Feasibility and reliability of a monitoring app for chronic inflammatory neuropathies
Lemmen, Doreen L van Eijk, Ruben P A van Unnik, Jordi W J Allen, Jeffrey A Rajabally, Yusuf A van den Berg, Leonard H van der Pol, W Ludo Goedee, H Stephan
Lemmen, Doreen L
van Eijk, Ruben P A
van Unnik, Jordi W J
Allen, Jeffrey A
Rajabally, Yusuf A
van den Berg, Leonard H
van der Pol, W Ludo
Goedee, H Stephan
Affiliation
University Medical Center Utrecht; University of Minnesota; University Hospitals Birmingham NHS Foundation Trust; Aston University
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Publication date
2025-03-18
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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.
Citation
Lemmen DL, van Eijk RPA, van Unnik JWJ, Allen JA, Rajabally YA, van den Berg LH, van der Pol WL, Goedee HS. Feasibility and Reliability of a Monitoring App for Chronic Inflammatory Neuropathies. J Peripher Nerv Syst. 2025 Mar;30(1):e70005. doi: 10.1111/jns.70005.
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Article