Feasibility and Reliability of a Monitoring App for Chronic Inflammatory Neuropathies

IF 3.9 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Peripheral Nervous System Pub Date : 2025-03-18 DOI:10.1111/jns.70005

Doreen L. Lemmen, Ruben P. A. van Eijk, Jordi W. J. van Unnik, Jeffrey A. Allen, Yusuf A. Rajabally, Leonard H. van den Berg, W. Ludo van der Pol, H. Stephan Goedee

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引用次数: 0

Abstract

Background and Aims

Multifocal motor neuropathy (MMN) and chronic inflammatory demyelinating polyneuropathy (CIDP) are immune-mediated neuropathies characterized by muscle weakness and/or sensory deficits. Identifying treatment response, relapse, and stability can be challenging in these chronic, sometimes unpredictable, conditions. This study explores the potential of a monitoring app designed to address these challenges.

Methods

Patients were monitored weekly or monthly, based on stability and patient preference, using grip strength, modified timed-up-and go (mTUG), and patient-reported outcome measures (PROMs). User experience was evaluated via a questionnaire addressing content and ease of use (scale 0–10). Adherence was measured as the percentage of completed mandatory assessments. We investigated reliability using intra-class correlation coefficients (ICCs) and standard errors of the mean (SEM) of repeated measurements. Longitudinal changes were analyzed using linear mixed-effects models.

Results

We included 38 patients, with a mean follow-up of 11 months (IQR 4.6–19.5). The mean user experience score was 8.35/10 (range 7–10). Adherence was 93% (95% CI: 91.9%–94.1%). Reported remote measurements for grip strength were 1358/1468 (93%), and 1343/1430 (94%) for mTUG. Grip strength and mTUG ICCs were both 0.96 (95% CI: 0.93–0.98 and 0.92–0.99, respectively). The average SEM was 8.46% (95% CI: 6.58–10.28) for grip strength and 8.18% (95% CI: 6.12–10.41) for mTUG. Only grip strength changed significantly, increasing by 3.1 pounds per 6 months (95% CI: 0.61–5.83; p = 0.016).

Interpretation

Our study demonstrates that tele-neuromonitoring is feasible and reliable, showing high adherence, positive user experience and high ICCs. We anticipate tele-neuromonitoring could complement routine follow-up, enabling clinicians to make better-informed treatment decisions.

Abstract Image

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慢性炎症性神经病监测应用程序的可行性和可靠性

背景和目的多灶性运动神经病（MMN）和慢性炎症性脱髓鞘多神经病变（CIDP）是一种以肌肉无力和/或感觉缺陷为特征的免疫介导的神经病变。在这些慢性、有时不可预测的疾病中，确定治疗反应、复发和稳定性是具有挑战性的。本研究探讨了一款监测应用程序的潜力，该应用程序旨在应对这些挑战。方法根据稳定性和患者偏好，每周或每月对患者进行监测，使用握力，改良的定时-出发（mTUG）和患者报告的结果测量（PROMs）。用户体验通过一份针对内容和易用性的问卷进行评估（评分0-10）。依从性以完成强制性评估的百分比来衡量。我们使用类内相关系数（ICCs）和重复测量的平均标准误差（SEM）来调查可靠性。纵向变化分析采用线性混合效应模型。结果38例患者，平均随访11个月（IQR 4.6 ~ 19.5）。平均用户体验得分为8.35/10（范围7-10）。依从性为93% （95% CI: 91.9%-94.1%）。据报道mTUG的握力远程测量值分别为1358/1468（93%）和1343/1430（94%）。握力和mTUG icc均为0.96 （95% CI分别为0.93-0.98和0.92-0.99）。握力的平均SEM为8.46% (95% CI: 6.58-10.28)， mTUG的平均SEM为8.18% （95% CI: 6.12-10.41）。只有握力发生了显著变化，每6个月增加3.1磅(95% CI: 0.61-5.83；p = 0.016)。我们的研究表明，远程神经监测是可行和可靠的，具有高依从性，积极的用户体验和高icc。我们期望远程神经监测可以补充常规随访，使临床医生做出更明智的治疗决定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the Peripheral Nervous System 医学-临床神经学

CiteScore

6.10

自引率

7.90%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of the Peripheral Nervous System is the official journal of the Peripheral Nerve Society. Founded in 1996, it is the scientific journal of choice for clinicians, clinical scientists and basic neuroscientists interested in all aspects of biology and clinical research of peripheral nervous system disorders. The Journal of the Peripheral Nervous System is a peer-reviewed journal that publishes high quality articles on cell and molecular biology, genomics, neuropathic pain, clinical research, trials, and unique case reports on inherited and acquired peripheral neuropathies. Original articles are organized according to the topic in one of four specific areas: Mechanisms of Disease, Genetics, Clinical Research, and Clinical Trials. The journal also publishes regular review papers on hot topics and Special Issues on basic, clinical, or assembled research in the field of peripheral nervous system disorders. Authors interested in contributing a review-type article or a Special Issue should contact the Editorial Office to discuss the scope of the proposed article with the Editor-in-Chief.