Accelerometer based analysis of gait initiation failure in advanced juvenile parkinsonism: a single subject study

Abstract

[Purpose] This study used an accelerometer placed close to the center of gravity to quantitatively investigate whether unexpected gait initiation aggravates start hesitation (freezing of gait in gait initiation). [Subject and Methods] The subject was a 53-year-old female who had been suffering from juvenile parkinsonism since she was aged 21 years. An alternating-treatment design was used to compare acceleration characteristics under two gait initiation conditions, which were 1) deliberate gait initiation and 2) gait initiation on a sudden “go” verbal command (sudden gait initiation), in the “on” state of the medication cycle. [Results] In six out of eight sessions, a combination of reduced peak positive anterior accelerations and large power percentage in the high frequency band was consistently observed in the sudden gait initiation compared with deliberate gait initiation. In the other two sessions, although a large acceleration just after the “go” signal was observed, subsequent acceleration signals were blocked by sudden gait initiation. [Conclusion] The results suggest that, even in the “on” state, start hesitation is apparent without increased reliance on frontal cortical attentional mechanisms to compensate for impaired automaticity. In advanced juvenile parkinsonism, sudden gait initiation may be an effective paradigm as a provoking test for start hesitation.

Characteristics associated with freezing of gait in actual daily living in Parkinson’s disease

“…In entering an elevator or automatic door, and answering a telephone or doorbell, it seems that task complexity is predominantly associated with triggering an FOG episode. In these situations, planning of the timing of gait initiation in advance and concentrating on each component of movements are effective strategies 20 ) .…”

Acceleration Gait Measures as Proxies for Motor Skill of Walking: A Narrative Review

“…Combining the knowledge of the gait cycle with simple measures, such as gait speed and speed variability [165], we can estimate the times of each of these events and phases (e.g., lengths and times of stance, swing, step, and strides [90], [99], [100], [107], [108], [110]- [116]). Cadence [80], [97], [107], [108], [112], [114], [116], [121], [166], [167], stride frequency [79], [82], [109], [122], step or stride irregularity [168], stride or step amplitude [169], and stride frequency variability [66], [156] can be calculated with AGMs. Other articles may provide some good insight into how gait cycle AGMs are measured and used [139], [170]- [173].…”

A Review on Accelerometry-Based Gait Analysis and Emerging Clinical Applications

“…Other applications include assessing the effect of prescription footwear on gait quality for gait rehabilitation [60], evaluating a mobility assistance system from healthy people and patients [187], quantitatively investigating whether an unexpected gait initiation aggravates FoG in patients with advanced juvenile parkinsonism [190], comparison of gait parameters between two patient groups (Dementia and PD patients) [191], comparison of various methods for gait parameter estimation using elderly, post stroke, PD, and Huntington's disease subjects [194], objectively assessing abnormal gait in patients with rheumatoid arthritis using a smartphone [183], investigating the effects of shoe fit on gait in communitydwelling older adults [168], detection of stride event exploiting cross-correlation and anisotropy characteristics of the accelerations using healthy and PD patients [200], a new measure of quantifying walking behavior in PD patients based on gait cycle-acceleration relationship [195] and investigating the gait patterns in post-menopausal women [197]. Animal related studies of trunk accelerometry include quantification of movement symmetry in the trotting horse [189] and examination of the changes in parameters after the drug administration in horses [176].…”