Your turn: At home turning angle estimation for Parkinson’s disease severity assessment

Abstract

People with Parkinson’s Disease (PD) often experience progressively worsening gait, including changes in how they turn around, as the disease progresses. Existing clinical rating tools are not capable of capturing hour-by-hour variations of PD symptoms, as they are confined to brief assessments within clinic settings, leaving gait performance outside these controlled environments unaccounted for. Measuring turning angles continuously and passively is a component step towards using gait characteristics as sensitive indicators of disease progression in PD. This paper presents a deep learning-based approach to automatically quantify turning angles by extracting 3D skeletons from videos and calculating the rotation of hip and knee joints. We utilise advanced human pose estimation models, Fastpose and Strided Transformer, on a total of 1386 turning video clips from 24 subjects (12 people with PD and 12 healthy control volunteers), trimmed from a PD dataset of unscripted free-living videos in a home-like setting (Turn-REMAP). We also curate a turning video dataset, Turn-H3.6M, from the public Human3.6M human pose benchmark with 3D groundtruth, to further validate our method. Previous gait research has primarily taken place in clinics or laboratories evaluating scripted gait outcomes, but this work focuses on free-living home settings where complexities exist, such as baggy clothing and poor lighting. Due to difficulties in obtaining accurate groundtruth data in a free-living setting, we quantise the angle into the nearest bin 45° based on the manual labelling of expert clinicians. Our method achieves a turning calculation accuracy of 41.6%, a Mean Absolute Error (MAE) of 34.7°, and a weighted precision (WPrec) of 68.3% for Turn-REMAP. On Turn-H3.6M, it achieves an accuracy of 73.5%, an MAE of 18.5°, and a WPrec of 86.2%. This is the first work to explore the use of single monocular camera data to quantify turns by PD patients in a home setting. All data and models are publicly available, providing a baseline for turning parameter measurement to promote future PD gait research.