Objective: To describe the differences in arm swing asymmetry between patients with PD and a healthy subjects group using portable RGBD camera.

Background: Changes in gait kinematics and it´s spatiotemporal characteristics are hallmarks for the characterization of Parkinson Disease (PD). Although motor changes mainly affect the lower limbs, recent studies showed that changes in arm movement are common and frequently reported, even in the early stages of PD (1). These changes are generally characterized by a bilateral and asymmetric reduction of arm swing. This asymmetry can be assessed and described qualitatively using clinical strategies such as the MDS-UPDRS scale (part III). However, there is a high variability in intra- and inter-observer assessment and arm swing changes can be subtle and influenced by age, which makes evaluation difficult (2).

Methods: 25 individuals with PD diagnosis and 25 healthy subjects (age matched) were recruited for the study. All participants participated in a single gait analysis session, to determine the motion of the arms. Body segments were tracked using an RGBD camera (Kinect 1). Each subject was instructed to start at the beginning of a corridor [Figure 1] (4 meters in length by 1.5 meters wide, a free of interference indoor capture area with controlled light and wind conditions) and walk at normal pace towards the Kinect®. Using digital signal processing techniques and based on wrist joints, Arm Swing Asymmetry (ASA) was calculated. Mann Whitney test was used for the comparison between groups. Statistically significant difference was considered if the p-value was lower than 0.05.

Results: Median duration of the disease from onset was 6 years (IQR 1-7). Hoehn and Yahr stage classification was I (16%) and II (84%). MDS-UPDRS mean was 36.88 (± 13.41) [table 1]. Arm swing analysis: Patient group exhibited significantly greater ASA compared to the control group (p: <0.001) [table 2]. This difference was only significant in the group between 40 to 59 years (MDS-UPDRS 32 ± 19.7, years of disease: 1, IQR 0-2) [Figure 2].

Conclusions: Arm swing asymmetry measured through a RGBD camera can differentiate quantitatively patients with Parkinson’s disease from healthy subjects this can be especially useful in recently diagnosed patients with low MDS-UPDRS scores.

References: 1. Lewek MD, Poole R, Johnson J, Halawa O, Huang X. Arm swing magnitude and asymmetry during gait in the early stages of Parkinson’s disease. Gait Posture. 2010 Feb;31(2):256-60. 2. Huang X, Mahoney JM, Lewis MM, Guangwei Du null, Piazza SJ, Cusumano JP. Both coordination and symmetry of arm swing are reduced in Parkinson’s disease. Gait Posture. 2012 Mar;35(3):373-7.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/arm-swing-asymmetry-in-parkinson-disease-patients-using-a-portable-rgbd-camera/