Clinical relevance of standardized mobile gait tests - reliability analysis between gait recordings at hospital and home in Parkinson’s disease: A pilot study

Please always quote using this URN: urn:nbn:de:bvb:29-opus4-142107
  • Background: Gait impairments in Parkinson’s disease (PD) are quantified using inertial sensors under standardized test settings in the hospital. Recent studies focused on the assessment of free-living gait in PD. However, the clinical relevance of standardized gait tests recorded at the patient’s home is unclear. Objective: To evaluate the reliability of supervised, standardized sensor-based gait outcomes at home compared to the hospital. Methods: Patients with PD (n=20) were rated by a trained investigator using the Unified Parkinson Disease Rating Scale (UPDRS-III). Gait tests included a standardized 4x10 m walk test and the Timed Up and Go Test (TUG). Tests were performed in theBackground: Gait impairments in Parkinson’s disease (PD) are quantified using inertial sensors under standardized test settings in the hospital. Recent studies focused on the assessment of free-living gait in PD. However, the clinical relevance of standardized gait tests recorded at the patient’s home is unclear. Objective: To evaluate the reliability of supervised, standardized sensor-based gait outcomes at home compared to the hospital. Methods: Patients with PD (n=20) were rated by a trained investigator using the Unified Parkinson Disease Rating Scale (UPDRS-III). Gait tests included a standardized 4x10 m walk test and the Timed Up and Go Test (TUG). Tests were performed in the hospital (HOSPITAL) and at patients’ home (HOME), and controlled for investigator, time of the day, and medication. Statistics included reliability analysis using Intra-Class correlations and Bland-Altman plots. Results: UPDRS-III and TUG were comparable between HOSPITAL and HOME. PD patients’ gait at HOME was slower (gait velocity Δ=-0.07±0.11 m/s,-6.1 %), strides were shorter (stride length Δ=-9.2±9.4 cm;-7.3 %), and shuffling of gait was more present (maximum toe-clearance Δ=-0.7±2.5 cm;-8.8 %). Particularly, narrow walkways (< 85 cm) resulted in a significant reduction of gait velocity at home. Reliability analysis (HOSPITAL vs. HOME) revealed excellent ICC coefficients for UPDRS-III (0.950, p<0.000) and gait parameters (e.g. stride length: 0.898,p<0.000; gait velocity: 0.914,p<0.000; stance time: 0.922,p<0.000; stride time: 0.907,p<0.000). Conclusions: This pilot study underlined the clinical relevance of gait parameters by showing excellent reliability for supervised, standardized gait tests at HOSPITAL and HOME, even though gait parameters were different between test conditions.show moreshow less

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Metadaten
Author:Heiko GaßnerORCiD, Philipp Sanders, Alisa Dietrich, Franz Marxreiter, Bjoern Eskofier, Jürgen Winkler, Jochen Klucken
URN:urn:nbn:de:bvb:29-opus4-142107
DOI:https://doi.org/10.3233/JPD-202129
Title of the journal / compilation (English):Journal of Parkinson’s disease
Document Type:Article
Language:English
Year of Completion:2020
Embargo Date:2020/07/29
Publishing Institution:Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU)
Creating Corporation:IOS Press
Release Date:2020/09/09
Tag:Parkinson’s disease, Gait analysis, Wearable sensors, Telemedicine, Home Monitoring
Institutes:Medizinische Fakultät
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
open_access (DINI-Set):open_access
Licence (German):Keine Creative Commons Lizenz - es gelten die Urheber- und Lizenzrechte des Verlags sowie die ggf. mit ihm verhandelten Open-Access-Rechte