Reliability of using foot-worn devices to measure gait parameters in people with Parkinson’s disease

2021 ◽  
pp. 1-8
Author(s):  
Ya-Yun Lee ◽  
Ming-Hao Li ◽  
Jer-Junn Luh ◽  
Chun-Hwei Tai

BACKGROUND: Recent advances in technology have warranted the use of wearable sensors to monitor gait and posture. However, the psychometric properties of using wearable devices to measure gait-related outcomes have not been fully established in patients with Parkinson’s disease (PD). OBJECTIVE: This study aimed to investigate the test-retest reliability of body-worn sensors for gait evaluation in people with PD. Additionally, the influence of disease severity on the reliability was determined. METHODS: Twenty individuals with PD were recruited. During the first evaluation, the participants wore inertial sensors on their shoes and walked along a walkway thrice at their comfortable walking speed. The participants were then required to return to the lab after 3–5 days to complete the second evaluation with the same study procedure. Test-retest reliability of gait-related outcomes were calculated. To determine whether the results would be affected by disease severity, reliability was re-calculated by subdividing the participants into early and mid-advanced stages of the disease. RESULTS: The results showed moderate to good reliability (ICC = 0.64–0.87) of the wearable sensors for gait assessment in the general population with PD. Subgroup analysis showed that the reliability was higher among patients at early stages (ICC = 0.71–0.97) compared to those at mid-advanced stages (ICC = 0.65–0.81) of PD. CONCLUSIONS: Wearable sensors could reliably measure gait parameters in people with PD, and the reliability was higher among individuals at early stages of the disease compared to those at mid-advanced stages. Absolute reliability values were calculated to act as references for future studies.

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Galina Stoyanova-Piroth ◽  
Ivan Milanov ◽  
Katerina Stambolieva

Abstract Background The purpose of the present study was to translate and cross-culturally adapt the King’s Parkinson’s Disease Pain Scale (KPPS) into Bulgarian and to investigate its psychometric properties in order to provide a validated Parkinson’s disease-specific pain instrument in Bulgarian language (KPPS-BG). Methods Translation into Bulgarian and a cultural adaptation were performed to obtain KPPS-BG. A total of 162 patients with idiopathic Parkinson’s disease were screened for pain using the complementary to the KPPS questionnaire – King’s Parkinson’s Disease Pain Questionnaire (KPPQ). KPPS-BG domain and total scores were calculated and internal consistency, construct validity and test-retest reliability were examined for 129 patients having one or more positive items in the KPPQ-BG. Results 79.6 % of the patients reported one or more types of pain. The most common type was musculoskeletal pain (83.7 %), followed by nocturnal pain (55.0 %), fluctuation-related pain (50.1 %), radicular pain (43.4 %), chronic pain (31.0 %), discoloration, edema/swelling (27.1 %) and, oro-facial pain (14.3 %). Mean KPPS-BG total score was 21.1 ± 17.3 SD. KPPS-BG showed a good reliability (Cronbach’s alpha 0.75). The test-retest reliability of the KPPS-BG was high and the intraclass correlation coefficient was 0.92, demonstrating а good repeatability. KPPS-BG total score was higher in patients with postural instability gait difficulty motor subtype, compared to tremor-dominant or indeterminate subtype. Significant positive correlations were found between KPPS-BG total score and modified H&Y, Movement Disorders Society Unified Parkinson’s Disease Rating Scale part III. Conclusions The KPPS-BG constitutes a reliable, comprehensive and useful tool for pain assessment in native Bulgarian patients with Parkinson’s disease.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Molood Behbahanipour ◽  
Maryam Peymani ◽  
Mehri Salari ◽  
Motahare-Sadat Hashemi ◽  
Mohammad Hossein Nasr-Esfahani ◽  
...  

