Wearable Sensors Measure Ankle Joint Changes of Patients with Parkinson’s Disease before and after Acute Levodopa Challenge

Wu, Zhuang; Jiang, Xu; Zhong, Min; Shen, Bo; Zhu, Jun; Pan, Yang; Dong, Jun; Xu, Pingyi; Zhang, Wenbin; Zhang, Li

doi:10.1155/2020/2976535

Cited by 16 publications

(19 citation statements)

References 38 publications

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“…The PIGD group exhibited smaller TO angle and ROM-AJ than the TD group. These results are in line with recent works that the AJ movement is decreased in PD, 3 and patients with PIGD have severely impaired distal movements. 21 The decreased TO and HS angles indicate a reduced foot clearance and may result in tripping.…”

Section: Discussionsupporting

confidence: 93%

“…31 HS angle is decreased whereas TO is not reduced in patients with PD. 3,12,32 However, in our study, the HS of both PD subtypes showed no difference. TO was remarkably decreased in the PIGD group.…”

Section: Discussioncontrasting

confidence: 82%

“…Previous studies found that stride length is improved most obviously, followed by gait velocity, stride time and cadence after taking levodopa. 3,4 Compared with the OFF state, the stride length, gait velocity and cadence increased significantly by ∼22.22%, ∼17.57%, ∼7.31% in the ON state in patients with PD, respectively. Stride time decreased remarkably by∼10.14% in the ON state than that of the OFF state in patients with PD.…”

Section: Discussionmentioning

confidence: 98%

“…For example, stride length is improved most obviously, followed by gait velocity, stride time, and cadence after treatment with levodopa. 3,4 Catechol-O-Methyl transferase (COMT) inhibitors and dopamine agonists are beneficial for the improvement of gait velocity. [5][6][7] Patients with PD on Monoamine oxidase type B inhibitors (MAOB-I) have demonstrated a lower probability of developing freezing of gait 8 and have a lower postural instability gait difficulty (PIGD) scores.…”

Section: Introductionmentioning

confidence: 99%

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<p>Can Quantitative Gait Analysis Be Used to Guide Treatment of Patients with Different Subtypes of Parkinson’s Disease?</p>

Zhong

Jiang

et al. 2020

NDT

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Purpose: Gait impairment is a common clinical symptom of patients with Parkinson's disease (PD). Detecting specific gait parameters' changes in order to guide clinical intervention is at present lacking. The present study aimed to (1) quantify gait impairments in different PD subtypes and (2) explore whether the results of quantitative gait analysis are beneficial to clinical treatment. Patients and Methods: We enrolled 86 patients with PD (48 men, and 38 women) from the Department of Geriatrics of the Affiliated Brain Hospital of Nanjing Medical University. Unified Parkinson's Disease Rating Scale (UPDRS) and Hoehn-Yahr Scale were used to evaluate the motor symptoms of PD. All patients stopped anti-Parkinsonian medication for 24 hours (72 hours for controlled release medicine). The patients were divided into two subtypes, namely, postural instability gait difficulty (PIGD; n=56) and tremor dominant (TD; n=30) subtypes according to UPDRS. All patients completed the instrumented stand and walk test, and a set of JiBuEn gait analysis system was used in gait data collection. Results: We observed a shorter stride length (p=0.021), a longer stride time (p=0.036), a faster cadence (p=0.036), and a more variable stride length (p=0.012) in the PIGD group compared with the TD group. In addition, compared with the TD group, we found that the toe-off angle (p=0.005) and the range of motion of ankle joint (p=0.009) decreased in the PIGD group. Conclusion: Our study demonstrated that the gait performance of patients with PIGD is worse than those with TD from the perspective of quantitative gait analysis. We extended previous research and found the PIGD group exhibited severe gait impairments in some specific spatiotemporal and kinematic gait parameters. The different manifestations of these gait impairments may guide in choosing appropriate treatment of patients with different PD subtypes.

