Feasibility and Reliability of a Monitoring App for Chronic Inflammatory Neuropathies

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.