The Challenge
Clinical trials have long struggled with how to measure Degenerative Cervical Myelopathy (DCM), a progressive spinal cord injury affecting approximately 1 in 50 adults. A key challenge is ensuring that trials capture outcomes that truly matter to patients. Historically, studies have selected outcomes at their discretion, leading to inconsistencies, underrepresentation of key disease aspects, and limited comparability between trials. This is not just a problem for DCM—measurement variability is a challenge across all neurological diseases, making it harder to track disease progression, evaluate treatments, and apply research findings to clinical care.
To address this, members of the MoveMed team led AO Spine RECODE-DCM initiative, which established what should be measured, alongside how and when. Thus creating a standardized framework for clinical trials. However, implementing these measurements in a scalable and patient-centered way remains a challenge.
The MoveMed Solution
MoveMed was developed to bridge this gap. A smartphone-based app created by researchers at the University of Cambridge, MoveMed enables real-time, objective assessments of upper and lower limb function in the user’s natural environment; the features of the disease prioritised by patients and professionals in AO Spine RECODE-DCM. Its inclusion will therefore ensure clinical trials focus on meaningful, patient-prioritized outcomes.
The app includes several performance-based tasks that measure key aspects of neurological function, including:
- Fast Tap Test – Assesses finger dexterity, an essential marker of neurological impairment
- Hold Test – Measures upper limb stability, important for everyday tasks
- Typing Test – Evaluates fine motor control and digital function
- Stand and Walk Test – Quantifies gait parameters to track mobility changes
The Broader Impact: Beyond DCM
While MoveMed was developed for DCM, its patient-centered design process has wider implications. The challenge of inconsistent, non-standardized measurement affects many neurological diseases, from multiple sclerosis to Parkinson’s disease and stroke recovery. By ensuring that research measures what truly matters to patients in a scalable and standardized way, MoveMed has the potential to transform how neurological diseases are monitored and treated.
Looking Forward
The MoveMed team continues to refine its approach, expand its application to other neurological and musculoskeletal conditions through the EMPOWER trial, and scientific partnership. As leaders in measurement science (clinimetrics), with patient priorities at the centre of our design principles, we are well placed to create a future where clinical trials deliver results that can drive real change in practice and improve patient outcomes.
Why Choose MoveMed?
- Patient-Centered Design – Measures the outcomes that matter most to patients, ensuring data reflects real-world needs and priorities.
- Expert-Led Measurement Science – Developed by the team behind RECODE-DCM, with a proven track record in designing and validating patient-centered outcome measures.
- Built for Neurological and Musculoskeletal Health – Spinal cord disability shares key goals with other neurological and musculoskeletal conditions, highlighting broader opportunities for MoveMed.
References
Davies BM, Yang X, Khan DZ, Mowforth OD, Touzet AY, Nouri A, Harrop JS, Aarabi B, Rahimi-Movaghar V, Kurpad SN, Guest JD, Tetreault L, Kwon BK, Boerger TF, Rodrigues-Pinto R, Furlan JC, Chen R, Zipser CM, Curt A, Milligan J, Kalsi-Rayn S, Sarewitz E, Sadler I, Blizzard T, Treanor C, Anderson D, Fallah N, Hazenbiller O, Salzman C, Zimmerman Z, Wandycz AM, Widdop S, Reeves M, Raine R, Ryan SK, Malone A, Gharooni A, Wilson JR, Martin AR, Fehlings MG, McNair AGK, Kotter MRN; AO SPINE RECODE-DCM Steering Committee and AO Spine RECODE DCM Community. A minimum data set-Core outcome set, core data elements, and core measurement set-For degenerative cervical myelopathy research (AO Spine RECODE DCM): A consensus study. PLoS Med. 2024 Aug 22;21(8):e1004447. doi: 10.1371/journal.pmed.1004447. PMID: 39173109; PMCID: PMC11379399.
Davies BM, Yanez AT, Fehlings MF. Chapter 5 – Clinical assessment tools in Degenerative Cervical Myelopathy: From Basic Science to Clinical Practice 2023.Edited by Michael G Fehlings. ISBN: 978-0-323-95334-4