Abstract MicroRNAs (miRNAs) have been reported to contribute to the pathophysiology of the Parkinson’s disease (PD), an age related-neurodegenerative disorder. The aim of present study was to compare the expression profiles of a new set of candidate miRNAs related to aging and cellular senescence in peripheral blood mononuclear cells (PBMCs) obtained from the PD patients with healthy controls and then in the early and advanced stages of the PD patients with their controls to clarify whether their expression was correlated with the disease severity. We have also proposed a consensus-based strategy to interpret the miRNAs expression data to gain a better insight into the molecular regulatory alterations during the incidence of PD. We evaluated the miRNA expression levels in the PBMCs obtained from 36 patients with PD and 16 healthy controls by the reverse transcription-quantitative real-time PCR and their performance to discriminate the PD patients from the healthy subjects assessed using the receiver operating characteristic curve analysis. Also, we applied our consensus and integration approach to construct a deregulated miRNA-based network in PD with the respective targets and transcription factors, and the enriched gene ontology and pathways using the enrichment analysis approach were obtained. There was a significant overexpression of miR-885 and miR-17 and the downregulation of miR-361 in the PD patients compared to the controls. The blood expression of miR-885 and miR-17 tended to increase along with the disease severity. On the other hand, the lower levels of miR-361 in the early stages of the PD patients, as compared to controls, and its higher levels in the advanced stages of PD patients, as compared to the early stages of the PD patients, were observed. Combination of all three miRNAs showed an appropriate value of AUC (0.985) to discriminate the PD patients from the healthy subjects. Also, the deregulated miRNAs were linked to the known PD pathways and the candidate related target genes were presented. We revealed 3 candidate biomarkers related to aging and cellular senescence for the first time in the patients with PD. Our in-silico analysis identified candidate target genes and TFs, including those related to neurodegeneration and PD. Overall, our findings provided novel insights into the probable age-regulatory mechanisms underlying PD and a rationale to further clarify the role of the identified miRNAs in the PD pathogenesis.


2021 ◽  
Author(s):  
Galina Stoyanova-Piroth ◽  
Ivan Milanov ◽  
Katerina Stambolieva

Abstract Introduction:The purpose of the present study was to translate and cross-culturally adapt the King's Parkinson's Disease Pain Scale (KPPS) into Bulgarian and to investigate its psychometric properties in order to provide a validated Parkinson’s disease-specific pain instrument in Bulgarian language (KPPS-BG).Methods:Translation into Bulgarian and a cultural adaptation were performed to obtain KPPS-BG. A total of 162 patients with idiopathic Parkinson’s disease were screened for pain using the complementary to the KPPS questionnaire-King’s Parkinson's Disease Pain Questionnaire (KPPQ). KPPS-BG domain and total scores were calculated and internal consistency, construct validity and test-retest reliability were examined for 129 patients having one or more positive items in the KPPQ-BG.Results:79.6% of the patients reported one or more types of pain. The most common type was musculoskeletal pain (83.7%), followed by nocturnal pain (55.0%), fluctuation-related pain (50.1%), radicular pain (43.4%), chronic pain (31.0%), discoloration, edema/swelling (27.1%) and, oro-facial pain (14.3%). Mean KPPS-BG total score was 21.1±17.3 SD. KPPS-BG showed a good reliability (Cronbach's alpha 0.75). The test-retest reliability of the KPPS-BG was high and the intraclass correlation coefficient was 0.92, demonstrating а good repeatability. KPPS-BG total score was higher in patients with postural instability gait difficulty motor subtype, compared to tremor-dominant or indeterminate subtype. Significant positive correlations were found between KPPS-BG total score and modified H&Y, Movement Disorders Society Unified Parkinson’s Disease Rating Scale part III.Conclusion:The KPPS-BG constitutes a reliable, comprehensive and useful tool for pain assessment in native Bulgarian patients with Parkinson’s disease.


Sensors ◽  
2020 ◽  
Vol 20 (11) ◽  
pp. 3216
Author(s):  
Daphne J. Geerse ◽  
Bert Coolen ◽  
Melvyn Roerdink

