Skip to main content
Top
Published in: Journal of NeuroEngineering and Rehabilitation 1/2019

Open Access 01-12-2019 | Parkinson's Disease | Research

Movement smoothness during a functional mobility task in subjects with Parkinson’s disease and freezing of gait – an analysis using inertial measurement units

Authors: Camila Pinto, Clarissa Pedrini Schuch, Gustavo Balbinot, Ana Paula Salazar, Ewald Max Hennig, Ana Francisca Rozin Kleiner, Aline Souza Pagnussat

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2019

Login to get access

Abstract

Background

Impairments of functional mobility may affect locomotion and quality of life in subjects with Parkinson’s disease (PD). Movement smoothness measurements, such as the spectral arc length (SPARC), are novel approaches to quantify movement quality. Previous studies analyzed SPARC in simple walking conditions. However, SPARC outcomes during functional mobility tasks in subjects with PD and freezing of gait (FOG) were never investigated. This study aimed to analyze SPARC during the Timed Up and Go (TUG) test in individuals with PD and FOG.

Methods

Thirty-one participants with PD and FOG and six healthy controls were included. SPARC during TUG test was calculated for linear and angular accelerations using an inertial measurement unit system. SPARC data were correlated with clinical parameters: motor section of the Unified Parkinson’s Disease Rating Scale, Hoehn & Yahr scale, Freezing of Gait Questionnaire, and TUG test.

Results

We reported lower SPARC values (reduced smoothness) during the entire TUG test, turn and stand to sit in subjects with PD and FOG, compared to healthy controls. Unlike healthy controls, individuals with PD and FOG displayed a broad spectral range that encompassed several dominant frequencies. SPARC metrics also correlated with all the above-mentioned clinical parameters.

