scholarly journals Atypical Gait Cycles in Parkinson’s Disease

Sensors ◽  
2021 ◽  
Vol 21 (15) ◽  
pp. 5079
Author(s):  
Marco Ghislieri ◽  
Valentina Agostini ◽  
Laura Rizzi ◽  
Marco Knaflitz ◽  
Michele Lanotte
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Score ◽  
Heel Strike ◽  
Flat Foot ◽  
Double Support ◽  
Total Percentage ◽  
Straight Line ◽  
Gait Parameters ◽  
Gait Phase

It is important to find objective biomarkers for evaluating gait in Parkinson’s Disease (PD), especially related to the foot and lower leg segments. Foot-switch signals, analyzed through Statistical Gait Analysis (SGA), allow the foot-floor contact sequence to be characterized during a walking session lasting five-minutes, which includes turnings. Gait parameters were compared between 20 PD patients and 20 age-matched controls. PDs showed similar straight-line speed, cadence, and double-support compared to controls, as well as typical gait-phase durations, except for a small decrease in the flat-foot contact duration (−4% of the gait cycle, p = 0.04). However, they showed a significant increase in atypical gait cycles (+42%, p = 0.006), during both walking straight and turning. A forefoot strike, instead of a “normal” heel strike, characterized the large majority of PD’s atypical cycles, whose total percentage was 25.4% on the most-affected and 15.5% on the least-affected side. Moreover, we found a strong correlation between the atypical cycles and the motor clinical score UPDRS-III (r = 0.91, p = 0.002), in the subset of PD patients showing an abnormal number of atypical cycles, while we found a moderate correlation (r = 0.60, p = 0.005), considering the whole PD population. Atypical cycles have proved to be a valid biomarker to quantify subtle gait dysfunctions in PD patients.

scholarly journals Quantitative assessment of gait parameters in people with Parkinson's disease in laboratory and clinical setting: Are the measures interchangeable?

2018 ◽  
Vol 10 (2) ◽  
Author(s):  
Massimiliano Pau ◽  
Federica Corona ◽  
Roberta Pili ◽  
Carlo Casula ◽  
Marco Guicciardi ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Setting ◽  
Stride Length ◽  
Experimental Setting ◽  
Optoelectronic System ◽  
Double Support ◽  
Gait Parameters ◽  
Spatio Temporal ◽  
Wearable Accelerometers

This study aimed to investigate possible differences in spatio-temporal gait parameters of people with Parkinson’s Disease (pwPD) when they are tested either in laboratory using 3D Gait Analysis or in a clinical setting using wearable accelerometers. The main spatio-temporal gait parameters (speed, cadence, stride length, stance, swing and double support duration) of 31 pwPD were acquired: i) using a wearable accelerometer in a clinical setting while wearing shoes (ISS); ii) same as condition 1, but barefoot (ISB); iii) using an optoelectronic system (OES) undressed and barefoot. While no significant differences were found for cadence, stance, swing and double support duration, the experimental setting affected speed and stride length that decreased (by 17% and 12% respectively, P<0.005) when passing from the clinical (ISS) to the laboratory (OES) setting. These results suggest that gait assessment should be always performed in the same conditions to avoid errors, which may lead to inaccurate patient’s evaluations.

scholarly journals Mild Gait Impairment and Its Potential Diagnostic Value in Patients with Early-Stage Parkinson’s Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Zhuang Wu ◽  
Xu Jiang ◽  
Min Zhong ◽  
Bo Shen ◽  
Jun Zhu ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Early Stage ◽  
Wearable Sensors ◽  
Diagnostic Value ◽  
Gait Pattern ◽  
Heel Strike ◽  
Phase Time ◽  
Gait Parameters ◽  
Gait Impairments

