Wearable sensors objectively measure gait parameters in Parkinson's disease

PLoS One. 2017 Oct 11;12(10):e0183989. doi: 10.1371/journal.pone.0183989. eCollection 2017.


Distinct gait characteristics like short steps and shuffling gait are prototypical signs commonly observed in Parkinson's disease. Routinely assessed by observation through clinicians, gait is rated as part of categorical clinical scores. There is an increasing need to provide quantitative measurements of gait, e.g. to provide detailed information about disease progression. Recently, we developed a wearable sensor-based gait analysis system as diagnostic tool that objectively assesses gait parameter in Parkinson's disease without the need of having a specialized gait laboratory. This system consists of inertial sensor units attached laterally to both shoes. The computed target of measures are spatiotemporal gait parameters including stride length and time, stance phase time, heel-strike and toe-off angle, toe clearance, and inter-stride variation from gait sequences. To translate this prototype into medical care, we conducted a cross-sectional study including 190 Parkinson's disease patients and 101 age-matched controls and measured gait characteristics during a 4x10 meter walk at the subjects' preferred speed. To determine intraindividual changes in gait, we monitored the gait characteristics of 63 patients longitudinally. Cross-sectional analysis revealed distinct spatiotemporal gait parameter differences reflecting typical Parkinson's disease gait characteristics including short steps, shuffling gait, and postural instability specific for different disease stages and levels of motor impairment. The longitudinal analysis revealed that gait parameters were sensitive to changes by mirroring the progressive nature of Parkinson's disease and corresponded to physician ratings. Taken together, we successfully show that wearable sensor-based gait analysis reaches clinical applicability providing a high biomechanical resolution for gait impairment in Parkinson's disease. These data demonstrate the feasibility and applicability of objective wearable sensor-based gait measurement in Parkinson's disease reaching high technological readiness levels for both, large scale clinical studies and individual patient care.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Female
  • Gait*
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Monitoring, Physiologic / instrumentation*
  • Parkinson Disease / physiopathology*
  • Postural Balance
  • Time Factors

Grant support

This research study was funded by the Bavarian Research Foundation (AZ-974-11) and the Emerging Fields Initiative (EFI Moves), Friedrich-Alexander University (FAU) Erlangen-Nürnberg. ASTRUM IT GmbH provided support in the form of salary for the thesis project of author J.B., but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Bjoern M Eskofier reports grants outside the submitted work from Bosch GmbH and Adidas Sport GmbH. Zacharias Kohl reports personal fees outside the submitted work from UCB Pharma GmbH, Actelion Pharmaceuticals, Desitin Arzneimittel GmbH, Ipsen Pharma. Jürgen Winkler reports personal fees outside of the submitted work from Abbvie GmbH & Co. KG. Jochen Klucken reports personal fees outside the submitted work from Teva GmbH, Licher MT GmbH, UCB Pharma GmbH, Ever Pharma GmbH, Desitin Arzneimittel GmbH, Abbvie GmbH & Co. KG, Biogen GmbH, GlaxoSmithKline GmbH & Co. KG. These funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the 'author contributions' section.