Conclusion

SPARC values provide valid and relevant clinical data about movement quality (e.g., smoothness) of subjects with PD and FOG during a functional mobility test.
Appendix
Available only for authorised users
Literature
1.
go back to reference Kerr GK, Worringham CJ, Cole MH, Lacherez PF, Wood JM, Silburn PA. Predictors of future falls in Parkinson disease. Neurology. 2010;75(2):116–24 Epub 2010/06/25.CrossRefPubMed Kerr GK, Worringham CJ, Cole MH, Lacherez PF, Wood JM, Silburn PA. Predictors of future falls in Parkinson disease. Neurology. 2010;75(2):116–24 Epub 2010/06/25.CrossRefPubMed
2.
go back to reference Perez-Lloret S, Negre-Pages L, Damier P, Delval A, Derkinderen P, Destee A, et al. Prevalence, determinants, and effect on quality of life of freezing of gait in Parkinson disease. JAMA Neurol. 2014;71(7):884–90 Epub 2014/05/21.CrossRefPubMed Perez-Lloret S, Negre-Pages L, Damier P, Delval A, Derkinderen P, Destee A, et al. Prevalence, determinants, and effect on quality of life of freezing of gait in Parkinson disease. JAMA Neurol. 2014;71(7):884–90 Epub 2014/05/21.CrossRefPubMed
3.
go back to reference Forsaa EB, Larsen JP, Wentzel-Larsen T, Alves G. A 12-year population-based study of freezing of gait in Parkinson's disease. Parkinsonism Relat Disord. 2015;21(3):254–8 Epub 2015/01/22.CrossRefPubMed Forsaa EB, Larsen JP, Wentzel-Larsen T, Alves G. A 12-year population-based study of freezing of gait in Parkinson's disease. Parkinsonism Relat Disord. 2015;21(3):254–8 Epub 2015/01/22.CrossRefPubMed
4.
go back to reference Thevathasan W, Cole MH, Graepel CL, Hyam JA, Jenkinson N, Brittain JS, et al. A spatiotemporal analysis of gait freezing and the impact of pedunculopontine nucleus stimulation. Brain. 2012;135(Pt 5):1446–54 Epub 2012/03/08.CrossRefPubMedPubMedCentral Thevathasan W, Cole MH, Graepel CL, Hyam JA, Jenkinson N, Brittain JS, et al. A spatiotemporal analysis of gait freezing and the impact of pedunculopontine nucleus stimulation. Brain. 2012;135(Pt 5):1446–54 Epub 2012/03/08.CrossRefPubMedPubMedCentral
5.
go back to reference Okuma Y. Practical approach to freezing of gait in Parkinson's disease. Pract Neurol. 2014;14(4):222–30 Epub 2014/02/18.CrossRefPubMed Okuma Y. Practical approach to freezing of gait in Parkinson's disease. Pract Neurol. 2014;14(4):222–30 Epub 2014/02/18.CrossRefPubMed
6.
go back to reference Giladi N, Shabtai H, Simon ES, Biran S, Tal J, Korczyn AD. Construction of freezing of gait questionnaire for patients with parkinsonism. Parkinsonism Relat Disord. 2000;6(3):165–70 Epub 2000/05/19.CrossRefPubMed Giladi N, Shabtai H, Simon ES, Biran S, Tal J, Korczyn AD. Construction of freezing of gait questionnaire for patients with parkinsonism. Parkinsonism Relat Disord. 2000;6(3):165–70 Epub 2000/05/19.CrossRefPubMed
7.
go back to reference Nanhoe-Mahabier W, Snijders AH, Delval A, Weerdesteyn V, Duysens J, Overeem S, et al. Walking patterns in Parkinson's disease with and without freezing of gait. Neuroscience. 2011;182:217–24 Epub 2011/03/09.CrossRefPubMed Nanhoe-Mahabier W, Snijders AH, Delval A, Weerdesteyn V, Duysens J, Overeem S, et al. Walking patterns in Parkinson's disease with and without freezing of gait. Neuroscience. 2011;182:217–24 Epub 2011/03/09.CrossRefPubMed
8.
go back to reference Podsiadlo D, Richardson S. The timed "up & go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142–8 Epub 1991/02/01.CrossRefPubMed Podsiadlo D, Richardson S. The timed "up & go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142–8 Epub 1991/02/01.CrossRefPubMed
9.
go back to reference Nocera JR, Stegemoller EL, Malaty IA, Okun MS, Marsiske M, Hass CJ. Using the timed up & go test in a clinical setting to predict falling in Parkinson's disease. Arch Phys Med Rehabil. 2013;94(7):1300–5 Epub 2013/03/12.CrossRefPubMedPubMedCentral Nocera JR, Stegemoller EL, Malaty IA, Okun MS, Marsiske M, Hass CJ. Using the timed up & go test in a clinical setting to predict falling in Parkinson's disease. Arch Phys Med Rehabil. 2013;94(7):1300–5 Epub 2013/03/12.CrossRefPubMedPubMedCentral
10.
