Investigation of anticipatory postural adjustments during One-Leg Stance using inertial sensors: Evidence from subjects with Parkinsonism

Gianluca Bonora, Martina Mancini, Ilaria Carpinella, Lorenzo Chiari, Maurizio Ferrarin, John Nutt, Fay Horak

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

The One-Leg Stance (OLS) test is a widely adopted tool for the clinical assessment of balance in the elderly and in subjects with neurological disorders. It was previously showed that the ability to control anticipatory postural adjustments (APAs) prior to lifting one leg is significantly impaired by idiopathic Parkinson's disease (iPD). However,it is not known how APAs are affected by other types of parkinsonism, such as frontal gait disorders (FGD). In this study, an instrumented OLS test based on wearable inertial sensors is proposed to investigate both the initial anticipatory phase and the subsequent unipedal balance. The sensitivity and the validity of the test have been evaluated. Twenty-five subjects with iPD presenting freezing of gait (FOG), 33 with iPD without FOG, 13 with FGD, and 32 healthy elderly controls were recruited. All subjects wore three inertial sensors positioned on the posterior trunk (L4-L5), and on the left and right frontal face of the tibias. Participants were asked to lift a foot and stand on a single leg as long as possible with eyes open, as proposed by the mini-BESTest. Temporal parameters and trunk acceleration were extracted from sensors and compared among groups. The results showed that, regarding the anticipatory phase, the peak of mediolateral trunk acceleration was significantly reduced compared to healthy controls (p < 0.05) in subjects with iPD with and without FOG, but not in FGD group (p = 0.151). Regarding the balance phase duration, a significant shortening was found in the three parkinsonian groups compared to controls (p < 0.001). Moreover, balance was significantly longer (p < 0.001) in iPD subjects without FOG compared to subjects with FGD and iPD subjects presenting FOG. Strong correlations between balance duration extracted by sensors and clinical mini-BESTest scores were found (ρ > 0.74), demonstrating the method's validity. Our findings support the validity of the proposed method for assessing the OLS test and its sensitivity in distinguishing among the tested groups. The instrumented test discriminated between healthy controls and people with parkinsonism and among the three groups with parkinsonism. The objective characterization of the initial anticipatory phase represents an interesting improvement compared to most clinical OLS tests.

Original languageEnglish (US)
Article number361
JournalFrontiers in Neurology
Volume8
Issue numberJUL
DOIs
StatePublished - Jul 25 2017

Fingerprint

Parkinsonian Disorders
Leg
Neurologic Gait Disorders
Parkinson Disease
Gait
Freezing
Nervous System Diseases
Tibia
Foot

Keywords

  • Anticipatory postural adjustments
  • Balance control
  • Frontal gait disorders
  • Parkinson's disease
  • Single-leg stance
  • Unipedal balance
  • Wearable sensors

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Investigation of anticipatory postural adjustments during One-Leg Stance using inertial sensors : Evidence from subjects with Parkinsonism. / Bonora, Gianluca; Mancini, Martina; Carpinella, Ilaria; Chiari, Lorenzo; Ferrarin, Maurizio; Nutt, John; Horak, Fay.

In: Frontiers in Neurology, Vol. 8, No. JUL, 361, 25.07.2017.

Research output: Contribution to journalArticle

@article{3fa258bc9b1c4796ba15af3e47b6d2cf,
title = "Investigation of anticipatory postural adjustments during One-Leg Stance using inertial sensors: Evidence from subjects with Parkinsonism",
abstract = "The One-Leg Stance (OLS) test is a widely adopted tool for the clinical assessment of balance in the elderly and in subjects with neurological disorders. It was previously showed that the ability to control anticipatory postural adjustments (APAs) prior to lifting one leg is significantly impaired by idiopathic Parkinson's disease (iPD). However,it is not known how APAs are affected by other types of parkinsonism, such as frontal gait disorders (FGD). In this study, an instrumented OLS test based on wearable inertial sensors is proposed to investigate both the initial anticipatory phase and the subsequent unipedal balance. The sensitivity and the validity of the test have been evaluated. Twenty-five subjects with iPD presenting freezing of gait (FOG), 33 with iPD without FOG, 13 with FGD, and 32 healthy elderly controls were recruited. All subjects wore three inertial sensors positioned on the posterior trunk (L4-L5), and on the left and right frontal face of the tibias. Participants were asked to lift a foot and stand on a single leg as long as possible with eyes open, as proposed by the mini-BESTest. Temporal parameters and trunk acceleration were extracted from sensors and compared among groups. The results showed that, regarding the anticipatory phase, the peak of mediolateral trunk acceleration was significantly reduced compared to healthy controls (p < 0.05) in subjects with iPD with and without FOG, but not in FGD group (p = 0.151). Regarding the balance phase duration, a significant shortening was found in the three parkinsonian groups compared to controls (p < 0.001). Moreover, balance was significantly longer (p < 0.001) in iPD subjects without FOG compared to subjects with FGD and iPD subjects presenting FOG. Strong correlations between balance duration extracted by sensors and clinical mini-BESTest scores were found (ρ > 0.74), demonstrating the method's validity. Our findings support the validity of the proposed method for assessing the OLS test and its sensitivity in distinguishing among the tested groups. The instrumented test discriminated between healthy controls and people with parkinsonism and among the three groups with parkinsonism. The objective characterization of the initial anticipatory phase represents an interesting improvement compared to most clinical OLS tests.",
keywords = "Anticipatory postural adjustments, Balance control, Frontal gait disorders, Parkinson's disease, Single-leg stance, Unipedal balance, Wearable sensors",
author = "Gianluca Bonora and Martina Mancini and Ilaria Carpinella and Lorenzo Chiari and Maurizio Ferrarin and John Nutt and Fay Horak",
year = "2017",
month = "7",
day = "25",
doi = "10.3389/fneur.2017.00361",
language = "English (US)",
volume = "8",
journal = "Frontiers in Neurology",
issn = "1664-2295",
publisher = "Frontiers Research Foundation",
number = "JUL",

