of a resource-limited setting.
Keywords:
Parkinson Disease; Videoconferencing; Telemedicine; Remote Consultation; Developing Countries; Neurologic Examination
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