Abstract
BackgroundAccurate assessment of balance and gait is necessary to monitor the clinical progress of Parkinson’s disease (PD). Conventional clinical scales can be biased and have limited accuracy. Novel interactive devices are potentially useful to detect subtle posture or gait-related impairments.MethodsPosturographic and single and dual-task gait assessments were performed to 54 individuals with PD and 43 healthy controls with the Wii Balance Board and the Kinect v2 and the, respectively. Individuals with PD were also assessed with the Tinetti Performance Oriented Mobility Assessment, the Functional Gait Assessment and the 10-m Walking Test. The influence of demographic and clinical variables on the performance in the instrumented posturographic and gait tests, the sensitivity of these tests to the clinical condition and phenotypes, and their convergent validity with clinical scales were investigated.ResultsIndividuals with PD in H&Y I and I.5 stages showed similar performance to controls. The greatest differences in posture and gait were found between subjects in H&Y II.5 and H&Y I–I.5 stage, as well as controls. Dual-tasking enhanced the differences among all groups in gait parameters. Akinetic/rigid phenotype showed worse postural control and gait than other phenotypes. High significant correlations were found between the limits of stability and most of gait parameters with the clinical scales.ConclusionsLow-cost devices showed potential to objectively quantify posture and gait in established PD (H&Y ≥ II). Dual-tasking gait evaluation was more sensitive to detect differences among PD stages and compared to controls than free gait. Gait and posture were more impaired in akinetic/rigid PD.
Highlights
Accurate assessment of balance and gait is necessary to monitor the clinical progress of Parkinson’s disease (PD)
Research has demonstrated that the performance of dual tasks has a significant and consistent negative effect on gait performance in PD patients, at different gait speeds and for different tasks [6], and dual-task associated gait evaluation can be used to distinguish individuals with de novo PD from healthy controls, which is not possible through the evaluation of regular walking [7]
The aim of this study was to determine the sensitivity of these tools for the evaluation of impairments associated with the clinical condition and phenotype of PD patients, and their convergent validity with conventional clinical scales
Summary
Accurate assessment of balance and gait is necessary to monitor the clinical progress of Parkinson’s disease (PD). Research has demonstrated that the performance of dual tasks has a significant and consistent negative effect on gait performance in PD patients, at different gait speeds and for different tasks [6], and dual-task associated gait evaluation can be used to distinguish individuals with de novo PD from healthy controls, which is not possible through the evaluation of regular walking [7]. Standardized clinical scales are commonly used to assess posture and gait in clinical settings, but their limited accuracy and intrinsic subjectivity may dramatically reduce their reliability [8]. To overcome these limitations, different instrumented tools, such as force plates and motion-tracking systems, have been developed for the accurate assessment of posture and gait, respectively [9, 10]. Recent low-cost interactive technologies have shown comparable accuracy to laboratory-grade instrumented systems while being portable and affordable [11,12,13]
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