}

TY - JOUR

T1 - Investigation of anticipatory postural adjustments during One-Leg Stance using inertial sensors

T2 - Evidence from subjects with Parkinsonism

AU - Bonora, Gianluca

AU - Mancini, Martina

AU - Carpinella, Ilaria

AU - Chiari, Lorenzo

AU - Ferrarin, Maurizio

AU - Nutt, John

AU - Horak, Fay

PY - 2017/7/25

Y1 - 2017/7/25

N2 - The One-Leg Stance (OLS) test is a widely adopted tool for the clinical assessment of balance in the elderly and in subjects with neurological disorders. It was previously showed that the ability to control anticipatory postural adjustments (APAs) prior to lifting one leg is significantly impaired by idiopathic Parkinson's disease (iPD). However,it is not known how APAs are affected by other types of parkinsonism, such as frontal gait disorders (FGD). In this study, an instrumented OLS test based on wearable inertial sensors is proposed to investigate both the initial anticipatory phase and the subsequent unipedal balance. The sensitivity and the validity of the test have been evaluated. Twenty-five subjects with iPD presenting freezing of gait (FOG), 33 with iPD without FOG, 13 with FGD, and 32 healthy elderly controls were recruited. All subjects wore three inertial sensors positioned on the posterior trunk (L4-L5), and on the left and right frontal face of the tibias. Participants were asked to lift a foot and stand on a single leg as long as possible with eyes open, as proposed by the mini-BESTest. Temporal parameters and trunk acceleration were extracted from sensors and compared among groups. The results showed that, regarding the anticipatory phase, the peak of mediolateral trunk acceleration was significantly reduced compared to healthy controls (p < 0.05) in subjects with iPD with and without FOG, but not in FGD group (p = 0.151). Regarding the balance phase duration, a significant shortening was found in the three parkinsonian groups compared to controls (p < 0.001). Moreover, balance was significantly longer (p < 0.001) in iPD subjects without FOG compared to subjects with FGD and iPD subjects presenting FOG. Strong correlations between balance duration extracted by sensors and clinical mini-BESTest scores were found (ρ > 0.74), demonstrating the method's validity. Our findings support the validity of the proposed method for assessing the OLS test and its sensitivity in distinguishing among the tested groups. The instrumented test discriminated between healthy controls and people with parkinsonism and among the three groups with parkinsonism. The objective characterization of the initial anticipatory phase represents an interesting improvement compared to most clinical OLS tests.

AB - The One-Leg Stance (OLS) test is a widely adopted tool for the clinical assessment of balance in the elderly and in subjects with neurological disorders. It was previously showed that the ability to control anticipatory postural adjustments (APAs) prior to lifting one leg is significantly impaired by idiopathic Parkinson's disease (iPD). However,it is not known how APAs are affected by other types of parkinsonism, such as frontal gait disorders (FGD). In this study, an instrumented OLS test based on wearable inertial sensors is proposed to investigate both the initial anticipatory phase and the subsequent unipedal balance. The sensitivity and the validity of the test have been evaluated. Twenty-five subjects with iPD presenting freezing of gait (FOG), 33 with iPD without FOG, 13 with FGD, and 32 healthy elderly controls were recruited. All subjects wore three inertial sensors positioned on the posterior trunk (L4-L5), and on the left and right frontal face of the tibias. Participants were asked to lift a foot and stand on a single leg as long as possible with eyes open, as proposed by the mini-BESTest. Temporal parameters and trunk acceleration were extracted from sensors and compared among groups. The results showed that, regarding the anticipatory phase, the peak of mediolateral trunk acceleration was significantly reduced compared to healthy controls (p < 0.05) in subjects with iPD with and without FOG, but not in FGD group (p = 0.151). Regarding the balance phase duration, a significant shortening was found in the three parkinsonian groups compared to controls (p < 0.001). Moreover, balance was significantly longer (p < 0.001) in iPD subjects without FOG compared to subjects with FGD and iPD subjects presenting FOG. Strong correlations between balance duration extracted by sensors and clinical mini-BESTest scores were found (ρ > 0.74), demonstrating the method's validity. Our findings support the validity of the proposed method for assessing the OLS test and its sensitivity in distinguishing among the tested groups. The instrumented test discriminated between healthy controls and people with parkinsonism and among the three groups with parkinsonism. The objective characterization of the initial anticipatory phase represents an interesting improvement compared to most clinical OLS tests.

KW - Anticipatory postural adjustments

KW - Balance control

KW - Frontal gait disorders

KW - Parkinson's disease

KW - Single-leg stance

KW - Unipedal balance

KW - Wearable sensors

UR - http://www.scopus.com/inward/record.url?scp=85025808536&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85025808536&partnerID=8YFLogxK

U2 - 10.3389/fneur.2017.00361

DO - 10.3389/fneur.2017.00361

M3 - Article

AN - SCOPUS:85025808536

VL - 8

JO - Frontiers in Neurology

JF - Frontiers in Neurology

SN - 1664-2295

IS - JUL

M1 - 361

ER -