The Challenge
Degenerative cervical myelopathy (DCM) is a slow-motion spinal cord injury affecting approximately 1 in 50 adults. Traditional assessment tools for DCM, such as the modified Japanese Orthopaedic Association (mJOA) score, have limited granularity and responsiveness, making it difficult to detect clinically important changes early and when it matters. This results in delayed treatment adjustments in clinical settings and requires larger sample sizes in research trials, increasing costs, feasibility and complexity. Digital outcome measures that can objectively measure disease remotely, repeatedly, and economically can address these challenges.
The MoveMed Solution
MoveMed is a smartphone app developed by researchers from the University of Cambridge to assess upper and lower limb function in real-time, in the user’s natural environment, and under standardized conditions. The app includes several performance tasks:
- Fast Tap Test: Measures finger dexterity through a 6-second touch-based task
- Hold Test: Assesses upper limb stability through an 8-second in-hand task
- Typing Test: Evaluates finger dexterity through a smartphone typing task
- Stand and Walk Test: Measures gait parameters during standing and walking
Research Evidence
Two key studies published in JMIR Neurotechnology (2024) have evaluated MoveMed’s measurement properties following COSMIN (Consensus-Based Standards for the Selection of Health Measurement Instruments) guidelines:
Validity and Reliability Findings
Validity Study: Research with 27 adults with DCM demonstrated that MoveMed tests correctly correlate with established clinical measures (P-mJOA score and WHOQOL-Bref), showing stronger correlations (≥0.3) with similar constructs and weaker correlations (<0.3) with unrelated constructs. The COSMIN assessment rated this as “very good” quality evidence for sufficient construct validity.
Reliability Study: In a 12-week study with 7 adults with stable DCM, MoveMed demonstrated:
- Moderate to excellent test-retest reliability (ICC values: 0.68-0.95 across all tests)
- Low measurement errors, with precise smallest detectable change values for each test
- “Very good” quality evidence according to COSMIN assessment
The Impact
The research demonstrates that MoveMed delivers:
- Valid measurements: Tests correlate appropriately with established clinical measures
- Reliable performance: Measurements remain stable when the disease remains stable
- Objective assessment: Quantifiable metrics that can detect small but important change
- Remote monitoring capability: Standardised assessments can be performed in the patient’s natural environment
Looking Forward
While these studies provide strong foundational evidence for MoveMed’s validity and reliability, the research team continues to investigate additional measurement properties. Ongoing work includes further evaluation of content validity, responsiveness to change, and application in other conditions that affect movement such as neurological, musculoskeletal, cardiovascular that share similar measurement constructs.
The existing evidence establishes MoveMed as a promising digital outcome measure for objectively assessing neurological function in DCM. Healthcare providers and researchers can have confidence in the app’s ability to deliver valid, reliable measurements that complement traditional assessment approaches.
Why Choose MoveMed?
- Evidence-based: Rigorous scientific validation following FDA and COSMIN guidelines
- User-friendly: Designed by healthcare professionals with patient input
- Versatile: Applicable across clinical care and research settings
- Remote-capable: Enables assessment outside traditional clinical environments
- Standardized: Controls for environmental variables to improve measurement quality
The combination of strong validity, excellent reliability, and ongoing research commitment makes MoveMed a trusted solution for objectively monitoring neuromuscular function in patients with DCM and potentially other disorders affecting movement.
References
Yanez Touzet A, Houhou T, Rahic Z, Laufer I, Margetis K, Martin A, Dea N, Ghogawala Z, Kapushesky M, Kotter M, Davies B, MoveMed. Validity of a Smartphone App to Objectively Monitor Performance Outcomes in Degenerative Cervical Myelopathy: Preliminary Findings From a Longitudinal Observational Study. JMIR Neurotech 2024;3:e52832. DOI: 10.2196/52832Yanez Touzet A, Houhou T, Rahic Z, et al. Reliability of a Smartphone App to Objectively Monitor Performance Outcomes in Degenerative Cervical Myelopathy: Observational Study. JMIR Form Res. 2024;8:e56889. Published 2024 May 24. doi:10.2196/56889
