Assessing Gait in Parkinson’s Disease Using Wearable Motion Sensors: A Systematic Review

Abstract

: Parkinson’s disease (PD) is a progressive neurodegenerative disorder. Gait impairments are common among people with PD. Wearable sensor systems can be used for gait analysis by providing spatio-temporal parameters useful to investigate the progression of gait problems in Parkinson disease. However, various methods and tools with very high variability have been developed. The aim of this study is to review published articles of the last 10 years (from 2008 to 2018) concerning the application of wearable sensors to assess spatio-temporal parameters of gait in patients with PD. We focus on inertial sensors used for gait analysis in the clinical environment (i.e., we do not cover the use of inertial sensors to monitor walking or general activities at home, in unsupervised environments). Materials and Methods: Relevant articles were searched in the Medline database using Pubmed. Results and Discussion: Two hundred ninety-four articles were initially identified while searching the scientific literature regarding this topic. Thirty-six articles were selected and included in this review. Conclusion: Wearable motion sensors are useful, non-invasive, low-cost, and objective tools that are being extensively used to perform gait analysis on PD patients. Being able to diagnose and monitor the progression of PD patients makes wearable sensors very useful to evaluate clinical efficacy before and after therapeutic interventions. However, there is no uniformity in the use of wearable sensors in terms of: number of sensors, positioning, chosen parameters, and other characteristics. Future research should focus on standardizing the measurement setup and selecting which spatio-temporal parameters are the most informative to analyze gait in PD. These parameters should be provided as standard assessments in all studies to increase replicability and comparability of results.

Functional and molecular early enteric biomarkers for Parkinson’s disease in mice and men

“…PD is currently diagnosed based on motor impairments that are only present during progressive stages of the disease 41,42,43 . These clinical symptoms are caused by Lewy bodies aggregating in the brain and by degeneration of dopaminergic neurons in the substantia nigra.…”

Beneficial Effect of Foot Plantar Stimulation in Gait Parameters in Individuals with Parkinson’s Disease

“…Various types of sensory receptors, such as proprioceptors, give continuous feedback to the central nervous system. Various studies, with different methods, have been investigating the effects of peripheral bottom-up stimulation in order to reduce motor impairment in PD patients [13][14][15][16][17][18]. By enhancing the sensory feedbacks coming from the feet, bottom-up stimulation allows patients to better integrate peripheral inputs with motor control response during gait, producing a stimulating effect of central nervous system areas involved in human movement [18].…”

“…Various studies, with different methods, have been investigating the effects of peripheral bottom-up stimulation in order to reduce motor impairment in PD patients [13][14][15][16][17][18]. By enhancing the sensory feedbacks coming from the feet, bottom-up stimulation allows patients to better integrate peripheral inputs with motor control response during gait, producing a stimulating effect of central nervous system areas involved in human movement [18]. Recent studies have shown the effectiveness of plantar mechanical stimulation in PD patients by applying punctual pressure in two specific areas of each foot (bottom-up rehabilitation) [19][20][21][22].…”

“…Recent studies have shown the effectiveness of plantar mechanical stimulation in PD patients by applying punctual pressure in two specific areas of each foot (bottom-up rehabilitation) [19][20][21][22]. Furthermore, a pilot study by Quattrocchi and co-workers demonstrated the effectiveness of a device for the motor rehabilitation in PD, based on non-invasive stimulations given via controlled mechanical impulses in specific areas of both feet [18]. The application of this device increased resting state functional connectivity of the sensory motor cortex, nucleus striatum, and cerebellum in PD patients treated with automated mechanical peripheral stimulation (AMPS) [18].…”

Estimating Movement Smoothness from Inertial Measurement Units

“…smartphones, smart watches, smart clothing, etc. This, along with the fact that IMUs are now relatively inexpensive, has sparked their use for movement analysis in different disciplines, such as movement neuroscience (Shull et al, 2014;Picerno, 2017;O'Reilly et al, 2018), movement biomechanics and sports science (Salmond et al, 2017;Li et al, 2016;Johnston et al, 2019), and neurorehabilitation (Brognara et al, 2019;Dobkin, 2013;Hubble et al, 2015;Parker et al, 2020;Vienne et al, 2017;Wang et al, 2017).…”