A new instrumented method for the evaluation of gait initiation and step climbing based on inertial sensors: a pilot application in Parkinson’s disease

This should be easily replicated in stroke patients. So ask your doctor when they are going to start up a clinical research trial based on this. Survivors need to know exactly how our gait is not working properly and protocols to correct that. If no research is forthcoming call the hospital president and ask why the stroke department is not running clinical trials. This is worth going to the mat for.  

Why are your doctors sitting on their asses waiting for someone else to solve the problem?

http://www.jneuroengrehab.com/content/12/1/45

Gianluca Bonora^1*, Ilaria Carpinella¹, Davide Cattaneo², Lorenzo Chiari³ and Maurizio Ferrarin¹

• * Corresponding author: Gianluca Bonora gbonora@dongnocchi.it

Author Affiliations

¹ Biomedical Technology Department, Found. Don C. Gnocchi Onlus, IRCCS, Via Capecelatro 66, Milan, 20148, Italy
² LaRiCe: Gait and Balance Disorders Laboratory, Department of Neurorehabilitation, Found. Don C. Gnocchi Onlus, IRCCS, Via Capecelatro 66, 20148, Milan, Italy
³ Department of Electrical, Electronic, and Information Engineering - Guglielmo Marconi (DEI), University of Bologna, Viale Risorgimento 2, Bologna, 40136, Italy

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Journal of NeuroEngineering and Rehabilitation 2015, 12:45  doi:10.1186/s12984-015-0038-0
The electronic version of this article is the complete one and can be found online at: http://www.jneuroengrehab.com/content/12/1/45

Received:	10 September 2014
Accepted:	22 April 2015
Published:	5 May 2015

© 2015 Bonora et al.; licensee BioMed Central.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Abstract

Background

Step climbing is a demanding task required for personal autonomy in daily living. Anticipatory Postural Adjustments (APAs) preceding gait initiation have been widely investigated revealing to be hypometric in Parkinson’s disease (PD) with consequences in movement initiation. However, only few studies focused on APAs prior to step climbing. In this work, a novel method based on wearable inertial sensors for the analysis of APAs preceding gait initiation and step climbing was developed to further understand dynamic balance control. Validity and sensitivity of the method have been evaluated.

Methods

Eleven PD and 20 healthy subjects were asked to perform two transitional tasks from quiet standing to level walking, and to step climbing respectively. All the participants wore two inertial sensors, placed on the trunk (L2-L4) and laterally on the shank. In addition, a validation group composed of healthy subjects and 5 PD patients performed the tasks on two force platforms. Correlation between parameters from wearable sensors and force platforms was evaluated. Temporal parameters and trunk acceleration from PD and healthy subjects were analyzed.

Results

Significant correlation was found for the validation group between temporal parameters extracted from wearable sensors and force platforms and between medio-lateral component of trunk acceleration and correspondent COP displacement. These results support the validity of the method for evaluating APAs prior to both gait initiation and step climbing. Comparison between PD subjects and a subgroup of healthy controls confirms a reduction in PD of the medio-lateral acceleration of the trunk during the imbalance phase in the gait initiation task and shows similar trends during the imbalance and unloading phase of the step climbing task. Interestingly, PD subjects presented difficulties in adapting the medio-lateral amplitude of the imbalance phase to the specific task needs.

Conclusions

Validity of the method was confirmed by the significant correlation between parameters extracted from wearable sensors and force platforms. Sensitivity was proved by the capability to discriminate PD subjects from healthy controls. Our findings support the applicability of the method to subjects of different age. This method could be a possible valid instrument for a better understanding of feed-forward anticipatory strategies.