Objective: To explore mobility measures collected in daily-living conditions in different stages of PD.

Background: Gait and mobility impairments are considered a cardinal sign in Parkinson’s disease (PD), gradually deteriorating as the disease progresses and severely impacting independence and quality of life. However, mobility assessment is usually done in a controlled clinical environment and little is known on the patterns of movement in everyday life and their progression with disease.

Method: The study used a cross-sectional design to compare between healthy controls (HC) and patients with PD divided into three groups based on their “Hoehn and Yahr” (H&Y) score. Mobility data was collected using a tri-axial accelerometer (AX3, Axivity) worn by patients on the lower back for 7 days. Signals were analyzed using a wavelet based algorithm. Gait epochs and Sit-to-Stand (StS) transitions were detected. Measures extracted for the postural transitions included the number of transitions-per-day, transition duration, jerk, vertical velocity, and acceleration range. Gait measures included step count, number of walking bouts (NoB), percent-of-activity (PoA) and mean SVM per day. Mobility data was supplemented by a thorough neurological assessment. Age, gender, and disease severity were included as co-variates in the analysis.

Results: 141 HC (mean age 53.0±10.2yrs), 63 early stage (ES)-PD (60.9±10.7yrs; H&Y: 1.1±0.2), 136 mild-PD (66.3 ± 9.2; H&Y: 2.0±0.1) and 44 moderate-PD (79.3 ± 6.9; H&Y: 2.87 ± 0.2) were compared. Step count, NoB, PoA, and mean SVM were not different between HC and ES-PD but showed a significant gradual decline between the PD groups. Similarly, the number of daily transitions declined with disease severity. However, transition “quality” measures such as jerk, vertical velocity and range only differed between HC and ES-PD but not between the PD groups.

Conclusion: Daily living activity collected by an accelerometer may provide useful insights into disease progression. With disease progression, transition quantity and changes in gait becomes more pronounced. Postural transitions quality measures may be sensitive indicators for PD more than activity and gait measures.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/changes-in-gait-and-mobility-measures-collected-in-daily-living-conditions-in-different-stages-of-parkinsons-disease/