Sensitivity to gait improvement after levodopa intake in Parkinson’s disease: A comparison study among synthetic kinematic indices

Abstract

The synthetic indices are widely used to describe balance and stability during gait. Some of these are employed to describe the gait features in Parkinson’s disease (PD). However, the results are sometimes inconsistent, and the same indices are rarely used to compare the individuals affected by PD before and after levodopa intake (OFF and ON condition, respectively). Our aim was to investigate which synthetic measure among Harmonic Ratio, Jerk Ratio, Golden Ratio and Trunk Displacement Index is representative of gait stability and harmony, and which of these are more sensitive to the variations between OFF and ON condition. We found that all indices, except the Jerk Ratio, significantly improve after levodopa. Only the improvement of the Trunk Displacement Index showed a direct correlation with the motor improvement measured through the clinical scale UPDRS-III (Unified Parkinson’s Disease Rating Scale–part III). In conclusion, we suggest that the synthetic indices can be useful to detect motor changes induced by, but not all of them clearly correlate with the clinical changes achieved with the levodopa administration. In our analysis, only the Trunk Displacement Index was able to show a clear relationship with the PD clinical motor improvement.

Translating digital healthcare to enhance clinical management: a protocol for an observational study using a digital health technology system to monitor medication adherence and its effect on mobility in people with Parkinson’s

“…At present, research exploring medication and mobility in PwP is typically conducted in controlled lab-based or clinical environments, in specific ON/OFF medication states. [8][9][10][11][12][13][14][15][16] Although some studies have been performed in the real world (ie, daily living, outside clinical or laboratory settings), 17 18 a more granular picture is required.…”

Network analysis of the whole body kinematics in Parkinson diseases following levodopa intake

“…An alternative approach has led to the development of synthetic biomechanical indices that enable the analysis of more complex characteristics of gait such as the fluidity, the rhythmicity and the symmetry [10][11][12][13] . However, the majority of these methodological approaches provide only "segmental" information, by selectively focusing only on a specific body segment such as the trunk or legs.…”

The kinectome: A comprehensive kinematic map of human motion in health and disease

“…To this end, we utilized a three‐dimensional motion analysis stereophotogrammetric system, which is the gold standard for quantitative analysis of movement, 22 and is widely applied for the assessment of motor skills in health and disease 23–27 . Specifically, we captured the position of reflective markers applied on specific bone reference points during gait.…”

“…To this end, we utilized a three‐dimensional motion analysis stereophotogrammetric system, which is the gold standard for quantitative analysis of movement, 22 and is widely applied for the assessment of motor skills in health and disease. 23 , 24 , 25 , 26 , 27 Specifically, we captured the position of reflective markers applied on specific bone reference points during gait. Each bone marker was considered as a node, and the edges linking the nodes were defined by the covariance of the acceleration and jerk (i.e., the first derivative of acceleration with respect to time) between each pair of bone markers.…”