Background and Purpose. Patients with early-stage Parkinson’s disease (PD) have gait impairments, and gait parameters may act as diagnostic biomarkers. We aimed to (1) comprehensively quantify gait impairments in early-stage PD and (2) evaluate the diagnostic value of gait parameters for early-stage PD. Methods. 32 patients with early-stage PD and 30 healthy control subjects (HC) were enrolled. All participants completed the instrumented stand and walk test, and gait data was collected using wearable sensors. Results. We observed increased variability of stride length (SL) ( P < 0.001 ), stance phase time (StPT) ( P = 0.004 ), and swing phase time (SwPT) ( P = 0.011 ) in PD. There were decreased heel strike (HS) ( P = 0.001 ), range of motion of knee ( P = 0.036 ), and hip joints ( P < 0.001 ) in PD. In symmetry analysis, no difference was found in any of the assessed gait parameters between HC and PD. Only total steps ( AUC = 0.763 , P < 0.001 ), SL ( AUC = 0.701 , P = 0.007 ), SL variability ( AUC = 0.769 , P < 0.001 ), StPT variability ( AUC = 0.712 , P = 0.004 ), and SwPT variability ( AUC = 0.688 , P = 0.011 ) had potential diagnostic value. When these five gait parameters were combined, the predictive power was found to increase, with the highest AUC of 0.802 ( P < 0.001 ). Conclusions. Patients with early-stage PD presented increased variability but still symmetrical gait pattern. Some specific gait parameters can be applied to diagnose early-stage PD which may increase diagnosis accuracy. Our findings are helpful to improve patient’s quality of life.

scholarly journals Which Gait Parameters and Walking Patterns Show the Significant Differences Between Parkinson’s Disease and Healthy Participants?

Biosensors ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. 59 ◽  
Author(s):  
Keloth ◽  
Viswanathan ◽  
Jelfs ◽  
Arjunan ◽  
Raghav ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Statistical Significance ◽  
Double Support ◽  
Gait Parameters ◽  
Stride Interval ◽  
Measurement Units ◽  
Mean And Variance ◽  
The Difference ◽  
And Control

This study investigated the difference in the gait of patients with Parkinson’s disease (PD), age-matched controls and young controls during three walking patterns. Experiments were conducted with 24 PD, 24 age-matched controls and 24 young controls, and four gait intervals were measured using inertial measurement units (IMU). Group differences between the mean and variance of the gait parameters (stride interval, stance interval, swing interval and double support interval) for the three groups were calculated and statistical significance was tested. The results showed that the variance in each of the four gait parameters of PD patients was significantly higher compared with the controls, irrespective of the three walking patterns. This study showed that the variance of any of the gait interval parameters obtained using IMU during any of the walking patterns could be used to differentiate between the gait of PD and control people.

scholarly journals Validation of a Sensor-Based Gait Analysis System with a Gold-Standard Motion Capture System in Patients with Parkinson’s Disease

Sensors ◽  
2021 ◽  
Vol 21 (22) ◽  
pp. 7680
Author(s):  
Verena Jakob ◽  
Arne Küderle ◽  
Felix Kluge ◽  
Jochen Klucken ◽  
Bjoern M. Eskofier ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Gait Analysis ◽  
Motion Capture ◽  
Gold Standard ◽  
Wearable Sensors ◽  
Heel Strike ◽  
Motion Capture System ◽  
Gait Parameters ◽  
Analysis System

Digital technologies provide the opportunity to analyze gait patterns in patients with Parkinson’s Disease using wearable sensors in clinical settings and a home environment. Confirming the technical validity of inertial sensors with a 3D motion capture system is a necessary step for the clinical application of sensor-based gait analysis. Therefore, the objective of this study was to compare gait parameters measured by a mobile sensor-based gait analysis system and a motion capture system as the gold standard. Gait parameters of 37 patients were compared between both systems after performing a standardized 5 × 10 m walking test by reliability analysis using intra-class correlation and Bland–Altman plots. Additionally, gait parameters of an age-matched healthy control group (n = 14) were compared to the Parkinson cohort. Gait parameters representing bradykinesia and short steps showed excellent reliability (ICC > 0.96). Shuffling gait parameters reached ICC > 0.82. In a stridewise synchronization, no differences were observed for gait speed, stride length, stride time, relative stance and swing time (p > 0.05). In contrast, heel strike, toe off and toe clearance significantly differed between both systems (p < 0.01). Both gait analysis systems distinguish Parkinson patients from controls. Our results indicate that wearable sensors generate valid gait parameters compared to the motion capture system and can consequently be used for clinically relevant gait recordings in flexible environments.

