Queen Mary University of London

Parkinson's disease (PD) is a condition in which parts of the brain become progressively damaged over many years. The main symptoms of PD disease are involuntary shaking of parts of the body (tremor), stiffness and slow movement. However, research shows that people can also experience a range of other symptoms, such as smell loss (hyposmia), sleep problems, constipation, depression and anxiety. These features can be mild and generally occur many years before a person notices a change to their movement.
Currently, there is no proven way of preventing PD. However, it is possible that regular exercise might keep the symptoms at bay for a number of years. This is because exercise can help protect brain cells from damage. Regular movement also helps our brains adapt (or 'rewire) if one part becomes affected by disease. This could mean living symptom-free for longer.
Researchers in The Netherlands have developed a smartphone app, known as the 'Slow-SPEED' app. It works by encouraging people to gradually increase their exercise level over a number of years. Hopefully, this will promote long-term changes to a person's lifestyle. However, the app has not yet been tested in a large enough group of people to say for certain whether it works.
Queen Mary University of London is testing the Slow-SPEED app in a group of participants that have been recently diagnosed with PD. The app is also being tested in people who do not have PD, but may be at an increased risk of developing it in the future.
Three groups of people are being recruited:
1. Diagnosed with PD within the last three years
2. A reduced sense of smell (known as 'hyposmia' or 'anosmia'), diagnosed by a smell test
3. A condition called REM-sleep behavioural disorder, diagnosed at a sleep clinic
Study participants will be asked to use the Slow-SPEED app for 3 years. During this time, information about their movement will be collected by a smartwatch ('Fitbit'), which is linked to the app in their smartphone. Periodically, health information will be collected through questionnaires, movement tests (e.g. tapping tests on a smartphone) and smell tests. Some participants will be invited to have blood tests, but this is not necessary for everyone. Most of these tests can be performed at home. In addition, there is an in-person visit at the beginning and end of study. Combined, these tests should give a comprehensive picture of how exercise might impact the early features of PD.
Aims of the study:
* To test whether the Slow-SPEED app can successfully motivate people to increase their exercise level over several years.
* To determine whether exercise can prevent (or reduce) the early, subtle changes associated with PD.

The main goal of this study is to see if a wearable device can reliably track changes in lactate levels in the body. We'll compare the device's readings to standard blood tests to ensure accuracy. If successful, this device could reduce the need for frequent blood tests during surgery recovery, making patients more comfortable. It might also be useful in emergency rooms for quick diagnoses, especially for patients with chest pain.
This study will take place at Barts Hospital with patients having planned coronary artery bypass graft (CABG) and/or replacement valve surgery. Participants will wear the sensors on their upper arm, during which the sensors will continuously measure lactate levels. Participants will also have hourly blood samples taken.
In the future, the data from this new device will be used to train computer algorithms to provide quick responses that help manage a patient's condition, improving future medical care and technology.