Objective: This study is an extension of a pilot study performed in 2021 and aims to investigate the clinical significance of exploiting wearable sensors such as pressure insoles, regarding Parkinson’s disease (PD), by applying a computational gait analysis in correlation with traditional clinical assessment tools.

Background: Wearable sensors, which permit precise and objective assessments, emerge as pivotal instruments in the management of PD. The usefulness of such tools is applicable to the diagnosis and monitoring of PD patients, both in clinical and research settings. The establishment of novel biomarkers is crucial in order to move towards a more personalized approach when treating PD patients.

Method: Patients diagnosed with PD from two Movement Disorders Centers in Greece, were enrolled in this study. The participants completed the Smart-Insole Gait Assessment Protocol, as previously described [1] and the MDS-UPDRS part III, performed by experts, in both OFF and ON medication states. During this protocol all the participants wore a validated sensor insole system, obtaining various spatiotemporal gait characteristics. These characteristics were then correlated with clinical variables, including medication state, MDS-UPDRSIII total score and Bradykinesia and Axal sub-scores.

Results: 174 PD patients were included and completed the protocol (61 female; mean age 65.2±9.5; mean Levodopa Equivalent Daily Dose 628.1±382.6). The mean total MDS-UPDRSIII was 39.4±16.3 and 29.5±13.9, during OFF and ON states. The Bradykinesia and Axial sub-scores were also calculated. Through statistical analyses, statistically significant correlations appeared between the sensor features and the clinical parameters considered. The most consistent of them was in regard with the discretion between the two medication states especially when the patients were performing the walking exercises in slow and normal pacing. Another significant finding was that the sensor features were best correlated with the axial sub-scores in most of the gait tasks.

Conclusion: The findings of this study suggest that the utilization of wearable devices for research or clinical purposes can result in numerous clinical conclusions that may facilitate the everyday medical practice when treating people with PD.

References: [1]Chatzaki, C.; Skaramagkas, V.; Kefalopoulou, Z.; Tachos, N.; Kostikis, N.; Kanellos, F.; Triantafyllou, E.; Chroni, E.; Fotiadis, D.I.; Tsiknakis, M. “Can Gait Features Help in Differentiating Parkinson’s Disease Medication States and Severity Levels? A Machine Learning Approach”. Sensors 2022, 22, 9937. https://doi.org/10.3390/s22249937

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MDS Abstracts - https://www.mdsabstracts.org/abstract/gait-assessment-for-parkinsons-disease-patients-utilizing-a-pressure-sensor-insole-system/