scholarly journals Temporal organization of stride duration variability as a marker of gait instability in Parkinson's disease

2016 ◽  
Vol 48 (10) ◽  
pp. 865-871 ◽  
Author(s):  
T Warlop ◽  
C Detrembleur ◽  
B Bollens ◽  
G Stoquart ◽  
F Crevecoeur ◽  
...  
2020 ◽  
Vol 11 ◽  
Author(s):  
Alexis Lheureux ◽  
Thibault Warlop ◽  
Charline Cambier ◽  
Baptiste Chemin ◽  
Gaëtan Stoquart ◽  
...  

Parkinson’s Disease patients suffer from gait impairments such as reduced gait speed, shortened step length, and deterioration of the temporal organization of stride duration variability (i.e., breakdown in Long-Range Autocorrelations). The aim of this study was to compare the effects on Parkinson’s Disease patients’ gait of three Rhythmic Auditory Stimulations (RAS), each structured with a different rhythm variability (isochronous, random, and autocorrelated). Nine Parkinson’s Disease patients performed four walking conditions of 10–15 min each: Control Condition (CC), Isochronous RAS (IRAS), Random RAS (RRAS), and Autocorrelated RAS (ARAS). Accelerometers were used to assess gait speed, cadence, step length, temporal organization (i.e., Long-Range Autocorrelations computation), and magnitude (i.e., coefficient of variation) of stride duration variability on 512 gait cycles. Long-Range Autocorrelations were assessed using the evenly spaced averaged Detrended Fluctuation Analysis (α-DFA exponent). Spatiotemporal gait parameters and coefficient of variation were not modified by the RAS. Long-Range Autocorrelations were present in all patients during CC and ARAS although all RAS conditions altered them. The α-DFA exponents were significantly lower during IRAS and RRAS than during CC, exhibiting anti-correlations during IRAS in seven patients. α-DFA during ARAS was the closest to the α-DFA during CC and within normative data of healthy subjects. In conclusion, Isochronous RAS modify patients’ Long-Range Autocorrelations and the use of Autocorrelated RAS allows to maintain an acceptable level of Long-Range Autocorrelations for Parkinson’s Disease patients’ gait.


Sensors ◽  
2020 ◽  
Vol 20 (20) ◽  
pp. 5769 ◽  
Author(s):  
Vrutangkumar V. Shah ◽  
James McNames ◽  
Graham Harker ◽  
Martina Mancini ◽  
Patricia Carlson-Kuhta ◽  
...  

Although the use of wearable technology to characterize gait disorders in daily life is increasing, there is no consensus on which specific gait bout length should be used to characterize gait. Clinical trialists using daily life gait quality as study outcomes need to understand how gait bout length affects the sensitivity and specificity of measures to discriminate pathological gait as well as the reliability of gait measures across gait bout lengths. We investigated whether Parkinson’s disease (PD) affects how gait characteristics change as bout length changes, and how gait bout length affects the reliability and discriminative ability of gait measures to identify gait impairments in people with PD compared to neurotypical Old Adults (OA). We recruited 29 people with PD and 20 neurotypical OA of similar age for this study. Subjects wore 3 inertial sensors, one on each foot and one over the lumbar spine all day, for 7 days. To investigate which gait bout lengths should be included to extract gait measures, we determined the range of gait bout lengths available across all subjects. To investigate if the effect of bout length on each gait measure is similar or not between subjects with PD and OA, we used a growth curve analysis. For reliability and discriminative ability of each gait measure as a function of gait bout length, we used the intraclass correlation coefficient (ICC) and area under the curve (AUC), respectively. Ninety percent of subjects walked with a bout length of less than 53 strides during the week, and the majority (>50%) of gait bouts consisted of less than 12 strides. Although bout length affected all gait measures, the effects depended on the specific measure and sometimes differed for PD versus OA. Specifically, people with PD did not increase/decrease cadence and swing duration with bout length in the same way as OA. ICC and AUC characteristics tended to be larger for shorter than longer gait bouts. Our findings suggest that PD interferes with the scaling of cadence and swing duration with gait bout length. Whereas control subjects gradually increased cadence and decreased swing duration as bout length increased, participants with PD started with higher than normal cadence and shorter than normal stride duration for the smallest bouts, and cadence and stride duration changed little as bout length increased, so differences between PD and OA disappeared for the longer bout lengths. Gait measures extracted from shorter bouts are more common, more reliable, and more discriminative, suggesting that shorter gait bouts should be used to extract potential digital biomarkers for people with PD.


