RESUMEN
BACKGROUND/AIM: Postural impairments and gait disorders in Parkinson's disease (PD) affect limits of stability, impaire postural adjustment, and evoke poor responses to perturbation. In the later stage of the disease, some patients can suffer from episodic features such as freezing of gait (FOG). Objective gait assessment and monitoring progress of the disease can give clinicians and therapist important information about changes in gait pattern and potential gait deviations, in order to prevent concomitant falls. The aim of this study was to propose a method for identification of freezing episodes and gait disturbances in patients with PD. A wireless inertial sensor system can be used to provide follow-up of the treatment effects or progress of the disease. METHODS: The system is simple for mounting a subject, comfortable, simple for installing and recording, reliable and provides high-quality sensor data. A total of 12 patients were recorded and tested. Software calculates various gait parameters that could be estimated. User friendly visual tool provides information about changes in gait characteristics, either in a form of spectrogram or by observing spatiotemporal parameters. Based on these parameters, the algorithm performs classification of strides and identification of FOG types. RESULTS: The described stride classification was merged with an algorithm for stride reconstruction resulting in a useful graphical tool that allows clinicians to inspect and analyze subject's movements. CONCLUSION: The described gait assessment system can be used for detection and categorization of gait disturbances by applying rule-based classification based on stride length, stride time, and frequency of the shank segment movements. The method provides an valuable graphical interface which is easy to interpret and provides clinicians and therapists with valuable information regarding the temporal changes in gait.
Asunto(s)
Marcha , Enfermedad de Parkinson/fisiopatología , Accidentes por Caídas , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Alternation of walking pattern decreases quality of life and may result in falls and injuries. Freezing of gait (FOG) in Parkinson's disease (PD) patients occurs occasionally and intermittently, appearing in a random, inexplicable manner. In order to detect typical disturbances during walking, we designed an expert system for automatic classification of various gait patterns. The proposed method is based on processing of data obtained from an inertial sensor mounted on shank. The algorithm separates normal from abnormal gait using Pearson's correlation and describes each stride by duration, shank displacement, and spectral components. A rule-based data processing classifies strides as normal, short (short(+)) or very short (short(-)) strides, FOG with tremor (FOG(+)) or FOG with complete motor block (FOG(-)). The algorithm also distinguishes between straight and turning strides. In 12 PD patients, FOG(+) and FOG(-) were identified correctly in 100% of strides, while normal strides were recognized in 95% of cases. Short(+) and short(-) strides were identified in about 84% and 78%. Turning strides were correctly identified in 88% of cases. The proposed method may be used as an expert system for detailed stride classification, providing warning for severe FOG episodes and near-fall situations.
Asunto(s)
Trastornos Neurológicos de la Marcha/diagnóstico , Enfermedad de Parkinson/diagnóstico , Adulto , Anciano , Algoritmos , Automatización , Fenómenos Biomecánicos , Reacciones Falso Negativas , Reacciones Falso Positivas , Femenino , Marcha , Trastornos Neurológicos de la Marcha/clasificación , Trastornos Neurológicos de la Marcha/etiología , Humanos , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson/clasificación , Enfermedad de Parkinson/complicaciones , Reproducibilidad de los ResultadosRESUMEN
A new data processing method is described for estimation of angles of leg segments, joint angles, and trajectories in the sagittal plane from data recorded by sensors units mounted at the lateral side of leg segments. Each sensor unit comprises a pair of three-dimensional accelerometers which send data wirelessly to a PC. The accelerometer signals comprise time-varying and temperature-dependent offset, which leads to drift and diverged signals after integration. The key features of the proposed method are to model the offset by a slowly varying function of time (a cubic spline polynomial) and evaluate the polynomial coefficients by nonlinear numerical simplex optimization with the goal to reduce the drift in processed signals (angles and movement displacements). The angles and trajectories estimated by our method were compared with angles measured by an optical motion capture system. The comparison shows that the errors for angles (rms) were below 4° and the errors in stride length were below 2%. The algorithm developed is applicable for real-time and off-line analysis of gait. The method does not need any adaptation with respect to gait velocity or individuality of gait.
Asunto(s)
Acelerometría/métodos , Algoritmos , Marcha/fisiología , Adulto , Fenómenos Biomecánicos , Humanos , Articulaciones/fisiología , Pierna/fisiología , Sistemas en Línea , Tecnología InalámbricaRESUMEN
A new method for estimation of angles of leg segments and joints, which uses accelerometer arrays attached to body segments, is described. An array consists of two accelerometers mounted on a rigid rod. The absolute angle of each body segment was determined by band pass filtering of the differences between signals from parallel axes from two accelerometers mounted on the same rod. Joint angles were evaluated by subtracting absolute angles of the neighboring segments. This method eliminates the need for double integration as well as the drift typical for double integration. The efficiency of the algorithm is illustrated by experimental results involving healthy subjects who walked on a treadmill at various speeds, ranging between 0.15 m/s and 2.0 m/s. The validation was performed by comparing the estimated joint angles with the joint angles measured with flexible goniometers. The discrepancies were assessed by the differences between the two sets of data (obtained to be below 6 degrees) and by the Pearson correlation coefficient (greater than 0.97 for the knee angle and greater than 0.85 for the ankle angle).