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Section: Discussionsupporting

confidence: 93%

Section: Discussioncontrasting

confidence: 82%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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<p>Can Quantitative Gait Analysis Be Used to Guide Treatment of Patients with Different Subtypes of Parkinson’s Disease?</p>

Zhong

Jiang

et al. 2020

NDT

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“…According to this observation, the index resulted able to represent the articular mobility of lower limbs, in which a lower TDI is related to higher mobility and vice versa. Studies generally agree about the fact that the joint ROMs are larger in the healthy population than in PD patients 40,41 .…”

Section: Tdi and Kinematic Parametersmentioning

confidence: 89%

A synthetic kinematic index of trunk displacement conveying the overall motor condition in Parkinson’s disease

Lopez

Minino

Sorrentino

et al. 2020

Preprint

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BACKGROUND: Parkinson's disease (PD) is characterized by motor impairment, affecting quality of life and increasing fall risk, due to ineffective postural control. To this day, the diagnosis remains based on clinical approach. Similarly, motor evaluation is based on heterogeneous, operator-dependent observational criteria. A synthetic, replicable index to quantify motor impairment is still lacking. In this paper, we build upon the idea that the trunk is crucial in balance control. Hence, we have designed a new measure of postural stability which assess the trunk displacement in relation to the center of mass, that we named trunk displacement index (TDI). METHODS: Twenty-three PD patients and twenty-three healthy controls underwent clinical (UPDRS-III) and motor examination (3D gait analysis). The TDI was extracted from kinematic measurements using a stereophotogrammetric system. A correlation analysis was performed to assess the relationship of TDI with typical gait parameters, to verify its biomechanical value, and UPDRS-III, to observe its clinical relevance. Finally, its sensitivity was measured, comparing pre- and post- L-DOPA subclinical intake. RESULTS: The TDI showed significant correlations with many gait parameters, including both velocity and stability characteristics of gait, and with the UPDRS-III. Finally, the TDI resulted capable in discriminating between off and on state in PD, whereas typical gait parameters failed two show any difference between those two conditions. CONCLUSIONS: Our results suggest that the TDI may be considered a highly sensitive biomechanical index, reflecting the overall motor condition in PD, and provided of clinical relevance due to the correlation with the clinical evaluation.

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3D Kinematics Quantifies Gait Response to Levodopa earlier and to a more Comprehensive Extent than the MDS‐Unified Parkinson's Disease Rating Scale in Patients with Motor Complications

Barbosa,

Mendonça,

Bastos

et al. 2024

Movement Disord Clin Pract

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BackgroundQuantitative 3D movement analysis using inertial measurement units (IMUs) allows for a more detailed characterization of motor patterns than clinical assessment alone. It is essential to discriminate between gait features that are responsive or unresponsive to current therapies to better understand the underlying pathophysiological basis and identify potential therapeutic strategies.ObjectivesThis study aims to characterize the responsiveness and temporal evolution of different gait subcomponents in Parkinson's disease (PD) patients in their OFF and various ON states following levodopa administration, utilizing both wearable sensors and the gold‐standard MDS‐UPDRS motor part III.MethodsSeventeen PD patients were assessed while wearing a full‐body set of 15 IMUs in their OFF state and at 20‐minute intervals following the administration of a supra‐threshold levodopa dose. Gait was reconstructed using a biomechanical model of the human body to quantify how each feature was modulated. Comparisons with non‐PD control subjects were conducted in parallel.ResultsSignificant motor changes were observed in both the upper and lower limbs according to the MDS‐UPDRS III, 40 minutes after levodopa intake. IMU‐assisted 3D kinematics detected significant motor alterations as early as 20 minutes after levodopa administration, particularly in upper limbs metrics. Although all “pace‐domain” gait features showed significant improvement in the Best‐ON state, most rhythmicity, asymmetry, and variability features did not.ConclusionIMUs are capable of detecting motor alterations earlier and in a more comprehensive manner than the MDS‐UPDRS III. The upper limbs respond more rapidly to levodopa, possibly reflecting distinct thresholds to levodopa across striatal regions.

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Wearable Sensors Measure Ankle Joint Changes of Patients with Parkinson’s Disease before and after Acute Levodopa Challenge

Cited by 16 publications

References 38 publications

<p>Can Quantitative Gait Analysis Be Used to Guide Treatment of Patients with Different Subtypes of Parkinson’s Disease?</p>

<p>Can Quantitative Gait Analysis Be Used to Guide Treatment of Patients with Different Subtypes of Parkinson’s Disease?</p>

A synthetic kinematic index of trunk displacement conveying the overall motor condition in Parkinson’s disease

3D Kinematics Quantifies Gait Response to Levodopa earlier and to a more Comprehensive Extent than the MDS‐Unified Parkinson's Disease Rating Scale in Patients with Motor Complications

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