scholarly journals Variance of the Gait Parameters and Fraction of Double-Support Interval for Determining the Severity of Parkinson’s Disease

2020 ◽  
Vol 10 (2) ◽  
pp. 577
Author(s):  
Sana M. Keloth ◽  
Sridhar P. Arjunan ◽  
Dinesh K. Kumar
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Statistical Significance ◽  
Mean Values ◽  
Support Interval ◽  
Double Support ◽  
Gait Parameters ◽  
Significant Difference ◽  
The Mean ◽  
The Difference

The aim of this study was to determine the gait features that are most suitable for the quantified assessment of the severity of Parkinson’s disease (PD). This study computed the mean and variance of the four phases of gait intervals, i.e., stride, swing, stance and double-support intervals, and lateral difference to determine the difference between three groups, i.e., control subjects and PD patients with two severity levels (early and advanced stage) of the disease, PD1 and PD2. Data from 31 subjects were used in the study. The data were obtained from the public database (16 control healthy subjects, 6 Parkinson’s disease patients with early stages, and 9 Parkinson’s disease patients with advanced stages based on the Hoehn and Yahr scale). The main outcome measure of the study was the group difference of the four gait interval parameters and the statistical significance of this difference. The results show that there was a significant increase in the variance of the four gait intervals with the severity of the disease. However, there was no significant difference in the mean values between the three groups. It was also observed that the fraction corresponding to the double-support interval was significantly higher for PD patients. This study has shown that the variance of the gait parameters and the fraction of double-support interval are associated with the severity of PD and may be suitable measures for a quantified evaluation of the disease.

scholarly journals Gait parameters of Parkinson’s disease compared with healthy controls: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ana Paula Janner Zanardi ◽  
Edson Soares da Silva ◽  
Rochelle Rocha Costa ◽  
Elren Passos-Monteiro ◽  
Ivan Oliveira dos Santos ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Stride Length ◽  
Walking Speed ◽  
Meta Analysis ◽  
The Self ◽  
Double Support ◽  
Swing Time ◽  
Gait Parameters ◽  
Healthy Control

AbstractWe systematically reviewed observational and clinical trials (baseline) studies examining differences in gait parameters between Parkinson’s disease (PD) in on-medication state and healthy control. Four electronic databases were searched (November-2018 and updated in October-2020). Independent researchers identified studies that evaluated gait parameters measured quantitatively during self-selected walking speed. Risk of bias was assessed using an instrument proposed by Downs and Black (1998). Pooled effects were reported as standardized mean differences and 95% confidence intervals using a random-effects model. A total of 72 studies involving 3027 participants (1510 with PD and 1517 health control) met the inclusion criteria. The self-selected walking speed, stride length, swing time and hip excursion were reduced in people with PD compared with healthy control. Additionally, PD subjects presented higher cadence and double support time. Although with a smaller difference for treadmill, walking speed is reduced both on treadmill (.13 m s−1) and on overground (.17 m s−1) in PD. The self-select walking speed, stride length, cadence, double support, swing time and sagittal hip angle were altered in people with PD compared with healthy control. The precise determination of these modifications will be beneficial in determining which intervention elements are most critical in bringing about positive, clinically meaningful changes in individuals with PD (PROSPERO protocol CRD42018113042).

scholarly journals Agreement between the GAITRite® System and the Wearable Sensor BTS G-Walk® for measurement of gait parameters in healthy adults and Parkinson’s disease patients

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e8835 ◽  
Author(s):  
Slávka Vítečková ◽  
Hana Horáková ◽  
Kamila Poláková ◽  
Radim Krupička ◽  
Evžen Růžička ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Systematic Error ◽  
Stride Length ◽  
Walking Speed ◽  
Inertial Sensor ◽  
Pressure Sensors ◽  
Double Support ◽  
Gait Parameters ◽  
Stride Duration

