How to Select Balance Measures Sensitive to Parkinson’s Disease from Body-Worn Inertial Sensors—Separating the Trees from the Forest
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Procedure
2.3. Outcome Measures
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Ethical Statement
Appendix A
Objective Measures | Unit | Definition |
---|---|---|
Sway (seven metrics) | ||
Sway area | m2/s4 | Area of an ellipse covering 95% of the sway angle in the horizontal plane |
Jerk | m2/s5 | Smoothness of sway from the time derivative of the sway path in each direction (ML or AP) |
Velocity | m/s | Mean velocity of derivative of acceleration in each direction (ML or AP) |
RMS | m/s2 | Root mean square of acceleration time series in each direction (ML or AP) |
APRs (seven metrics) | ||
Latency | s | Time from release to onset of the first step |
Time to stability | s | Time from release to the point of trunk acceleration becoming stationary |
First foot strike time | s | Time from release to heel strike of the first moving leg (approximation of the first step length in the horizontal plane) |
Number of steps | N | Number of left and right foot steps to reach stability |
Length | m | Length of the first step of derivative of foot acceleration (ML: ML direction, AP: AP direction, Vertical: height) |
APAs (six metrics) | ||
peak ML | m/s2 | Peak trunk acceleration toward the stance foot of the lateral trunk acceleration |
peak AP | m/s2 | Peak trunk acceleration forward from baseline |
Duration | s | Time from APA onset to end |
First step ROM | degree | Range of motion of the leg (calculated from the integrated sagittal angular velocity, approximation of first step length) |
First step duration | s | Time from toe-off to first heel strike |
Latency | s | Time from APA onset to first heel strike (approximation of the first step velocity) |
Gait (12 metrics) | ||
Gait cycle duration | s | Duration of a complete gait cycle |
Gait speed | m/s | The forward speed of the subject |
Stride length | m/s | Distance between two consecutive heel strikes |
Foot strike angle | degree | Average angle of the foot at the point of initial contact |
Toe off angle | degree | Average angle of the foot at the point of push off |
Stance time | % of gait cycle | Percentage of a gait cycle that either foot is on the ground |
Double support time | % of gait cycle | Percentage of a gait cycle that both feet are on the ground |
Arm ROM | degree | Average of range of motion of both arms during arm-swing |
Trunk ROM | degree | Average range of motion of trunk (coronal: in frontal plane, sagittal: in sagittal plane, transverse: in horizontal plane) |
Domain | Task | Kept Measures (N = 44) | Removed Measures (N = 42) | ||
---|---|---|---|---|---|
Sway | EOFirm | Sway area | Jerk AP | Jerk ML | |
Velocity ML | RMS ML | Velocity AP | RMS AP | ||
EOFoam | Sway area | ||||
Jerk AP | Jerk ML | ||||
Velocity AP | Velocity ML | ||||
RMS AP | RMS ML | ||||
ECFirm | Velocity ML | Sway area | |||
Jerk AP | Jerk ML | ||||
Velocity AP | |||||
RMS AP | RMSML | ||||
ST and DT | Sway area | ||||
Jerk AP | Jerk ML | ||||
Velocity AP | Velocity ML | ||||
RMS AP | RMS ML | ||||
APRs | Time to stability | Number of steps | Latency | First foot strike time | |
Length ML | Length vertical | Length AP | |||
APAs | ST and DT | Peak ML | First step ROM | Peak AP | Duration |
Latency | First step duration | ||||
Gait | ST | Gait cycle duration SD | Gait speed | Trunk transverse ROM | |
Stride length | Foot strike angle | ||||
Toe off angle | Stance time | ||||
Double support time | Arm ROM | ||||
Trunk coronal ROM | Trunk sagittal ROM | ||||
Turn velocity | |||||
DT | Gait speed | Stride length | Gait cycle duration SD | ||
Foot strike angle | Toe off angle | ||||
Stance time | Double support time | ||||
Arm ROM | Trunk coronal ROM | ||||
