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 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 Association of Gait Characteristics and Depression in Patients with Parkinson’s Disease Assessed in Goal-Directed Locomotion Task

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Péter Kincses ◽  
Norbert Kovács ◽  
Kázmér Karádi ◽  
Ádám Feldmann ◽  
Krisztina Dorn ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Stride Length ◽  
Gait Pattern ◽  
Exact Nature ◽  
Gait Characteristics ◽  
Gait Parameters ◽  
Healthy Control ◽  
Affective Variables ◽  
Affective Disturbances

Introduction.In the genesis of Parkinson’s disease (PD) clinical phenomenology the exact nature of the association between bradykinesia and affective variables is unclear. In the present study, we analyzed the gait characteristics and level of depression in PD and healthy volunteers.Methods.Patients with PD (n=48) and healthy controls (n=52) were recruited for the present study. Walking speed, stride length, and cadence were compared between groups while participants completed a goal-directed locomotion task under visually controlled (VC) and visually noncontrolled conditions (VnC).Results.Significantly higher depression scores were found in PD comparing to healthy control groups. In PD, depression was associated with gait components in the VC wherein the place of the target was visible. In contrast, in healthy subjects the depression was associated with gait components in VnC wherein the location and image of the target were memorized and recalled. In patients with PD and depression, the visually deprived multitask augments the rate of cadence and diminishes stride length, while velocity remains relatively unchanged. The depression associated with gait characteristics as a comorbid affective factor in PD, and that impairs the coherence of gait pattern.Conclusion.The relationship between depression and gait parameters appears to indicate that PD not only is a neurological disease but also incorporates affective disturbances that associate with the regulation of gait characteristics.

Differential Gait Decline in Parkinson’s Disease Enhances Discrimination of Gait Freezers from Non-Freezers

2020 ◽  
Vol 10 (4) ◽  
pp. 1657-1673
Author(s):  
Aliyah Glover ◽  
Lakshmi Pillai ◽  
Shannon Doerhoff ◽  
Tuhin Virmani
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Regression Model ◽  
Stride Length ◽  
Freezing Of Gait ◽  
Binary Regression ◽  
Levodopa Dose ◽  
Gait Parameters ◽  
Neuroprotective Strategies ◽  
Change In Mean

Background: Freezing of gait (FOG) is a debilitating feature of Parkinson’s disease (PD) for which treatments are limited. To develop neuroprotective strategies, determining whether disease progression is different in phenotypic variants of PD is essential. Objective: To determine if freezers have a faster decline in spatiotemporal gait parameters. Methods: Subjects were enrolled in a longitudinal study and assessed every 3– 6 months. Continuous gait in the levodopa ON-state was collected using a gait mat (Protokinetics). The slope of change/year in spatiotemporal gait parameters was calculated. Results: 26 freezers, 31 non-freezers, and 25 controls completed an average of 6 visits over 28 months. Freezers had a faster decline in mean stride-length, stride-velocity, swing-%, single-support-%, and variability in single-support-% compared to non-freezers (p < 0.05). Gait decline was not correlated with initial levodopa dose, duration of levodopa therapy, change in levodopa dose or change in Montreal Cognitive Assessment scores (p > 0.25). Gait progression parameters were required to obtain 95% accuracy in categorizing freezers and non-freezers groups in a forward step-wise binary regression model. Change in mean stride-length, mean stride-width, and swing-% variability along with initial foot-length variability, mean swing-% and apathy scores were significant variables in the model. Conclusion: Freezers had a faster temporal decline in objectively quantified gait, and inclusion of longitudinal gait changes in a binary regression model greatly increased categorization accuracy. Levodopa dosing, cognitive decline and disease severity were not significant in our model. Early detection of this differential decline may help define freezing prone groups for testing putative treatments.

scholarly journals Gait Characteristics under Imposed Challenge Speed Conditions in Patients with Parkinson’s Disease During Overground Walking

Sensors ◽  
2020 ◽  
Vol 20 (7) ◽  
pp. 2132 ◽  
Author(s):  
Myeounggon Lee ◽  
Changhong Youm ◽  
Byungjoo Noh ◽  
Hwayoung Park ◽  
Sang-Myung Cheon
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Stride Length ◽  
Motor Symptoms ◽  
Overground Walking ◽  
Gait Stability ◽  
Double Support ◽  
Gait Characteristics ◽  
Measurement Units ◽  
Walking Tests

