A wearable setup for auditory cued gait analysis in patients with Parkinson's Disease

Gait disorders are a primary consequence of Parkinson's Disease (PD), resulting in loss of patients' independence. Recently, Rhythmical Auditory Stimulation (RAS) gave a preliminary proof to benefit gait quality, but the specific methodology requires a long walkway, preventing the use of a traditional complete gait analysis. In the present work we describe an unobtrusive, wearable setup and the related biomechanical model developed for analyzing gait of people with PD during the administration of RAS. One healthy subject was enrolled in the experimental session to validate the estimation of the spatial gait parameters provided by the proposed setup, against an optoelectronic system. Three PD patients were then enrolled to test the setup feasibility in evaluating gait parameters typically adopted in these type of studies. Results related to the validation of the spatial parameter estimation showed a high accuracy of the system in the estimation of the stride length. Preliminary tests on PD patients provided encouraging insights on the wearable setup usability and versatility. Future experimental validation on a larger population will be conducted to fully validate the setup, which opens the way for conducting RAS studies also outside the laboratory environment.

[1]  Jeffrey M. Hausdorff,et al.  Gait variability and basal ganglia disorders: Stride‐to‐stride variations of gait cycle timing in parkinson's disease and Huntington's disease , 1998, Movement disorders : official journal of the Movement Disorder Society.

[2]  J G Nutt,et al.  Classification, diagnosis, and etiology of gait disorders. , 2001, Advances in neurology.

[3]  F. Cody,et al.  Auditory cues can modify the gait of persons with early-stage Parkinson's disease: a method for enhancing parkinsonian walking performance? , 2003, Clinical rehabilitation.

[4]  Bryan C. Heiderscheit Movement Variability as a Clinical Measure for Locomotion , 2000 .

[5]  Javier Cudeiro,et al.  Temporal variability of gait in Parkinson disease: effects of a rehabilitation programme based on rhythmic sound cues. , 2005, Parkinsonism & related disorders.

[6]  G. Kwakkel,et al.  Effects of external rhythmical cueing on gait in patients with Parkinson's disease: a systematic review , 2005, Clinical rehabilitation.

[7]  Gianluigi Ferrari,et al.  Body-Sensor-Network-Based Kinematic Characterization and Comparative Outlook of UPDRS Scoring in Leg Agility, Sit-to-Stand, and Gait Tasks in Parkinson's Disease , 2015, IEEE Journal of Biomedical and Health Informatics.

[8]  W De Weerdt,et al.  The effect of a home physiotherapy program for persons with Parkinson's disease. , 2001, Journal of rehabilitation medicine.

[9]  Stanley Fahn,et al.  Safety of IPX066, an extended release carbidopa–levodopa formulation, for the treatment of Parkinson’s disease , 2015, Expert opinion on drug safety.

[10]  Jeffrey M. Hausdorff,et al.  Gait asymmetry in patients with Parkinson’s disease and elderly fallers: when does the bilateral coordination of gait require attention? , 2007, Experimental Brain Research.

[11]  Jeffrey M. Hausdorff,et al.  The power of cueing to circumvent dopamine deficits: A review of physical therapy treatment of gait disturbances in Parkinson's disease , 2002, Movement disorders : official journal of the Movement Disorder Society.

[12]  Lynn Rochester,et al.  Gait variability in Parkinson’s disease: an indicator of non-dopaminergic contributors to gait dysfunction? , 2011, Journal of Neurology.

[13]  R. Freedland,et al.  The effects of pulsed auditory stimulation on various gait measurements in persons with Parkinson's Disease. , 2002, NeuroRehabilitation.

[14]  G. Kwakkel,et al.  Efficacy of a physical therapy program in patients with Parkinson's disease: a randomized controlled trial. , 2005, Archives of physical medicine and rehabilitation.

[15]  M. Rogers,et al.  Disorders of posture, balance, and gait in Parkinson's disease. , 1996, Clinics in geriatric medicine.

[16]  Jeffrey M. Hausdorff,et al.  Rhythmic auditory stimulation modulates gait variability in Parkinson's disease , 2007, The European journal of neuroscience.

[17]  Sazali Yaacob,et al.  Technologies for Assessment of Motor Disorders in Parkinson’s Disease: A Review , 2015, Sensors.

[18]  M. Thaut,et al.  Rhythmic auditory-motor facilitation of gait patterns in patients with Parkinson's disease. , 1997, Journal of neurology, neurosurgery, and psychiatry.

[19]  J. M. Brault,et al.  Rhythmic auditory stimulation in gait training for Parkinson's disease patients , 1996, Movement disorders : official journal of the Movement Disorder Society.

[20]  Iris Tien,et al.  Characterization of gait abnormalities in Parkinson's disease using a wireless inertial sensor system , 2010, 2010 Annual International Conference of the IEEE Engineering in Medicine and Biology.

[21]  J. Summers,et al.  Stride length regulation in Parkinson's disease. Normalization strategies and underlying mechanisms. , 1996, Brain : a journal of neurology.

[22]  Eduardo Palermo,et al.  Gait Partitioning Methods: A Systematic Review , 2016, Sensors.

[23]  P Cappa,et al.  Experimental evaluation of indoor magnetic distortion effects on gait analysis performed with wearable inertial sensors , 2014, Physiological measurement.

[24]  Michael H. Thaut,et al.  Rhythmic Auditory Stimulation in Rehabilitation of Movement Disorders: A Review Of Current Research , 2010 .

[25]  Eduardo Palermo,et al.  Experimental evaluation of accuracy and repeatability of a novel body-to-sensor calibration procedure for inertial sensor-based gait analysis , 2014 .

[26]  R. Iansek,et al.  Movement-related potentials in Parkinson's disease. Presence and predictability of temporal and spatial cues. , 1995, Brain : a journal of neurology.

[27]  Nicola Smania,et al.  Three-dimensional motion analysis of the effects of auditory cueing on gait pattern in patients with Parkinson’s disease: a preliminary investigation , 2010, Neurological Sciences.

[28]  Andrzej Wit,et al.  Comparison of four methods of calculating the symmetry of spatial-temporal parameters of gait. , 2014, Acta of bioengineering and biomechanics.

[29]  R M Pickering,et al.  A community-dwelling sample of people with Parkinson's disease: characteristics of fallers and non-fallers. , 2001, Age and ageing.

[30]  R. B. Davis,et al.  A gait analysis data collection and reduction technique , 1991 .