Microsoft’s HoloLens, a mixed-reality headset, provides, besides holograms, rich position data of the head, which can be used to quantify what the wearer is doing (e.g., walking) and to parameterize such acts (e.g., speed). The aim of the current study is to determine test-retest reliability, concurrent validity, and face validity of HoloLens 1 for quantifying spatiotemporal gait parameters. This was done in a group of 23 healthy young adults (mean age 21 years) walking at slow, comfortable, and fast speeds, as well as in a group of 24 people with Parkinson’s disease (mean age 67 years) walking at comfortable speed. Walking was concurrently measured with HoloLens 1 and a previously validated markerless reference motion-registration system. We comprehensively evaluated HoloLens 1 for parameterizing walking (i.e., walking speed, step length and cadence) in terms of test-retest reliability (i.e., consistency over repetitions) and concurrent validity (i.e., between-systems agreement), using the intraclass correlation coefficient (ICC) and Bland–Altman’s bias and limits of agreement. Test-retest reliability and between-systems agreement were excellent for walking speed (ICC ≥ 0.861), step length (ICC ≥ 0.884), and cadence (ICC ≥ 0.765), with narrower between-systems than over-repetitions limits of agreement. Face validity was demonstrated with significantly different walking speeds, step lengths and cadences over walking-speed conditions. To conclude, walking speed, step length, and cadence can be reliably and validly quantified from the position data of the wearable HoloLens 1 measurement system, not only for a broad range of speeds in healthy young adults, but also for self-selected comfortable speed in people with Parkinson’s disease.


2020 ◽  
Vol 79 ◽  
pp. 86-91
Author(s):  
Sergio Clavijo-Buendía ◽  
Francisco Molina-Rueda ◽  
Patricia Martín-Casas ◽  
Paulina Ortega-Bastidas ◽  
Esther Monge-Pereira ◽  
...  

2019 ◽  
Vol 71 ◽  
pp. 177-180
Author(s):  
Mira Ambrus ◽  
Jose A. Sanchez ◽  
Jose A Sanchez Miguel ◽  
Fernandez del-Olmo

PLoS ONE ◽  
2017 ◽  
Vol 12 (10) ◽  
pp. e0183989 ◽  
Author(s):  
Johannes C. M. Schlachetzki ◽  
Jens Barth ◽  
Franz Marxreiter ◽  
Julia Gossler ◽  
Zacharias Kohl ◽  
...  

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Zhuang Wu ◽  
Xu Jiang ◽  
Min Zhong ◽  
Bo Shen ◽  
Jun Zhu ◽  
...  

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.


2021 ◽  
Author(s):  
Maximilien Burq ◽  
Erin Rainaldi ◽  
King Chung Ho ◽  
Chen Chen ◽  
Bastiaan R Bloem ◽  
...  

Sensor-based remote monitoring could help us better track Parkinson's disease (PD) progression, and measure patients' response to putative disease-modifying therapeutic interventions. To be useful, the remotely-collected measurements should be valid, reliable and sensitive to change, and people with PD must engage with the technology. We developed a smartwatch-based active assessment that enables unsupervised measurement of motor signs of PD. 388 study participants with early-stage PD (Personalized Parkinson Project, 64% men, average age 63 years) wore a smartwatch for a median of 390 days, allowing for continuous passive monitoring. Participants performed unsupervised motor tasks both in the clinic (once) and remotely (twice weekly for one year). Dropout rate was 2% at the end of follow-up. Median wear-time was 21.1 hours/day, and 59% of per-protocol remote assessments were completed. In-clinic performance of the virtual exam verified that most participants correctly followed watch-based instructions. Analytical validation was established for in-clinic measurements, which showed moderate-to-strong correlations with consensus MDS-UPDRS Part III ratings for rest tremor (R=0.70), bradykinesia (R=-0.62), and gait (R=-0.46). Test-retest reliability of remote measurements, aggregated monthly, was good-to-excellent (ICC: 0.75 - 0.96). Remote measurements were sensitive to the known effects of dopaminergic medication (on vs off Cohen's d: 0.19 - 0.54). Of note, in-clinic assessments often did not reflect the patients' typical status at home. This demonstrates the feasibility of using smartwatch-based unsupervised active tests, and establishes the analytical validity of associated digital measurements. Weekly measurements can create a more complete picture of patient functioning by providing a real-life distribution of disease severity, as it fluctuates over time. Sensitivity to medication-induced change, together with the improvement in test-retest reliability from temporal aggregation implies that these methods could help reduce sample sizes needed to demonstrate a response to therapeutic intervention or disease progression.


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