Usability and Validation of Smartphone-based Neuroperformance Tests in Multiple Sclerosis
Katherine Beshears1, Mandy Koop2, Kelsey Owen2, Jay Alberts2, Marisa McGinley3
1Cleveland Clinic Lerner College of Medicine, 2Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, 3Mellen Center for Multiple Sclerosis, Cleveland Clinic
Objective:
To cross-sectionally validate smartphone-based tests of motor and cognitive function in multiple sclerosis (MS).
Background:
The standard neuroperformance tests for MS require patients to undergo testing in a clinic and are often infrequent. Smartphone-based, at-home neuroperformance tests may allow for more frequent measurements and objective testing for teleneurology visits.
Design/Methods:
A smartphone application including tests of gait function (timed up and go (TUG) and 5 times sit-to-stand test (5STS)), manual dexterity (finger tapping test (FTT)), and cognitive function (processing speed test (PST)) were developed. MS patients and healthy controls performed each of the smartphone tests and the previously validated, iPad-based Multiple Sclerosis Performance Test (MSPT). Linear regressions were performed to assess for convergent validity between the smartphone tests and MSPT.
Results:
23 healthy controls (mean age 41.2 (SD 19.1), 65.4% female, 76.9% white, 7.69% Hispanic) and 23 MS patients (mean age 52.1 (SD 12.7), 55.2% female, 86.2% white, 0% Hispanic, mean disease duration 11.9 years (SD 7.00), 58.6% relapsing-remitting MS, mean patient-determined disease steps 3) completed the neuroperformance tests at a single visit. Valid taps per second on FTT using the right and left hands was significantly correlated with manual dexterity test (MDT) performance (Pearson correlation coefficients r = -0.561 and -0.597, respectively). Total number correct on smartphone-administered PST significantly correlated with iPad-administered PST (r = 0.774). Finally, TUG and 5STS times significantly correlated with timed 25-foot walk test (r = 0.954 and 0.825, respectively).
Conclusions:
The FTT, PST, TUG, and 5STS, as performed using the smartphone application, demonstrate convergent validity with their analogous MSPT neuroperformance tests. These smartphone-based tests, as an alternative to traditional, in-clinic assessments, may allow for more frequent, remote measurement of MS patients’ level of disability, as well as easy integration of these data into the electronic medical record.