go back to reference Zampieri C, Salarian A, Carlson-Kuhta P, Aminian K, Nutt JG, Horak FB. The instrumented timed up and go test: potential outcome measure for disease modifying therapies in Parkinson's disease. J Neurol Neurosurg Psychiatry. 2010;81(2):171–6 Epub 2009/09/04.CrossRefPubMed Zampieri C, Salarian A, Carlson-Kuhta P, Aminian K, Nutt JG, Horak FB. The instrumented timed up and go test: potential outcome measure for disease modifying therapies in Parkinson's disease. J Neurol Neurosurg Psychiatry. 2010;81(2):171–6 Epub 2009/09/04.CrossRefPubMed
11.
go back to reference van Lummel RC, Walgaard S, Hobert MA, Maetzler W, van Dieen JH, Galindo-Garre F, et al. Intra-rater, inter-rater and test-retest reliability of an instrumented timed up and go (iTUG) test in patients with Parkinson's Disease. PLoS One. 2016;11(3):e0151881 Epub 2016/03/22.CrossRefPubMedPubMedCentral van Lummel RC, Walgaard S, Hobert MA, Maetzler W, van Dieen JH, Galindo-Garre F, et al. Intra-rater, inter-rater and test-retest reliability of an instrumented timed up and go (iTUG) test in patients with Parkinson's Disease. PLoS One. 2016;11(3):e0151881 Epub 2016/03/22.CrossRefPubMedPubMedCentral
12.
go back to reference Vienne A, Barrois RP, Buffat S, Ricard D, Vidal PP. Inertial sensors to assess gait quality in patients with neurological disorders: a systematic review of technical and analytical challenges. Front Psychol. 2017;8:817 Epub 2017/06/03.CrossRefPubMedPubMedCentral Vienne A, Barrois RP, Buffat S, Ricard D, Vidal PP. Inertial sensors to assess gait quality in patients with neurological disorders: a systematic review of technical and analytical challenges. Front Psychol. 2017;8:817 Epub 2017/06/03.CrossRefPubMedPubMedCentral
13.
go back to reference Balasubramanian S, Melendez-Calderon A, Roby-Brami A, Burdet E. On the analysis of movement smoothness. J Neuroeng Rehabil. 2015;12:112 Epub 2015/12/15.CrossRefPubMedPubMedCentral Balasubramanian S, Melendez-Calderon A, Roby-Brami A, Burdet E. On the analysis of movement smoothness. J Neuroeng Rehabil. 2015;12:112 Epub 2015/12/15.CrossRefPubMedPubMedCentral
14.
go back to reference di Biase L, Summa S, Tosi J, Taffoni F, Marano M, Cascio Rizzo A, et al. Quantitative analysis of bradykinesia and rigidity in Parkinson's Disease. Front Neurol. 2018;9:121 Epub 2018/03/24.CrossRefPubMedPubMedCentral di Biase L, Summa S, Tosi J, Taffoni F, Marano M, Cascio Rizzo A, et al. Quantitative analysis of bradykinesia and rigidity in Parkinson's Disease. Front Neurol. 2018;9:121 Epub 2018/03/24.CrossRefPubMedPubMedCentral
15.
go back to reference Brach JS, McGurl D, Wert D, Vanswearingen JM, Perera S, Cham R, et al. Validation of a measure of smoothness of walking. J Gerontol A Biol Sci Med Sci. 2011;66(1):136–41 Epub 2010/10/07.CrossRefPubMed Brach JS, McGurl D, Wert D, Vanswearingen JM, Perera S, Cham R, et al. Validation of a measure of smoothness of walking. J Gerontol A Biol Sci Med Sci. 2011;66(1):136–41 Epub 2010/10/07.CrossRefPubMed
16.
go back to reference Dixon PC, Stirling L, Xu X, Chang CC, Dennerlein JT, Schiffman JM. Aging may negatively impact movement smoothness during stair negotiation. Hum Mov Sci. 2018;60:78–86 Epub 2018/05/31.CrossRefPubMed Dixon PC, Stirling L, Xu X, Chang CC, Dennerlein JT, Schiffman JM. Aging may negatively impact movement smoothness during stair negotiation. Hum Mov Sci. 2018;60:78–86 Epub 2018/05/31.CrossRefPubMed
18.
go back to reference Castagna A, Frittoli S, Ferrarin M, Del Sorbo F, Romito LM, Elia AE, et al. Quantitative gait analysis in parkin disease: possible role of dystonia. Mov Disord. 2016;31(11):1720–8 Epub 2016/07/08.CrossRefPubMed Castagna A, Frittoli S, Ferrarin M, Del Sorbo F, Romito LM, Elia AE, et al. Quantitative gait analysis in parkin disease: possible role of dystonia. Mov Disord. 2016;31(11):1720–8 Epub 2016/07/08.CrossRefPubMed
19.
go back to reference Beck Y, Herman T, Brozgol M, Giladi N, Mirelman A, Hausdorff JM. SPARC: a new approach to quantifying gait smoothness in patients with Parkinson's disease. J Neuroeng Rehabil. 2018;15(1):49 Epub 2018/06/20.CrossRefPubMedPubMedCentral Beck Y, Herman T, Brozgol M, Giladi N, Mirelman A, Hausdorff JM. SPARC: a new approach to quantifying gait smoothness in patients with Parkinson's disease. J Neuroeng Rehabil. 2018;15(1):49 Epub 2018/06/20.CrossRefPubMedPubMedCentral
20.
go back to reference Sprint G, Cook DJ, Weeks DL. Toward automating clinical assessments: a survey of the timed up and go. IEEE Rev Biomed Eng. 2015;8:64–77 Epub 2015/01/17.CrossRefPubMedPubMedCentral Sprint G, Cook DJ, Weeks DL. Toward automating clinical assessments: a survey of the timed up and go. IEEE Rev Biomed Eng. 2015;8:64–77 Epub 2015/01/17.CrossRefPubMedPubMedCentral