Evaluating gait stability at slower or faster speeds and self-preferred speeds based on continuous steps may assist in determining the severity of motor symptoms in Parkinson’s disease (PD) patients. This study aimed to investigate the gait ability at imposed speed conditions in PD patients during overground walking. Overall, 74 PD patients and 52 age-matched healthy controls were recruited. Levodopa was administered to patients in the PD group, and all participants completed imposed slower, preferred, and faster speed walking tests along a straight 15-m walkway wearing shoe-type inertial measurement units. Reliability of the slower and faster conditions between the estimated and measured speeds indicated excellent agreement for PD patients and controls. PD patients demonstrated higher gait asymmetry (GA) and coefficient of variance (CV) for stride length and stance phase than the controls at slower speeds and higher CVs for phases for single support, double support, and stance. CV of the double support phase could distinguish between PD patients and controls at faster speeds. The GA and CVs of stride length and phase-related variables were associated with motor symptoms in PD patients. Speed conditions should be considered during gait analysis. Gait variability could evaluate the severity of motor symptoms in PD patients.

scholarly journals Clinical Relevance of Standardized Mobile Gait Tests. Reliability Analysis Between Gait Recordings at Hospital and Home in Parkinson’s Disease: A Pilot Study

2020 ◽  
Vol 10 (4) ◽  
pp. 1763-1773
Author(s):  
Heiko Gaßner ◽  
Philipp Sanders ◽  
Alisa Dietrich ◽  
Franz Marxreiter ◽  
Bjoern M. Eskofier ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Pilot Study ◽  
Reliability Analysis ◽  
Clinical Relevance ◽  
Stride Length ◽  
Standardized Test ◽  
Gait Velocity ◽  
Gait Parameters ◽  
At Home

Background: Gait impairments in Parkinson’s disease (PD) are quantified using inertial sensors under standardized test settings in the hospital. Recent studies focused on the assessment of free-living gait in PD. However, the clinical relevance of standardized gait tests recorded at the patient’s home is unclear. Objective: To evaluate the reliability of supervised, standardized sensor-based gait outcomes at home compared to the hospital. Methods: Patients with PD (n = 20) were rated by a trained investigator using the Unified Parkinson Disease Rating Scale (UPDRS-III). Gait tests included a standardized 4×10 m walk test and the Timed Up and Go Test (TUG). Tests were performed in the hospital (HOSPITAL) and at patients’ home (HOME), and controlled for investigator, time of the day, and medication. Statistics included reliability analysis using Intra-Class correlations and Bland-Altman plots. Results: UPDRS-III and TUG were comparable between HOSPITAL and HOME. PD patients’ gait at HOME was slower (gait velocity Δ= –0.07±0.11 m/s, –6.1%), strides were shorter (stride length Δ= –9.2±9.4 cm; –7.3%), and shuffling of gait was more present (maximum toe-clearance Δ= –0.7±2.5 cm; –8.8%). Particularly, narrow walkways (<85 cm) resulted in a significant reduction of gait velocity at home. Reliability analysis (HOSPITAL vs. HOME) revealed excellent ICC coefficients for UPDRS-III (0.950, p < 0.000) and gait parameters (e.g., stride length: 0.898, p < 0.000; gait velocity: 0.914, p < 0.000; stance time: 0.922, p < 0.000; stride time: 0.907, p < 0.000). Conclusion: This pilot study underlined the clinical relevance of gait parameters by showing excellent reliability for supervised, standardized gait tests at HOSPITAL and HOME, even though gait parameters were different between test conditions.

Periventricular White Matter Lesions Influence Gait Functions in Parkinson’s Disease

2019 ◽  
Vol 81 (3-4) ◽  
pp. 120-127 ◽  
Author(s):  
Kunio Toda ◽  
Mutsumi Iijima ◽  
Kazuo Kitagawa
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
White Matter ◽  
Frontal Lobe ◽  
Stride Length ◽  
Walking Speed ◽  
White Matter Lesions ◽  
Periventricular White Matter ◽  
Gait Parameters ◽  
Calculation Task

Objective: We quantitatively evaluated the gait of Parkinson’s disease (PD) patients over a 10-m course during normal walking and during dual-task walking while performing a calculation task, and clarified which parts of white matter lesions (WML) influence gait in PD patients. Methods: Gait parameters, including walking speed, gait cycle, stride length, and left-right instability, were measured in 64 PD patients and 20 controls who walked 10 m with normal gait and as they were performing a calculation task. WML on magnetic resonance imaging (MRI) of PD patients were scored according to Scheltens’ criteria, and associations with gait parameters were investigated. Results: Compared to controls, the PD group showed decreased walking speed and narrowed stride (p < 0.05), and the stride length and step time coefficient of variation changed significantly during the calculation task (p < 0.001). Frontal lobe functions correlated positively with walking speed and stride during the calculation task in patients with PD (p < 0.05). The total score for periventricular hyperintensity (PVH) on MRI correlated with walking speed and stride (p < 0.01). Multiple regression analysis revealed significant correlations between walking speed and frontal cap of PVH, and between stride and occipital cap (p < 0.05). Conclusion: Gait of PD patients deteriorated not only due to motor dysfunction but also due to mental burden in association with frontal lobe function and periventricular lesions of cerebral white matter.

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 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.

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