Remote Multi-modal Monitoring in ALS Using Wearable and Digital Assessments
Ashkan Vaziri1, Ram Kinker Mishra1, Adonay Sastre Nunes1, Zachary Simmons2, Andrew Geronimo2
1BioSensics LLC, 2Department of Neurology, Penn State College of Medicine
Objective:
To develop and validate a remote monitoring system using wearable and digital assessments to track disease progression and symptoms in individuals with amyotrophic lateral sclerosis (ALS)
Background:
A comprehensive assessment of neurological symptoms and disease progression can improve patient care and readiness for clinical trials in ALS. This study developed a remote monitoring system using wearable technology to track changes in physical activity, fine motor function, patient-reported outcomes (PROs), and speech in individuals with ALS.
Design/Methods:
ALS participants were followed for up to 12 months, with clinical visits at baseline and every three months. After each visit, participants wore a PAMSys™ pendant and two PAMSys ULM™ wrist sensors to monitor daily physical activity and hand movements for one week. Bi-weekly digital assessments of speech, handwriting, and pattern-tracing were conducted using BioDigit Home tablets. Data were analyzed using repeated measures correlation and linear mixed models.
Results:
Data from 18 ALS participants (mean age 66.3 ± 9.6 years; 6 females) across 51 visits were analyzed. Physical activity sensor data correlated significantly with ALSFRS-R gross motor scores (r = 0.41 to 0.60, p < 0.05). Speech metrics, including articulatory rate and intelligibility, showed moderate to strong associations with ALSFRS-R bulbar and respiratory scores. High compliance rates were observed: 91.9% for speech tasks, 96.5% for pendant sensors (>18 hours worn), and 88% for handwriting and pattern-tracing tasks.
Conclusions:
These pilot results demonstrate the feasibility of multi-modal, at-home monitoring for ALS. Digital assessments offer objective measurement, high compliance, scalability, and cost-effectiveness, supporting efforts to improve ALS care and health equity.
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