Objective: Evaluate gait symmetry index as progression marker for motor impairment in patients with Parkinson’s disease (PD).

Background: PD is a neurodegenerative disease characterized by asymmetric motor symptoms and progressing gait deficits over the disease course, longitudinally requiring multiple adjustments in medication. Sensor-based gait analysis provides technically robust, objective, and quantitative spatiotemporal parameters for gait in PD [1]. Yet, there is a lack of robust PD-specific parameters that are useful in a longitudinal assessment of the progressive motor impairment. Therefore, we evaluated symmetry of gait reflected by a symmetry index derived from sensor-based gait parameters for its potential to reflect progression of motor impairment. In a longitudinal analysis, gait symmetry index was compared to disease-specific characteristics and clinical outcomes.

Method: In this retrospective analysis of longitudinal data, structured PD patient visits performed in the Movement Disorders Outpatient Center at the University Hospital Erlangen were used. Motor symptoms rated by certified and trained investigators using the Unified Parkinson’s Disease Rating Scale (UPDRS-III) were compared with gait parameters of standardized walking tests (4×10 m gait test, 2-Minute walk test), with a particular emphasis on a gait symmetry index (SI), calculated for gait parameters [2]. In addition, disease-specific characteristics (e.g. subtype, disease onset) and medication (Levodopa Equivalent Daily Dose, LEDD) were documented.

Results: In total, 282 structured visits of 108 PD patients were analysed. Motor-impairment progression rated by the UPDRS-III was compared with alterations of sensor-based symmetry gait parameters.

Conclusion: This longitudinal analysis assessed sensor-based gait symmetry parameters as progression markers of motor impairment in PD.

References: [1] Jakob, V.; Küderle, A.; Kluge, F.; Klucken, J.; Eskofier, B.M.; Winkler, J.;Winterholler, M.; Gassner, H. Validation of a Sensor-Based Gait Analysis System with a Gold-Standard Motion Capture System in Patients with Parkinson’s Disease. Sensors 2021, 21, 7680. https://doi.org/10.3390/s21227680
[2] H. Zhao, Z. Wang, S. Qiu, Y. Shen and J. Wang, “IMU-based gait analysis for rehabilitation assessment of patients with gait disorders,” 2017 4th International Conference on Systems and Informatics (ICSAI), 2017, pp. 622-626, doi: 10.1109/ICSAI.2017.8248364.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/monitoring-disease-course-by-sensor-based-gait-analysis-gait-symmetry-and-motor-impairment-progression-in-parkinsons-disease/