Body-Fixed Sensors for Parkinson Disease

Mirelman, Anat; Giladi, Nir; Hausdorff, Jeffrey M.

doi:10.1001/jama.2015.8530

Cited by 26 publications

(20 citation statements)

References 7 publications

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“…Body‐fixed wearable sensors have great potential for augmenting the diagnosis, prognosis, and early identification of PD . We hypothesized that by using body‐fixed sensors, we could identify increased arm swing asymmetry in healthy carriers of the LRRK2‐ G2019S mutation.…”

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confidence: 99%

“…Body-fixed wearable sensors have great potential for augmenting the diagnosis, prognosis, and early identification of PD. [5][6][7] We hypothesized that by using body-fixed sensors, we could identify increased arm swing asymmetry in healthy carriers of the LRRK2-G2019S mutation. As such, we addressed the following three aims: (1) to evaluate whether alterations in arm swing can be detected in healthy subjects who have an increased risk of developing PD, that is, nonmanifesting carriers of the LRRK2-G2019S mutation;…”

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confidence: 99%

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Arm swing as a potential new prodromal marker of Parkinson's disease

et al. 2016

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Background Reduced arm swing is a well-known clinical feature of Parkinson’s disease (PD), often observed early in the course of the disease. We hypothesized that subtle changes in arm swing and axial rotation may also be detectable in the prodromal phase. Objective The purpose of this study was to evaluate the relationship between the LRRK2-G2019S mutation, arm swing, and axial rotation in healthy nonmanifesting carriers and noncarriers of the G2019S mutation and in patients with PD. Methods A total of 380 participants (186 healthy nonmanifesting controls and 194 PD patients) from 6 clinical sites underwent gait analysis while wearing synchronized 3-axis body-fixed sensors on the lower back and bilateral wrists. Participants walked for 1 minute under the following 2 conditions: (1) usual walking and (2) dual-task walking. Arm swing amplitudes, asymmetry, variability, and smoothness were calculated for both arms along with measures of axial rotation. Results A total of 122 nonmanifesting participants and 67 PD patients were carriers of the G2019S mutation. Nonmanifesting mutation carriers walked with greater arm swing asymmetry and variability and lower axial rotation smoothness under the dual task condition when compared with noncarriers (P < .04). In the nonmanifesting mutation carriers, arm swing asymmetry was associated with gait variability under dual task (P = .003). PD carriers showed greater asymmetry and variability of movement than PD noncarriers, even after controlling for disease severity (P < .009). Conclusions The G2019S mutation is associated with increased asymmetry and variability among nonmanifesting participants and patients with PD. Prospective studies should determine if arm swing asymmetry and axial rotation smoothness may be used as motor markers of prodromal PD.

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Arm swing as a potential new prodromal marker of Parkinson's disease

et al. 2016

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“…The fact that NFOG‐Q scores did not differ significantly between time points as such and that no systematic decrease or increase of scores was found across the cohorts suggests that becoming more aware of freezing behavior could go in both directions, that is, more or less positive assessments of FOG. Several studies reported recall bias as a limitation in the previous freezing of gait questionnaire (FOG‐Q) or other clinical scales . As a result, one study even used the second assessment of the FOG‐Q instead of the first to compensate for this issue .…”

Section: Discussionmentioning

confidence: 99%

“…Several studies reported recall bias as a limitation in the previous freezing of gait questionnaire (FOG-Q) or other clinical scales. [36][37][38] As a result, one study even used the second assessment of the FOG-Q instead of the first to compensate for this issue. 39 To help the accuracy of retrospective assessment of FOG, the NFOG-Q is accompanied by exemplary videos of FOG to serve as a reference before it is completed.…”

Section: Discussionmentioning

confidence: 99%

The New Freezing of Gait Questionnaire: Unsuitable as an Outcome in Clinical Trials?