21.
go back to reference Nieuwboer A, Rochester L, Herman T, Vandenberghe W, Emil GE, Thomaes T, et al. Reliability of the new freezing of gait questionnaire: agreement between patients with Parkinson's disease and their carers. Gait Posture. 2009;30(4):459–63 Epub 2009/08/08.CrossRefPubMed Nieuwboer A, Rochester L, Herman T, Vandenberghe W, Emil GE, Thomaes T, et al. Reliability of the new freezing of gait questionnaire: agreement between patients with Parkinson's disease and their carers. Gait Posture. 2009;30(4):459–63 Epub 2009/08/08.CrossRefPubMed
22.
go back to reference Hausdorff JM, Schaafsma JD, Balash Y, Bartels AL, Gurevich T, Giladi N. Impaired regulation of stride variability in Parkinson's disease subjects with freezing of gait. Exp Brain Res. 2003;149(2):187–94 Epub 2003/03/01.CrossRefPubMed Hausdorff JM, Schaafsma JD, Balash Y, Bartels AL, Gurevich T, Giladi N. Impaired regulation of stride variability in Parkinson's disease subjects with freezing of gait. Exp Brain Res. 2003;149(2):187–94 Epub 2003/03/01.CrossRefPubMed
23.
go back to reference Nonnekes J, Snijders AH, Nutt JG, Deuschl G, Giladi N, Bloem BR. Freezing of gait: a practical approach to management. Lancet Neurol. 2015;14(7):768–78 Epub 2015/05/29.CrossRefPubMed Nonnekes J, Snijders AH, Nutt JG, Deuschl G, Giladi N, Bloem BR. Freezing of gait: a practical approach to management. Lancet Neurol. 2015;14(7):768–78 Epub 2015/05/29.CrossRefPubMed
24.
go back to reference Weiss A, Herman T, Plotnik M, Brozgol M, Giladi N, Hausdorff JM. An instrumented timed up and go: the added value of an accelerometer for identifying fall risk in idiopathic fallers. Physiol Meas. 2011;32(12):2003–18 Epub 2011/11/19.CrossRefPubMed Weiss A, Herman T, Plotnik M, Brozgol M, Giladi N, Hausdorff JM. An instrumented timed up and go: the added value of an accelerometer for identifying fall risk in idiopathic fallers. Physiol Meas. 2011;32(12):2003–18 Epub 2011/11/19.CrossRefPubMed
25.
go back to reference von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344–9 Epub 2008/03/04.CrossRef von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344–9 Epub 2008/03/04.CrossRef
26.
go back to reference Disease P's. National Clinical Guideline for diagnosis and Management in Primary and Secondary Care. London: Royal College of Physicians of London; 2006. Disease P's. National Clinical Guideline for diagnosis and Management in Primary and Secondary Care. London: Royal College of Physicians of London; 2006.
27.
go back to reference Kleiner AFR, Pacifici I, Vagnini A, Camerota F, Celletti C, Stocchi F, et al. Timed up and go evaluation with wearable devices: validation in Parkinson's disease. J Bodyw Mov Ther. 2018;22(2):390–5 Epub 2018/06/05.CrossRefPubMed Kleiner AFR, Pacifici I, Vagnini A, Camerota F, Celletti C, Stocchi F, et al. Timed up and go evaluation with wearable devices: validation in Parkinson's disease. J Bodyw Mov Ther. 2018;22(2):390–5 Epub 2018/06/05.CrossRefPubMed
28.
go back to reference Rodriguez-Martin D, Sama A, Perez-Lopez C, Catala A, Moreno Arostegui JM, Cabestany J, et al. Home detection of freezing of gait using support vector machines through a single waist-worn triaxial accelerometer. PLoS One. 2017;12(2):e0171764 Epub 2017/02/16.CrossRefPubMedPubMedCentral Rodriguez-Martin D, Sama A, Perez-Lopez C, Catala A, Moreno Arostegui JM, Cabestany J, et al. Home detection of freezing of gait using support vector machines through a single waist-worn triaxial accelerometer. PLoS One. 2017;12(2):e0171764 Epub 2017/02/16.CrossRefPubMedPubMedCentral
29.
go back to reference Ahlrichs C, Sama A, Lawo M, Cabestany J, Rodriguez-Martin D, Perez-Lopez C, et al. Detecting freezing of gait with a tri-axial accelerometer in Parkinson's disease patients. Med Biol Eng Comput. 2016;54(1):223–33 Epub 2015/10/03.CrossRefPubMed Ahlrichs C, Sama A, Lawo M, Cabestany J, Rodriguez-Martin D, Perez-Lopez C, et al. Detecting freezing of gait with a tri-axial accelerometer in Parkinson's disease patients. Med Biol Eng Comput. 2016;54(1):223–33 Epub 2015/10/03.CrossRefPubMed
30.