Trunk sagittal ROM | Trunk transverse ROM | ||||
Turn velocity | |||||
DC | Stride length | Gait cycle duration SD | Gait speed | ||
Stance time | Double support time | ||||
LOS | Backward | Forward | |||
Total range |
Task | Measures | N | Test | Re-Test | Test-Retest ICC | SEM | MDC | ||
---|---|---|---|---|---|---|---|---|---|
Mean | SD | Mean | SD | ||||||
Gait ST | Gait cycle duration SD | 43 | 0.04 | 0.02 | 0.03 | 0.01 | 0.72 | 0.01 | 0.03 |
Foot strike angle | 43 | 11.54 | 5.65 | 11.43 | 5.30 | 0.97 | 1.03 | 2.84 | |
Toe off angle | 43 | 29.16 | 4.94 | 29.75 | 5.00 | 0.95 | 1.12 | 3.12 | |
Stance time | 43 | 61.55 | 2.10 | 60.95 | 2.03 | 0.94 | 0.51 | 1.41 | |
Trunk coronal ROM | 43 | 4.37 | 1.87 | 4.27 | 1.72 | 0.97 | 0.29 | 0.80 | |
Trunk sagittal ROM | 43 | 3.67 | 0.73 | 3.93 | 0.73 | 0.81 | 0.33 | 0.91 | |
Arm ROM | 43 | 26.51 | 11.48 | 27.39 | 12.84 | 0.96 | 2.46 | 6.83 | |
Turn velocity | 41 | 134.24 | 35.52 | 138.59 | 35.93 | 0.95 | 8.39 | 23.26 | |
Gait DT | Gait speed | 40 | 0.75 | 0.20 | 0.79 | 0.20 | 0.90 | 0.06 | 0.18 |
Trunk transverse ROM | 40 | 6.88 | 1.94 | 6.85 | 2.25 | 0.84 | 0.85 | 2.34 | |
Dual task cost | Stride length | 40 | −12.27 | 8.30 | −10.94 | 12.57 | 0.66 | 6.20 | 17.17 |
EOFirm | Sway area | 37 | 0.09 | 0.05 | 0.10 | 0.07 | 0.57 | 0.04 | 0.11 |
EOFoam | Jerk AP | 34 | 9.16 | 12.63 | 11.34 | 21.63 | 0.63 | 10.87 | 30.12 |
RMS ML | 34 | 0.12 | 0.04 | 0.12 | 0.06 | 0.79 | 0.02 | 0.06 | |
RMS AP | 34 | 0.13 | 0.04 | 0.14 | 0.09 | 0.46 | 0.05 | 0.14 | |
ECFirm | Velocity ML | 37 | 0.12 | 0.06 | 0.13 | 0.11 | 0.47 | 0.06 | 0.18 |
APA ST | peak ML | 37 | 0.04 | 0.01 | 0.03 | 0.02 | 0.70 | 0.01 | 0.02 |
First step ROM | 42 | 29.72 | 9.18 | 27.12 | 11.25 | 0.82 | 4.44 | 12.29 | |
Latency | 37 | 0.68 | 0.21 | 0.74 | 0.19 | 0.49 | 0.14 | 0.40 | |
APA DT | peak ML | 36 | 0.03 | 0.02 | 0.03 | 0.02 | 0.83 | 0.01 | 0.02 |
Latency | 36 | 0.76 | 0.20 | 0.81 | 0.34 | 0.23 | 0.25 | 0.68 | |
APR | Time to stability | 32 | 1.36 | 0.70 | 1.23 | 0.76 | 0.79 | 0.34 | 0.93 |
Length ML | 32 | 0.14 | 0.11 | 0.17 | 0.11 | 0.44 | 0.08 | 0.22 | |
Length vertical | 32 | 0.04 | 0.02 | 0.05 | 0.03 | 0.86 | 0.01 | 0.03 |
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Controls (N = 79) | PD (N = 144) | p Value | |||
---|---|---|---|---|---|
Mean | SD | Mean | SD | ||
Male/Female | 48/31 | 93/51 | 0.571 a | ||
Age | 68.2 | 8.1 | 68.4 | 8.0 | 0.822 |
Height (cm) | 171.5 | 10.0 | 173.4 | 9.9 | 0.184 b |
Weight (kg) | 73.7 | 13.1 | 79.7 | 16.9 | 0.018 b |
Disease Duration (years) | - | - | 6.2 | 5.0 | - |
MDS-UPDRS | |||||
Total | - | - | 68.7 | 20.4 | - |
Part II | - | - | 13.6 | 7.0 | - |
Part III | - | - | 40.6 | 12.6 | - |
Mini-BEST | 24.0 | 2.6 | 18.5 | 4.8 | <0.001 b |
ABC scale | 95.9 | 5.3 | 80.5 | 16.3 | <0.001 b |
PDQ-39 | |||||
Total | - | - | 17.6 | 11.8 | - |
Mobility | - | - | 17.0 | 17.4 | - |
MoCA | 26.8 | 2.3 | 25.8 | 3.4 | 0.080b |
Hoehn & Yahr stage | - | 1/115/15/13 | - | ||
(I/II/III/IV) |
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Hasegawa, N.; Shah, V.V.; Carlson-Kuhta, P.; Nutt, J.G.; Horak, F.B.; Mancini, M. How to Select Balance Measures Sensitive to Parkinson’s Disease from Body-Worn Inertial Sensors—Separating the Trees from the Forest. Sensors 2019, 19, 3320. https://doi.org/10.3390/s19153320
Hasegawa N, Shah VV, Carlson-Kuhta P, Nutt JG, Horak FB, Mancini M. How to Select Balance Measures Sensitive to Parkinson’s Disease from Body-Worn Inertial Sensors—Separating the Trees from the Forest. Sensors. 2019; 19(15):3320. https://doi.org/10.3390/s19153320
Chicago/Turabian StyleHasegawa, Naoya, Vrutangkumar V. Shah, Patricia Carlson-Kuhta, John G. Nutt, Fay B. Horak, and Martina Mancini. 2019. "How to Select Balance Measures Sensitive to Parkinson’s Disease from Body-Worn Inertial Sensors—Separating the Trees from the Forest" Sensors 19, no. 15: 3320. https://doi.org/10.3390/s19153320