Objective: Assess the role of inertial sensors in the phenotyping and differential diagnosis of Parkinson’s Disease vs. Atypical Parkinsonisms

Background: Wearable devices have been used to study human movement. However, their role on the differential diagnosis of movement disorders remains unclear. Improving patients’ assessment with multimodal phenotyping of gait, posture and finger movement could provide us with a better understanding of movement disorders physiology and have a role on diagnosis.

Method: We recruited 32 subjects with a diagnosis of Parkinson’s Disease (PD), 33 age-matched controls and 11 subjects with an atypical parkinsonism (AP). A set of 7 inertial sensors was mounted in the lower limbs and, leveraged by biomechanical models, we’ve assessed gait and posture kinematics during a 3×20 meters walk and stance. Subjects were evaluated during an outpatient clinic visit.

Results: Parkinsonian (PD and AP) subjects had significantly slower (gait speed: 0.77 ± 0.20 m/s vs 1.00 ± 0.19 m/s) and smaller (stride length: 0.92±0.18 m vs 1.1±0.14 m, p<0.001) movements when compared to control subjects. An accuracy of 82.9% predicting parkinsonism/non-parkinsonism was found using 162 gait-related metrics (43 traditional gait parameters, 18 non-linear parameters, 66 angular parameters, and 35 asymmetry coefficients) using a random forest model with 10-fold cross validation. AP patients differed from the PD group with lower ranges of motions in the ankle (22.12º ± 6.47º vs 29.83º ± 6.59º, p<0.001), and higher velocity asymmetries in hip and ankle joints (AP: 0.656 ± 0.563 m/s vs PD 0.268 ± 0.177 m/s, p=0.002, AP: 1.586 ± 1.227 m/s, PD 0.636 ± 0.537 m/s, p=0.002).

Conclusion: We have used a fast and standardized movement assessment protocol that was able to extract and identify kinematic differences between patients and healthy age-matched subjects. Expanding these results to earlier stages of diagnosis could provide important insights in the role of this tool in differential diagnosis and clinical assessment.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/inertial-sensor-based-kinematics-in-the-differential-diagnosis-of-parkinsons-disease-and-atypical-parkinsonisms/