Article

People with Parkinson's disease (PD) typically demonstrate impaired anticipatory
postural adjustments (APAs) that shift the body center of mass forward
(imbalance) and over the stance leg (unloading) prior to gait initiation. APAs
are known to be smallest when people with PD are in their OFF-medication state
compared to ON-medication or healthy controls.
The aim of this pilot study is to
validate a previously developed method for the assessment of gait initiation on
PD patients in OFF state with body-worn, inertial sensors.
Ten subjects with
mild-to-moderate idiopathic PD and twelve healthy controls of similar age
performed three gait initiation trials. The spatio-temporal parameters of APAs
were extracted from three wearable sensors, placed on the shins and on the lower
back, and validated with two force plates. Temporal parameters extracted from
sensors and force plates, as well as the trunk medio-lateral acceleration and the
correspondent displacement of the center of pressure, were significantly
correlated. Subjects with PD showed hypometric adjustments in the medio-lateral
direction (p-value<0.003) and increased duration of the unloading phase
(p-value=0.04). The unloading phase was significantly longer than the imbalance
(p-value=0.003) only in subjects with PD. The validity of the method of
quantifying APAs from inertial sensors was confirmed in PD subjects by comparison
with force plates. Sensitivity in discriminating PD patients from healthy
controls was proven by both spatial and temporal parameters. Objective measures
of gait initiation deficits with wearable technology provides valuable instrument
for the assessment of gait initiation in clinical environments.
CI - Copyright A(c) 2016 Elsevier B.V. All rights reserved.

Langue : ANGLAIS