go back to reference Mancini M, Priest KC, Nutt JG, Horak FB. Quantifying freezing of gait in Parkinson's disease during the instrumented timed up and go test. Conf Proc IEEE Eng Med Biol Soc. 2012;2012:1198–201 Epub 2013/02/01.PubMedCentral Mancini M, Priest KC, Nutt JG, Horak FB. Quantifying freezing of gait in Parkinson's disease during the instrumented timed up and go test. Conf Proc IEEE Eng Med Biol Soc. 2012;2012:1198–201 Epub 2013/02/01.PubMedCentral
31.
go back to reference Mancini M, Weiss A, Herman T, Hausdorff JM. Turn around freezing: community-living turning behavior in people with Parkinson's Disease. Front Neurol. 2018;9:18 Epub 2018/02/13.CrossRefPubMedPubMedCentral Mancini M, Weiss A, Herman T, Hausdorff JM. Turn around freezing: community-living turning behavior in people with Parkinson's Disease. Front Neurol. 2018;9:18 Epub 2018/02/13.CrossRefPubMedPubMedCentral
33.
go back to reference Cohen J. The concepts of power analysis. Statistical power analysis for the behavioral sciences. Hillsdale, New Jersey: Academic Press; 1988. p. 1–17. Epub 17 Cohen J. The concepts of power analysis. Statistical power analysis for the behavioral sciences. Hillsdale, New Jersey: Academic Press; 1988. p. 1–17. Epub 17
34.
go back to reference Miller Koop M, Ozinga SJ, Rosenfeldt AB, Alberts JL. Quantifying turning behavior and gait in Parkinson's disease using mobile technology. IBRO Rep. 2018;5:10–6 Epub 2018/08/24.CrossRefPubMedPubMedCentral Miller Koop M, Ozinga SJ, Rosenfeldt AB, Alberts JL. Quantifying turning behavior and gait in Parkinson's disease using mobile technology. IBRO Rep. 2018;5:10–6 Epub 2018/08/24.CrossRefPubMedPubMedCentral
35.
go back to reference Weiss A, Herman T, Mirelman A, Shiratzky SS, Giladi N, Barnes LL, et al. The transition between turning and sitting in patients with Parkinson's disease: a wearable device detects an unexpected sequence of events. Gait Posture. 2019;67:224–9 Epub 2018/11/01.CrossRefPubMed Weiss A, Herman T, Mirelman A, Shiratzky SS, Giladi N, Barnes LL, et al. The transition between turning and sitting in patients with Parkinson's disease: a wearable device detects an unexpected sequence of events. Gait Posture. 2019;67:224–9 Epub 2018/11/01.CrossRefPubMed
37.
go back to reference Schaafsma JD, Balash Y, Gurevich T, Bartels AL, Hausdorff JM, Giladi N. Characterization of freezing of gait subtypes and the response of each to levodopa in Parkinson's disease. Eur J Neurol. 2003;10(4):391–8 Epub 2003/06/26.CrossRefPubMed Schaafsma JD, Balash Y, Gurevich T, Bartels AL, Hausdorff JM, Giladi N. Characterization of freezing of gait subtypes and the response of each to levodopa in Parkinson's disease. Eur J Neurol. 2003;10(4):391–8 Epub 2003/06/26.CrossRefPubMed
39.
go back to reference Rodriguez-Molinero A, Sama A, Perez-Lopez C, Rodriguez-Martin D, Alcaine S, Mestre B, et al. Analysis of correlation between an accelerometer-based algorithm for detecting parkinsonian gait and UPDRS subscales. Front Neurol. 2017;8:431 Epub 2017/09/19.CrossRefPubMedPubMedCentral Rodriguez-Molinero A, Sama A, Perez-Lopez C, Rodriguez-Martin D, Alcaine S, Mestre B, et al. Analysis of correlation between an accelerometer-based algorithm for detecting parkinsonian gait and UPDRS subscales. Front Neurol. 2017;8:431 Epub 2017/09/19.CrossRefPubMedPubMedCentral
40.
go back to reference Galna B, Murphy AT, Morris ME. Obstacle crossing in Parkinson's disease: mediolateral sway of the Centre of mass during level-ground walking and obstacle crossing. Gait Posture. 2013;38(4):790–4 Epub 2013/05/08.CrossRefPubMed Galna B, Murphy AT, Morris ME. Obstacle crossing in Parkinson's disease: mediolateral sway of the Centre of mass during level-ground walking and obstacle crossing. Gait Posture. 2013;38(4):790–4 Epub 2013/05/08.CrossRefPubMed
Metadata
Title
Movement smoothness during a functional mobility task in subjects with Parkinson’s disease and freezing of gait – an analysis using inertial measurement units
Authors
Camila Pinto
Clarissa Pedrini Schuch
Gustavo Balbinot
Ana Paula Salazar
Ewald Max Hennig
Ana Francisca Rozin Kleiner
Aline Souza Pagnussat
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of NeuroEngineering and Rehabilitation / Issue 1/2019
Electronic ISSN: 1743-0003
DOI
https://doi.org/10.1186/s12984-019-0579-8

Other articles of this Issue 1/2019

Journal of NeuroEngineering and Rehabilitation 1/2019 Go to the issue