Ambulatory Quantitative Assessment of Body Position, Bradykinesia, and Hypokinesia in Parkinson's Disease

Abstract

We used ambulatory monitoring to quantify body position, bradykinesia, and hypokinesia simultaneously in 50 patients with Parkinson's disease (PD) and 43 healthy elderly during the diurnal period. Reliable automatic detection of three defined body positions proved possible. As compared with controls, PD patients spent less time upright and more time during the day lying down, which correlated well with the self-reported time spent lying down. PD patients had significantly lower mean values of extremity acceleration and higher mean values of immobility than controls. The objective measures of bradykinesia and hypokinesia showed only a modest or no relation to the semiquantitative subjective Unified Parkinson's Disease Rating Scale (UPDRS) motor scores, which most likely was due to differences between the methods. In contrast to bradykinesia measures, hypokinesia measures showed clear sex differences in both patients and controls. Over time, trunk and arm movements occurred more frequently in women than in men. Our ambulatory monitoring assessment disclosed clinically relevant information about the mobility profile and offers a way to quantify cardinal movement features simultaneously in PD patients throughout the day.

Ambulatory Monitoring of Activities and Motor Symptoms in Parkinson's Disease

“…Salarian [5] incorporated an AC into a PD monitoring system, but used it only for the determination of on and off periods. In addition, Dunnewold et al [10] used an AC, but they only considered static activities and they assessed just a few basic aspects of PD motor symptoms. In contrast, the AC itself has been a subject of research for a long time [8]- [14].…”

A holistic approach to assess the feasability of telehealth for Parkinson's disease management

“…One of the first attempts to build a tool for the automatic assessment of bradykinesia was carry out in 1997 by Dunnewold et al [532], on that work accelerometers were used to quantify hand movements during finger tapping and movement time. The quantification of the bradykinesia severity was estimated with the mean value of the acquired signal and it was correlated with the UPDRS values.…”

Selective stimulation of the subthalamic nucleus

“…Salarian et al incorporated an AC into a PD monitoring system, but used it only for the determination of on and off periods. In addition, Dunnewold et al (Dunnewold et al 1998) used an AC, but they only considered static activities and they assessed just a few basic aspects of PD motor symptoms. In contrast, the AC itself has been a subject of research for a long time (Bouten et al 1994;Veltink et al 1996;Dunnewold et al 1998;Najafi et al 2003;Zhang et al 2003;Bao and Intille 2004;Mackey et al 2006).…”

“…In addition, Dunnewold et al (Dunnewold et al 1998) used an AC, but they only considered static activities and they assessed just a few basic aspects of PD motor symptoms. In contrast, the AC itself has been a subject of research for a long time (Bouten et al 1994;Veltink et al 1996;Dunnewold et al 1998;Najafi et al 2003;Zhang et al 2003;Bao and Intille 2004;Mackey et al 2006). Methods have been proposed for the discrimination of static from dynamic activities using the alternating current component of an acceleration signal (Bouten et al 1994;Veltink et al 1996).…”

“…Methods have been proposed for the discrimination of static from dynamic activities using the alternating current component of an acceleration signal (Bouten et al 1994;Veltink et al 1996). Within the static activities, posture detection can be performed by assessing the direct current component of the acceleration signal (Veltink et al 1996;Dunnewold et al 1998). Considering dynamic activities, it has been proposed that detection of walking is possible by analyzing signal morphology (Veltink et al 1996), peak detection (Najafi et al 2003) or the frequency domain entropy (Bao and Intille 2004).…”