Dataset Information

What happens before the first step? A New Approach to Quantifying Gait Initiation Using a Wearable Sensor.

ABSTRACT:

Background

Walking is a volitional behavior that requires planning and initiation before a step is observed. Following a signal to begin walking, studies of gait initiation in specialized labs have identified three phases that occur during the transition from a standing position via anticipatory postural adjustment (APA) to the first step. Routine instrumented gait testing outside of the laboratory setting focuses on gait execution and does not include gait initiation measures.

Research question

Can a single IMU sensor be used for performing gait initiation evaluations outside the lab?

Methods

We recorded walking in young (N?=?41) and older (N?=?26) adults using an instrumented gait mat while they were wearing a 3D accelerometer on their lower back. Subjects were instructed to begin walking following an auditory signal. An algorithm was developed to extract the following measures from the acceleration signal: gait initiation time, measured from the start of the auditory cue to begin walking and ends at the heel-strike of the swing leg, time-to-APA (reaction time), APA duration and swing time (execution of the first step).

Results

Intraclass correlation coefficient analysis showed good to excellent agreement between gait initiation metrics obtained with the gait mat and the wearable sensor (mean 0.88, range [0.75-0.96]). Except for swing time, all measures were longer in the older subjects, compared to the young adults (p?SignificanceExtracting gait initiation measures from routine instrumented gait testing may facilitate studies that can better determine the extent to which impaired gait planning and execution contribute to mobility impairments.

SUBMITTER: Gazit E

PROVIDER: S-EPMC7015786 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

What happens before the first step? A New Approach to Quantifying Gait Initiation Using a Wearable Sensor.

Gazit Eran E Buchman Aron S AS Dawe Robert R Curran Thomas A TA Mirelman Anat A Giladi Nir N Hausdorff Jeffrey M JM

Gait & posture 20191109

<h4>Background</h4>Walking is a volitional behavior that requires planning and initiation before a step is observed. Following a signal to begin walking, studies of gait initiation in specialized labs have identified three phases that occur during the transition from a standing position via anticipatory postural adjustment (APA) to the first step. Routine instrumented gait testing outside of the laboratory setting focuses on gait execution and does not include gait initiation measures.<h4>Resear ...[more]

PMID: 31760316

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Project description:BACKGROUND:Gait impairments including shuffling gait and hesitation are common in people with Parkinson's disease (PD), and have been linked to increased fall risk and freezing of gait. Nowadays the gait metrics mostly focus on the spatiotemporal characteristics of gait, but less is known of the angular characteristics of the gait, which may provide helpful information pertaining to the functional status and effects of the treatment in PD. OBJECTIVE:This study aimed to quantify the angles of steps during walking, and explore if this novel step angle metric is associated with the severity of PD and the effects of the treatment including the acute levodopa challenge test (ALCT) and deep brain stimulation (DBS). METHODS:A total of 18 participants with PD completed the walking test before and after the ALCT, and 25 participants with PD completed the test with the DBS on and off. The walking test was implemented under two conditions: walking normally at a preferred speed (single task) and walking while performing a cognitive serial subtraction task (dual task). A total of 17 age-matched participants without PD also completed this walking test. The angular velocity was measured using wearable sensors on each ankle, and three gait angular metrics were obtained, that is mean step angle, initial step angle, and last step angle. The conventional gait metrics (ie, step time and step number) were also calculated. RESULTS:The results showed that compared to the control, the following three step angle metrics were significantly smaller in those with PD: mean step angle (F1,48=69.75, P<.001, partial eta-square=0.59), initial step angle (F1,48=15.56, P<.001, partial eta-square=0.25), and last step angle (F1,48=61.99, P<.001, partial eta-square=0.56). Within the PD cohort, both the ALCT and DBS induced greater mean step angles (ACLT: F1,38=5.77, P=.02, partial eta-square=0.13; DBS: F1,52=8.53, P=.005, partial eta-square=0.14) and last step angles (ACLT: F1,38=10, P=.003, partial eta-square=0.21; DBS: F1,52=4.96, P=.003, partial eta-square=0.09), but no significant changes were observed in step time and number after the treatments. Additionally, these step angles were correlated with the Unified Parkinson's Disease Rating Scale, Part III score: mean step angle (single task: r=-0.60, P<.001; dual task: r=-0.52, P<.001), initial step angle (single task: r=-0.35, P=.006; dual task: r=-0.35, P=.01), and last step angle (single task: r=-0.43, P=.001; dual task: r=-0.41, P=.002). CONCLUSIONS:This pilot study demonstrated that the gait angular characteristics, as quantified by the step angles, were sensitive to the disease severity of PD and, more importantly, can capture the effects of treatments on the gait, while the traditional metrics cannot. This indicates that these metrics may serve as novel markers to help the assessment of gait in those with PD as well as the rehabilitation of this vulnerable cohort.

Dataset Information

What happens before the first step? A New Approach to Quantifying Gait Initiation Using a Wearable Sensor.

Background

Research question

Methods

Results

Publications

What happens before the first step? A New Approach to Quantifying Gait Initiation Using a Wearable Sensor.

Similar Datasets

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