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Introduction to ParkService

ParkService is an existing prototype offering telematic support for people with Parkinson’s disease (PD) living at home. People with PD (PWP) quickly become excluded both due to the general effects of disability and age and also because of disabling symptoms peculiar to PD. In particular, people with PD suffer from periods of limited mobility or paralysis which have a severe effect on their physical and emotional health, leading to social exclusion. PD affects 2 in 1000 of the general population and is the most common neurological disorder after Alzheimer’s. People with PD become socially excluded due to a combination of many disabling symptoms such as lack of mobility, speech disorders, and emotional problems such as depression or lack of confidence. Two further problems faced by people with PD are lack of access to suitable neurologists needed to treat this complex disease and difficulties in travelling easily to clinics or hospitals.

A preceding IST project PARREHA (IST 1999 12552) demonstrated that the aforementioned symptoms, and therefore isolation, could be alleviated in suitable people with PD through a simple to use, wearable aid, ParkWalker. By targeting specific effects of PD, ParkWalker acts as a mobility aid, using tailored visual stimulation to dramatically increase mobility in suitable users. PARREHA found that this effect was dramatic and amounted to some subjects being able to walk and talk normally where before they displayed considerable disabilities. Small scale trials suggested the PARREHA prototype device was effective, acceptable in principle to users and had no side effects.

In May 2003 the PARREHA consortium formed ParkAid, a start-up company whose sole aim is to exploit ParkWalker and build a supporting service around it (ParkService). ParkService extended the PARREHA support to sources of exclusion not specific to PD by providing wireless home connectivity to specialised carers and also off-line services such as reminders to the user of their personal drug regime. ParkAid also developed ParkWalker from the PARREHA prototypes – concentrating on ease-of-use and comfort. ParkWalker, which recently took the commercial name of INDIGO (INDependent IGO), is based upon a small display which clips on to a normal pair of glasses. Visual stimulation is generated by a small portable device which can also wirelessly connect to a clinician when the user is at home.

We have found that the telematic aspect is the foundation of effective ParkService support for people with PD at home and addresses the associated problems of a lack of neurologists in the EU and the difficulty of travelling to them for people with PD. During PARREHA we researched the effectiveness of telemedicine and its applicability to PD and found great potential to “bring the clinician to the user’s home”. This aspect is very much linked, for people with PD, with the difficulty of reporting their degree of impairment at home during their visits to doctors. The main problem here is the largely variable nature of PD disability at different times of the day. It is commonly impossible for the patient to demonstrate to the doctor their most disabling symptoms. Two further aspects need to be taken into account: the natural “positive attitude” of the person with PD, concerning his/her condition when meeting the doctor, and the general difficulties of describing, in an objective way, symptoms and reactions to a (sometimes new) medical protocols. Parkservice aims at supporting people with PD and the medical community in tackling these problems, providing an effective, simple-to-use mean and objective means to report on conditions and reactions when at home by offering easy-to-use video recording functionalities.

The service is now ready to be tested in the field. This proposal brings together people with PD, clinicians, ParkAid and former members of PARREHA to pilot ParkService in Italy, Germany, UK and Greece. The objective is to use the feedback from pilots (i) to validate the prototype service with all user groups, (ii) to build a sound plan for business development and (iii) to refine and localise the prototype service across many member states.

The first service will be finalised and rolled out in the targeted countries in 2006.