Foot Trajectory Features in Gait of Parkinson’s Disease Patients

Abstract

Parkinson’s disease (PD) is a progressive neurological disorder characterized by movement disorders, such as gait instability. This study investigated whether certain spatial features of foot trajectory are characteristic of patients with PD. The foot trajectory of patients with mild and advanced PD in on-state and healthy older and young individuals was estimated from acceleration and angular velocity measured by inertial measurement units placed on the subject’s shanks, just above the ankles. We selected six spatial variables in the foot trajectory: forward and vertical displacements from heel strike to toe-off, maximum clearance, and change in supporting leg (F1 to F3 and V1 to V3, respectively). Healthy young individuals had the greatest F2 and F3 values, followed by healthy older individuals, and then mild PD patients. Conversely, the vertical displacements of mild PD patients were larger than the healthy older individuals. Still, those of healthy older individuals were smaller than the healthy young individuals except for V3. All six displacements of the advanced PD patients were smaller than the mild PD patients. To investigate features in foot trajectories in detail, a principal components analysis and soft-margin kernel support vector machine was used in machine learning. The accuracy in distinguishing between mild PD patients and healthy older individuals and between mild and advanced PD patients was 96.3 and 84.2%, respectively. The vertical and forward displacements in the foot trajectory was the main contributor. These results reveal that large vertical displacements and small forward ones characterize mild and advanced PD patients, respectively.

Single- and dual-task gait performance and their diagnostic value in early-stage Parkinson's disease

“…In line with previous studies, the HS was smaller in the early-stage PD group than in the HC group during both the ST and DT walking tests in this study (15,(27)(28)(29). A previous study suggested in patients with PD, the DT condition increased the attention required for joint flexion, extension, and muscle strength of the ankle (27).…”

“…While in previous studies, the changes in TO in patients with early-stage PD remain controversial (12,28,29,61). We attribute it to the inclusion of PD patients with different spontaneous GV and various stages in these studies (12,28,29,61). In this study, TO was smaller in the earlystage PD group, but after adjusting for GV, the difference was not significant, consistent with previous research enrolling earlystage PD patients (15).…”

“…Particularly, after adjusting for GV, the difference in HS and SL between groups was still significant, indicating these two parameters were disease-related. While in previous studies, the changes in TO in patients with early-stage PD remain controversial (12,28,29,61). We attribute it to the inclusion of PD patients with different spontaneous GV and various stages in these studies (12,28,29,61).…”

“…Studies using structured gait measurement and controlling for covariates are needed to increase the comparability of different studies and explore diagnostic gait markers for early-stage PD. Second, most of the previous studies have focused on spatiotemporal gait parameters, while few studies have analyzed kinematic parameters in PD patients and the results are controversial in the limited studies (12,(27)(28)(29). Further studies validating changes in kinematic gait parameters in early-stage PD are needed.…”