Use of Mobile Device Accelerometry to Enhance Evaluation of Postural Instability in Parkinson Disease

Abstract

Objective To determine the accuracy of inertial measurement unit data from a mobile device using the mobile device relative to posturography to quantify postural stability in individuals with Parkinson’s disease (PD). Design Criterion standard. Setting Motor control laboratory at Cleveland Clinic. Participants Fourteen mild to moderate individuals with PD and 14 healthy age-matched community dwelling controls completed the project. Interventions Not applicable. Main Outcome Measures Center of mass (COM) acceleration measures were compared between the mobile device and NeuroCom force platform to determine accuracy of mobile device measurements during performance of the Sensory Organization Test (SOT). Analyses examined test-retest reliability for both systems and sensitivity of: 1) the Equilibrium Score from the SOT and 2) COM acceleration measures from the force platform and mobile device to quantify postural stability across populations. Results Metrics of COM acceleration from inertial measurement unit data and NeuroCom force platform were significantly correlated across balance conditions and groups (Pearson’s r ranged from 0.35 to 0.97). The SOT Equilibrium Scores failed to discriminate individuals with PD and controls. However, the multi-planar measures of COM acceleration from the mobile device exhibited good to excellent reliability across SOT conditions and were able to discriminate individuals with PD and controls in conditions with the greatest balance demands. Conclusions Metrics employing medial-lateral movement produce a more sensitive outcome than the Equilibrium Score in identifying postural instability associated with PD. Overall, the output from the mobile device provides an accurate and reliable method of rapidly quantifying balance in individuals with PD. The portable and affordable nature of a mobile device with the application make it ideally suited to utilize biomechanical data to aid in clinical decision-making.

How Wearable Sensors Can Support Parkinson's Disease Diagnosis and Treatment: A Systematic Review

“…The pull test is the main clinical examination to assess postural instability, as suggested by MDS-UPDRS, even if the equilibrium score derived from the Sensory Organization Test (SOT) is largely used. Postural instability accounts for 70% of PwPD that fall at least once each year, resulting in an increase of hospitalization and decrease in QoL (Ozinga et al, 2017 ). Postural control problems cause impairments in PD patients from the early stages of the disease (Gago et al, 2015 ; Masu et al, 2016 ).…”

“…Even if the retropulsion test is included in the MDS-UPDRS 3.12 item to evaluate the postural stability, only two studies included in this review attempted to replace this test (Caudron et al, 2014 ; Hubble et al, 2016 ), probably due to methodological difficulties. The accelerometer-based approach makes it easier to quantify postural impairments compared to the conventional protocol with force plates, which are more expensive and not portable (Palmerini et al, 2011 ; Mancini et al, 2016 ; Ozinga et al, 2017 ). APA and postural sway, both in ML and AP directions, are the most analyzed features, able to differentiate between PD patients and HC (Ozinga et al, 2017 ) in the early stages of the disease (e.g., APA disruption can precede the compromission of the step execution) (Gago et al, 2015 ; Mancini et al, 2016 ), as well as between mild and severe PD groups (Baston et al, 2016 ) for differential diagnosis or between ON/OFF states for the advanced patients (Baston et al, 2016 ; Yelshyna et al, 2016 ).…”

“…The accelerometer-based approach makes it easier to quantify postural impairments compared to the conventional protocol with force plates, which are more expensive and not portable (Palmerini et al, 2011 ; Mancini et al, 2016 ; Ozinga et al, 2017 ). APA and postural sway, both in ML and AP directions, are the most analyzed features, able to differentiate between PD patients and HC (Ozinga et al, 2017 ) in the early stages of the disease (e.g., APA disruption can precede the compromission of the step execution) (Gago et al, 2015 ; Mancini et al, 2016 ), as well as between mild and severe PD groups (Baston et al, 2016 ) for differential diagnosis or between ON/OFF states for the advanced patients (Baston et al, 2016 ; Yelshyna et al, 2016 ). Alternatively, only one work took into account atypical parkinsonism (i.e., vascular PwPD) other than idiopathic PD patients (Gago et al, 2015 ), analyzing the response to L-dopa therapy.…”

Quantitative Assessment of Dance Therapy Infulence on the Parkinson’s Disease Patients’ Lower Limb Biomechanics / Šokių Įtaka Apatinių Galūnių Biomechanikai Sergant Parkinsono Liga

“…PD is characterized by four main motor symptoms: tremor is characterized by involuntary shaking of the body parts, which is characterized by 4-6 Hz vibration frequency (Deuschl et al 1998), bradykinesia -slowness of movements (Shiner et al 2012), rigidity -increased agonistic, antagonistic and synergistic muscle tone, rigidity feeling sick (Santens et al 2003), postural instability -impaired balance and gait changes (Ozinga et al 2016). The human gait is characterized by spatial and temporal parameters (Hollman et al 2011).…”

“…Motion capture systems require special facilities, are expensive both in purchasing and time spent on training qualified personnel and integration in regular clinical practice is rather slow. Body-worn wireless inertial sensors available today are relatively cheaper alternative and easier to apply in clinical setting for capturing the motion data (Ozinga et al 2016). Parkinson's disease -progressive neurologic disorder that damages a variety of motor function and reduces the quality of life.…”