Background Nowadays, the most widely used types of wearable sensors in gait analysis are inertial sensors. The aim of the study was to assess the agreement between two different systems for measuring gait parameters (inertial sensor vs. electronic walkway) on healthy control subjects (HC) and patients with Parkinson’s disease (PD). Methods Forty healthy volunteers (26 men, 14 women, mean age 58.7 ± 7.7 years) participated in the study and 24 PD patients (19 men, five women, mean age 62.7 ± 9.8 years). Each participant walked across an electronic walkway, GAITRite, with embedded pressure sensors at their preferred walking speed. Concurrently a G-Walk sensor was attached with a semi-elastic belt to the L5 spinal segment of the subject. Walking speed, cadence, stride duration, stride length, stance, swing, single support and double support phase values were compared between both systems. Results The Passing-Bablock regression slope line manifested the values closest to 1.00 for cadence and stride duration (0.99 ≤ 1.00) in both groups. The slope of other parameters varied between 0.26 (double support duration in PD) and 1.74 (duration of single support for HC). The mean square error confirmed the best fit of the regression line for speed, stride duration and stride length. The y-intercepts showed higher systematic error in PD than HC for speed, stance, swing, and single support phases. Conclusions The final results of this study indicate that the G-Walk system can be used for evaluating the gait characteristics of the healthy subjects as well as the PD patients. However, the duration of the gait cycle phases should be used with caution due to the presence of a systematic error.

scholarly journals Validation of IMU-based gait event detection during curved walking and turning in older adults and Parkinson’s Disease patients

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Robbin Romijnders ◽  
Elke Warmerdam ◽  
Clint Hansen ◽  
Julius Welzel ◽  
Gerhard Schmidt ◽  
...  
Keyword(s):  
Older Adults ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Daily Life ◽  
Neurological Diseases ◽  
Detection Performance ◽  
Measurement Unit ◽  
Straight Line ◽  
Optical Motion ◽  
Task Conditions

Abstract Background Identification of individual gait events is essential for clinical gait analysis, because it can be used for diagnostic purposes or tracking disease progression in neurological diseases such as Parkinson’s disease. Previous research has shown that gait events can be detected from a shank-mounted inertial measurement unit (IMU), however detection performance was often evaluated only from straight-line walking. For use in daily life, the detection performance needs to be evaluated in curved walking and turning as well as in single-task and dual-task conditions. Methods Participants (older adults, people with Parkinson’s disease, or people who had suffered from a stroke) performed three different walking trials: (1) straight-line walking, (2) slalom walking, (3) Stroop-and-walk trial. An optical motion capture system was used a reference system. Markers were attached to the heel and toe regions of the shoe, and participants wore IMUs on the lateral sides of both shanks. The angular velocity of the shank IMUs was used to detect instances of initial foot contact (IC) and final foot contact (FC), which were compared to reference values obtained from the marker trajectories. Results The detection method showed high recall, precision and F1 scores in different populations for both initial contacts and final contacts during straight-line walking (IC: recall $$=$$ = 100%, precision $$=$$ = 100%, F1 score $$=$$ = 100%; FC: recall $$=$$ = 100%, precision $$=$$ = 100%, F1 score $$=$$ = 100%), slalom walking (IC: recall $$=$$ = 100%, precision $$\ge$$ ≥ 99%, F1 score $$=$$ = 100%; FC: recall $$=$$ = 100%, precision $$\ge$$ ≥ 99%, F1 score $$=$$ = 100%), and turning (IC: recall $$\ge$$ ≥ 85%, precision $$\ge$$ ≥ 95%, F1 score $$\ge$$ ≥ 91%; FC: recall $$\ge$$ ≥ 84%, precision $$\ge$$ ≥ 95%, F1 score $$\ge$$ ≥ 89%). Conclusions Shank-mounted IMUs can be used to detect gait events during straight-line walking, slalom walking and turning. However, more false events were observed during turning and more events were missed during turning. For use in daily life we recommend identifying turning before extracting temporal gait parameters from identified gait events.

scholarly journals Gait phase triggered deep brain stimulation in Parkinson’s disease

2021 ◽  
Vol 14 (2) ◽  
pp. 420-422
Author(s):  
Kenneth H. Louie ◽  
Chiahao Lu ◽  
Tessneem Abdallah ◽  
Jacob C. Guzior ◽  
Emily Twedell ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Gait Phase ◽  
Deep Brain
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