Potential markers of progression in idiopathic Parkinson’s disease derived from assessment of circular gait with a single body-fixed-sensor: A 5 year longitudinal study

M. Encarna Micó-Amigo*, Idsart Kingma, Sebastian Heinzel, Sietse M. Rispens, Tanja Heger, Susanne Nussbaum, Rob C. van Lummel, Daniela Berg, Walter Maetzler, Jaap H. van Dieën

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


Background and Aim: Development of objective, reliable and easy-to-use methods to obtain progression markers of Parkinson’s disease (PD) is required to evaluate interventions and to advance research in PD. This study aimed to provide quantitative markers of progression in idiopathic PD from the assessment of circular gait (walking in circles) with a single body-fixed inertial sensor placed on the lower back. Methods: The assessments were performed every 6 months over a (up to) 5 years period for 22 patients in early-stage PD, 27 patients in middle-stage PD and 25 healthy controls (HC). Longitudinal changes of 24 gait features extracted from accelerometry were compared between PD groups and HCs with generalized estimating equations (GEE) analysis, accounting for gait speed, age and levodopa medication state confounders when required. Results: Five gait features indicated progressive worsening in early stages of PD: number of steps, total duration and harmonic ratios calculated from vertical (VT), medio-lateral (ML), and anterior-posterior (AP) accelerations. For middle stages of PD, three gait features were identified as potential progression markers: stride time variability, and stride regularity from VT and AP acceleration. Conclusion: Faster progressive worsening of gait features in early and middle stages of PD relative to healthy controls over 5 years confirmed the potential of accelerometry-based assessments as quantitative progression markers in early and middle stages of the disease. The difference in significant parameters between both PD groups suggests that distinct domains of gait deteriorate in these PD stages. We conclude that instrumented circular walking assessment is a practical and useful tool in the assessment of PD progression that may have relevant potential to be implemented in clinical trials and even clinical routine, particularly in a developing digital era.

Original languageEnglish
Article number59
Pages (from-to)1-14
Number of pages14
JournalFrontiers in Human Neuroscience
Issue numberFEBRUARY
Publication statusPublished - 19 Feb 2019


We thank all the participants of this study for their contribution. Moreover, we thank Martijn Heijmans, for his advice in statistical analysis and Aner Weiss and Satadal Dutta for their advice in signals processing. Funding. On behalf of all authors the corresponding author states that the MODEP study received precompetitive support by Solvay Pharmaceuticals, Teva Pharmaceutical Industries Ltd. and Lundbeck. Moreover, this work was supported by the Moving Beyond Industrial Academic Training Network, funded through the European Community‘s Seventh Framework Program, Marie Curie Actions FP7/2012 (Grant Agreement No. 316639). The funders were not involved in study design, data collection and analysis, decision to publish and preparation of the manuscript.

FundersFunder number
European Community‘s Seventh Framework Program
Marie Curie Actions FP7/2012
Teva Pharmaceutical Industries
Seventh Framework Programme316639
Solvay Pharmaceuticals


    • Accelerometry
    • Gait analysis
    • Movement disorders
    • Parkinson’s disease
    • Walking


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