TY - JOUR
T1 - Potential markers of progression in idiopathic Parkinson’s disease derived from assessment of circular gait with a single body-fixed-sensor
T2 - A 5 year longitudinal study
AU - Micó-Amigo, M. Encarna
AU - Kingma, Idsart
AU - Heinzel, Sebastian
AU - Rispens, Sietse M.
AU - Heger, Tanja
AU - Nussbaum, Susanne
AU - van Lummel, Rob C.
AU - Berg, Daniela
AU - Maetzler, Walter
AU - van Dieën, Jaap H.
PY - 2019/2/19
Y1 - 2019/2/19
N2 - 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.
AB - 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.
KW - Accelerometry
KW - Gait analysis
KW - Movement disorders
KW - Parkinson’s disease
KW - Walking
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U2 - 10.3389/fnhum.2019.00059
DO - 10.3389/fnhum.2019.00059
M3 - Article
C2 - 30837857
VL - 13
SP - 1
EP - 14
JO - Frontiers in Human Neuroscience
JF - Frontiers in Human Neuroscience
SN - 1662-5161
IS - FEBRUARY
M1 - 59
ER -