2010 ◽  
Vol 224 (2) ◽  
pp. 542-544 ◽  
Author(s):  
Jongil Lim ◽  
Manjit K. Sanghera ◽  
Olivier Darbin ◽  
R. Malcolm Stewart ◽  
Joseph Jankovic ◽  
...  

2021 ◽  
Vol 12 ◽  
Author(s):  
Alessia Putortì ◽  
Michele Corrado ◽  
Micol Avenali ◽  
Daniele Martinelli ◽  
Marta Allena ◽  
...  

Background: The sequence effect (SE), defined as a reduction in amplitude of repetitive movements, is a common clinical feature of Parkinson's disease (PD) and is supposed to be a major contributor to freezing of gait (FOG). During walking, SE manifests as a step-by-step reduction in step length when approaching a turning point or gait destination, resulting in the so-called destination sequence effect (dSE). Previous studies explored the therapeutic effects of several strategies on SE, but none of them evaluated the role of an intensive rehabilitative program.Objectives: Here we aim to study the effects of a 4-week rehabilitative program on dSE in patients with PD with and without FOG.Methods: Forty-three patients (30 males, 70.6 ± 7.5 years old) with idiopathic PD were enrolled. The subjects were divided into two groups: patients with (PD + FOG, n = 23) and without FOG (PD – FOG, n = 20). All patients underwent a standardized 4-week intensive rehabilitation in-hospital program. At hospital admission (T0) and discharge (T1), all subjects were evaluated with an inertial gait analysis for dSE recording.Results: At T0, the dSE was more negative in the PD + FOG group (−0.80 ± 0.6) when compared to the PD – FOG group (−0.39 ± 0.3) (p = 0.007), even when controlling for several clinical and demographic features. At T1, the dSE was reduced in the overall study population (p = 0.001), with a more pronounced improvement in the PD + FOG group (T0: −0.80 ± 0.6; T1: −0.23 ± 0.4) when compared to the PD – FOG group (T0: −0.39 ± 0.3; T1: −0.22 ± 0.5) (p = 0.012). At T1, we described in the overall study population an improvement in speed, cadence, stride duration, and stride length (p = 0.001 for all variables).Conclusions: dSE is a core feature of PD gait dysfunction, specifically in patients with FOG. A 4-week intensive rehabilitative program improved dSE in PD patients, exerting a more notable beneficial effect in the PD + FOG group.


Author(s):  
Thibault Warlop ◽  
Christine Detrembleur ◽  
Maïté Buxes Lopez ◽  
Gaëtan Stoquart ◽  
Thierry Lejeune ◽  
...  

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e8835 ◽  
Author(s):  
Slávka Vítečková ◽  
Hana Horáková ◽  
Kamila Poláková ◽  
Radim Krupička ◽  
Evžen Růžička ◽  
...  

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.


Sensors ◽  
2021 ◽  
Vol 21 (10) ◽  
pp. 3449
Author(s):  
Stefano Filippo Castiglia ◽  
Antonella Tatarelli ◽  
Dante Trabassi ◽  
Roberto De Icco ◽  
Valentina Grillo ◽  
...  

The aims of this study were to assess the ability of 16 gait indices to identify gait instability and recurrent fallers in persons with Parkinson’s disease (pwPD), regardless of age and gait speed, and to investigate their correlation with clinical and kinematic variables. The trunk acceleration patterns were acquired during the gait of 55 pwPD and 55 age-and-speed matched healthy subjects using an inertial measurement unit. We calculated the harmonic ratios (HR), percent recurrence, and percent determinism (RQAdet), coefficient of variation, normalized jerk score, and the largest Lyapunov exponent for each participant. A value of ≤1.50 for the HR in the antero-posterior direction discriminated between pwPD at Hoehn and Yahr (HY) stage 3 and healthy subjects with a 67% probability, between pwPD at HY 3 and pwPD at lower HY stages with a 73% probability, and it characterized recurrent fallers with a 77% probability. Additionally, HR in the antero-posterior direction was correlated with pelvic obliquity and rotation. RQAdet in the antero-posterior direction discriminated between pwPD and healthy subjects with 67% probability, regardless of the HY stage, and was correlated with stride duration and cadence. Therefore, HR and RQAdet in the antero-posterior direction can both be used as age- and-speed-independent markers of gait instability.


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