In-home measurement of the effect of strategically weighted vests on ambulation

Abstract

Strategically weighted vests are currently being used to treat patients with Parkinson's, Multiple Sclerosis, and ataxia. While studies have been conducted to demonstrate the effectiveness of these vests, there has been very little research into the mechanisms that give rise to the vest's results. This study demonstrates the ability to capture gait parameters from depth images[1] in the home with sufficient sensitivity to support future investigation of the weighted vest intervention. The study also explores multiple metrics, using in-home gait sensing, to study a subject's ambulatory ability including gait mechanics, uncertainty in motion, and gait cadence. We then investigate the effects of these vests on a subject's ambulation by examining these metrics both before and after the vest is worn. While only four subjects were used, results are promising, showing a statistically significant and clinically significant change in many of these metrics as a result of the vest. The cases presented here concern two subjects, one with a "tight" gait caused by Progressive Supranuclear Palsy, and the second with an excessively "loose" gait due to Parkinson's disease. We show that in both subjects, using the vest immediately moved the metrics in a direction beneficial to the subject's clinical condition. This result concurs with clinical observations as measured using various clinical fall risk instruments.

Exercise and Progressive Supranuclear Palsy: the need for explicit exercise reporting

“…While often not specifically described, it was evident from the single case study design [24, 35–38] and case series investigations [26] that some exercise interventions were performed individually (7/11 (64%)). The RCTs were inconsistent with reported individual or group administration [21, 22] and unreported mode of delivery [23].…”

“…Complex equipment [23, 25, 35, 36, 39] was assumed by the reviewers to require supervision at a clinic. The home-based programs did not report the levels of supervision required by a therapist or care-giver [26, 37, 38].…”

Systematic Review Looking at the Use of Technology to Measure Free-Living Symptom and Activity Outcomes in Parkinson’s Disease in the Home or a Home-like Environment

“…There were two papers detailing a case-control design whereby people with PD were directly compared to control participants when evaluating various parameters such as activity levels and keyboard typing metrics [29,30]. In two studies, technologies were being used in the home environment as outcome measures in clinical therapeutic trials [31,32] and a further four were randomised controlled trials or sub-studies thereof [33][34][35][36].…”

“…Where the study duration was specified, the majority of the studies included in this review described testing of their sensors/technology over two weeks or less, however 10 studies detailed longer period of study time of up to a year [32,34,[41][42][43][44][45][46][47][48]. Data from sensing technology was collected on more than one occasion by three studies.…”

“…Gait, including freezing of gait, turning of gait and missteps, was evaluated by technologies in 19 studies included in this systematic review. Wearable technologies were used to measure this metric in 18 of the 19 papers, with the exception of Wallace et al [32] who used in-depth video cameras to assess gait in the context of the impact of wearing strategicallyweighted vests on this metric. Smartphones were included in the 'wearable' category given that they are worn on a person in a pocket or similar in order to capture the movements which inform gait analysis; these devices were utilised by two groups [34,44].…”