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Sensors 2014, 14(1), 356-369; doi:10.3390/s140100356

Continuous Monitoring of Turning in Patients with Movement Disability

1,* , 1
1 APDM, Inc., Portland, OR 97201, USA 2 Oregon Health & Science University, Portland, OR 97239, USA 3 University of Bologna, Bologna 40126, Italy
* Author to whom correspondence should be addressed.
Received: 6 November 2013 / Revised: 10 December 2013 / Accepted: 11 December 2013 / Published: 27 December 2013
(This article belongs to the Special Issue Wearable Gait Sensors)
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Difficulty with turning is a major contributor to mobility disability and falls in people with movement disorders, such as Parkinson’s disease (PD). Turning often results in freezing and/or falling in patients with PD. However, asking a patient to execute a turn in the clinic often does not reveal their impairments. Continuous monitoring of turning with wearable sensors during spontaneous daily activities may help clinicians and patients determine who is at risk of falls and could benefit from preventative interventions. In this study, we show that continuous monitoring of natural turning with wearable sensors during daily activities inside and outside the home is feasible for people with PD and elderly people. We developed an algorithm to detect and characterize turns during gait, using wearable inertial sensors. First, we validate the turning algorithm in the laboratory against a Motion Analysis system and against a video analysis of 21 PD patients and 19 control (CT) subjects wearing an inertial sensor on the pelvis. Compared to Motion Analysis and video, the algorithm maintained a sensitivity of 0.90 and 0.76 and a specificity of 0.75 and 0.65, respectively. Second, we apply the turning algorithm to data collected in the home from 12 PD and 18 CT subjects. The algorithm successfully detects turn characteristics, and the results show that, compared to controls, PD subjects tend to take shorter turns with smaller turn angles and more steps. Furthermore, PD subjects show more variability in all turn metrics throughout the day and the week.
Keywords: Parkinson’s disease; movement disability; continuous monitoring; turning; inertial sensors; gyroscopes; accelerometers Parkinson’s disease; movement disability; continuous monitoring; turning; inertial sensors; gyroscopes; accelerometers
This is an open access article distributed under the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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El-Gohary, M.; Pearson, S.; McNames, J.; Mancini, M.; Horak, F.; Mellone, S.; Chiari, L. Continuous Monitoring of Turning in Patients with Movement Disability. Sensors 2014, 14, 356-369.

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