Hulzinga

Nieuwboer

Dijkstra

et al. 2020

Movement Disord Clin Pract

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Background Background: Freezing of gait (FOG) is a common gait deficit in Parkinson's disease. The New Freezing of Gait Questionnaire (NFOG-Q) is a widely used and valid tool to quantify freezing of gait severity. However, its test-retest reliability and minimal detectable change remain unknown. Objective Objective: To determine the test-retest reliability and responsiveness of the NFOG-Q. Methods Methods: Two groups of freezers, involved in 2 previous rehabilitation trials, completed the NFOG-Q at 2 time points (T1 and T2), separated by a 6-week control period without active intervention. Sample 1 (N = 57) was measured in ON and sample 2 (N = 14) in OFF. We calculated various reliability statistics for the NFOG-Q scores between T1 and T2 as well as correlation coefficients with clinical descriptors to explain the variability between time points. Results Results: In sample 1 the NFOG-Q showed modest reliability (intraclass correlation coefficient = 0.68 [0.52-0.80]) without differences between T1 and T2. However, a minimal detectable change of 9.95 (7.90-12.27) points emerged for the total score (range 28 points, relative minimal detectable change of 35.5%). Sample 2 showed largely similar results. We found no associations between cognitive-related or disease severity-related outcomes and variability in NFOG-Q scores. Conclusions Conclusions: We conclude that the NFOG-Q is insufficiently reliable or responsive to detect small effect sizes, as changes need to go beyond 35% to surpass measurement error. Therefore, we warrant caution in using the NFOG-Q as a primary outcome in clinical trials. These results emphasize the need for robust and objective freezing of gait outcome measures.Freezing of gait (FOG) is a prominent and debilitating symptom of Parkinson's disease (PD). It affects up to 80% of PD patients during the course of the disease. 1-3 FOG is defined as the inability to progress forward stepping despite the intention to walk and reach a destination. 4 Furthermore, FOG is one of the most frequent causes of falls in PD, thus contributing to high fall rates ranging from 35% up to 90%. 1,5,6 FOG seriously impedes daily life functioning and overall quality of life. 7,8 So far, the treatment of FOG, including pharmacological, surgical, and rehabilitation interventions, is only partially effective. 4,9 Therefore, new and more personalized rehabilitation approaches are now being developed. To evaluate their effectiveness, valid and reliable assessment is necessary to document FOG severity and its progression.A recent review of Mancini and colleagues 10 highlighted that FOG assessment is hampered by several factors in clinical and laboratory settings. First, the episodic and unpredictable nature of FOG increases the likelihood of missing the event during formal or "online" performance tests of gait. Second, various "testing effects" may be at play that enhance or reduce the occurrence of FOG, such as consciously attending to walking, stepping in broad and well-lit corridors, and experiencing medication effects and...

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“…In this way, inertia-based motion analysis (e.g. accelerometers) is a new outcome assessment tool that can produce objective movement parameters while being fast, economical and easy to use (26).…”

Section: Discussionmentioning

confidence: 99%

Temporal organization of stride duration variability as a marker of gait instability in Parkinson's disease

Warlop¹,

Detrembleur²,

Bollens³

et al. 2016

J Rehabil Med

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Degradation of LRA was strongly correlated with other clinical scores, in such a way that the temporal organization of gait variability was more random for patients presenting with greater motor impairments. Importantly, these measures were relatively independent of age, and gait speed, thus they can be applied to a wide clinical population. Conclusion: The findings of this study emphasize that temporal organization of gait variability is related to degree of functional impairment in Parkinson's disease. LRA may thus be regarded as an objective and quantitative measure of gait stability for both clinical practice and research.

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Body-Fixed Sensors for Parkinson Disease

Cited by 26 publications

References 7 publications

Arm swing as a potential new prodromal marker of Parkinson's disease

Arm swing as a potential new prodromal marker of Parkinson's disease

The New Freezing of Gait Questionnaire: Unsuitable as an Outcome in Clinical Trials?

Temporal organization of stride duration variability as a marker of gait instability in Parkinson's disease

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