Investigating the Potential of Gait and Postural Indices to Identify the Possibility of Freezing in Individuals with Parkinson’s Disease using Wearable System

Abstract

Freezing of Gait (FoG) is a debilitating motor symptom of individuals with Parkinson’s Disease (PD). Literature reports that often the FoG can be linked with an increased variability in gait-related (e.g., Step Time, Double Limb Support Time, etc.) and postural (e.g., knee flexion) indices. The FoG can be triggered by various environmental factors, changes in motor task requirements and can become prevalent with disease progression. Research shows that there exists a time window (during gait) before freezing episode when there occurs a progressive decrease in the strides being made. This window might offer an opportunity to gauge one’s possibility of freezing so that measures to avoid freezing can be adopted. Given the importance of (i) quantifying the variability in gait-related and postural indices to characterize one’s FoG and (ii) measuring these indices within specific time window (during gait) before freezing happens, we have come up with a wearable system (SmartWear). This can help quantify variability in one’s gait and posture (namely knee flexion) during one’s overground walk (under free living conditions) for every consecutive steps (to enable measuring these indices within specific time window before actual freezing happens). Results of a study conducted with 14 individuals with PD who walked overground on pathways with and without turn under single and dual task conditions are impressive in terms of understanding the relative importance of the indices in the perspective of identification of one’s proneness to freeze before the actual freezing episode along with the clinical relevance of the index of interest.