
Measurement
In parkinsonism, the global clinical score holds sway, but is a blunt
instrument. It was obvious, all along, to our clinical pharmacology core
group that quantification of the facets is essential. Simple relevant tests
of performance have been advocated, but often with inadequate attention
to their sensitivity, specificity and reliability. Emphasis on suitable
methodology opens up the field to:
• Conducting studies with a high statistical power, using small numbers
of subjects.
• Much needed longitudinal studies.
• Detection of, and intervention in, early disease states.
Novel methods of measuring syndrome and effects intervention
• Development of an inexpensive, simple to use “pocket gait
laboratory”.
• Defining quantitative functional markers of the risk of falling
in early parkinsonism.
• Measurement of nocturnal axial rotation, with a high resolution,
to identify those at risk of pressure sores and as a marker of early parkinsonism.

• Re-engineering to produce a lightweight, portable device for quantifying
rigidity and devising a protocol, to give reproducible results.
• Putting together a comprehensive objective assessment facility to
analyse patients’ problems, quantify disability and follow disease
progression.
• Quantification of the prolonged cognitive processing time sometimes
associated with parkinsonism.
• Design of a pill box with an electronic monitor for measurement
and display of consistency, as well as totality, of compliance with medication.