Abstract

Stooped posture, which is usually aggravated during walking, is one of the typical postural deformities in patients with parkinsonism. However, the degree of stooped posture is difficult to quantitatively measure during walking. Furthermore, continuous feedback on posture is also difficult to provide. The purpose of this study is to measure the degree of stooped posture during gait and to investigate whether vibration feedback from sensor modules can improve a patient’s posture. Parkinsonian patients with stooped posture were recruited for this study. Two wearable sensors with three-axis accelerometers were attached, one at the upper neck and the other just below the C7 spinous process of the patients. After being calibrated in the most upright posture, the sensors continuously recorded the sagittal angles at 20 Hz and averaged the data at every second during a 6 min walk test. In the control session, the patients walked with the sensors as usual. In the vibration session, sensory feedback was provided through vibrations from the neck sensor module when the sagittal angle exceeded a programmable threshold value. Data were collected and analyzed successfully in a total of 10 patients. The neck flexion and back flexion were slightly aggravated during gait, although the average change was <10° in most patients in both measurement sessions. Therefore, it was difficult to evaluate the effect of sensory feedback through vibration. However, some patients showed immediate response to the feedback and corrected their posture during gait. In conclusion, this preliminary study suggests that stooped posture could be quantitatively measured during gait by using wearable sensors in patients with parkinsonism. Sensory feedback through vibration from sensor modules may help in correcting posture during gait in selected patients.

Highlights

  • Postural deformities are one of the major abnormalities observed in >30% of patients with Parkinson’s disease (PD) and may result in stooped posture, dropped head syndrome and Pisa syndrome [1,2]

  • We mainly focused on the feasibility of wearable sensors for the assessment of stooped posture in patients with parkinsonism and the response to sensory feedback in each case

  • Further studies will be required to evaluate the effectiveness of these sensors in daily life. This preliminary study suggests that stooped posture could be quantitatively measured during gait by using wearable sensors in patients with parkinsonism

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Summary

Introduction

Postural deformities are one of the major abnormalities observed in >30% of patients with Parkinson’s disease (PD) and may result in stooped posture, dropped head syndrome and Pisa syndrome [1,2]. Many treatments have been proposed to date for other symptoms such as gait and balance problems [9], there is still no clearly proven treatment for stooped posture in patients with parkinsonism. There has been no consistent method for evaluating the effect of treatment for stooped posture [3]. The measurement of bent posture is mostly performed in the static state using only photography or radiography [10,11,12]. These modalities cannot accurately measure the flexion angle during gait, which limits the evaluation of treatment effects

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