Covariance analysis of accelerometer sig
S16
Abstracts / Gait & Posture 37 (2013) S1–S31
Methods:
Study design: RCT.
Subjects: 18 patients with a diagnosis of PD.
Inclusion criteria: evidence of motor deficit in one lower limb,
age between 18 and 79 years. Exclusion criteria: Association of
neurological, orthopaedic or cardiopulmonary pathologies. Psychiatric disorders reducing patient collaboration. At the beginning of
the treatment and after 20 sessions, optocynematic analysis of gait
and clinical scales Hoehn and Yahr, were delivered. Treatment: all
patients will receive traditional treatment (Physiotherapy, Occupational Therapy and Speech Therapy). All subjects excepted will
undergo inpatient rehabilitation consisting of a treatment cycle
using the G-EO system (Reha Technologies) or treadmill device
GAIT TRAINER, according to individually tailored exercise scheduling. (Group A and CG.) All the treatment consists of 20 sessions
for the lower limbs, each lasting 45 min, 5 days a week for 4 weeks.
Results: The clinical characteristic of the experimental groups
were: Hoehn and Yahr Stage range 2–3 median 3, age 70.00 ± 8.396
yrs, weight 70.22 ± 17.14 kg, height 159.6 ± 9.13 cm. The clinical
characteristic of the control groups were: Hoehn and Yahr Stage
range 2–3 median 3, age 70 ± 10.2 yrs, weight 85.11 ± 19.27 kg,
height 162 ± 11 cm. The ones treated with GEO showed a significative improvement of Barthel (45 vs 62) and FIM (57 vs 86) scores at
discharge compared to admittance. No statistical difference at T0
were found. The spatio-temporal parameter (mean velocity, stride
length, stance and swing time) showed a statistical improvement
in Robot group.
Discussion: Our preliminary results show that G-EO system
treatment is well tolerated by patients with a statistical improvement of intra group performance and compared to Treadmill group.
References
[1] Sale P, De Pandis MF, Vimercati SL, Sova I, Foti C, Tenore N, et al. The relation
between Parkinson’s disease and ageing – comparison of the gait patterns of
young Parkinson’s disease subjects with healthy elderly subjects. Eur J Phys
Rehabil Med 2012;(May).
[2] Sale P, Semprini R, Foti C, Fini M, Franceschini M. Gait impairment
in neurological disorders: a new technological approach. Funct Neurol
2009;24(October–December (4)):179–83.
[3] Lo AC, Chang VC, Gianfrancesco MA, Friedman JH, Patterson TS, Benedicto DF.
Reduction of freezing of gait in Parkinson’s disease by repetitive robot-assisted
treadmill training: a pilot study. J Neuroeng Rehabil 2010;7(October):51.
sors. To our knowledge, this is the first study that integrates SOT and
inertial sensors information. This study aims at verifying if inertial
sensors might be used to characterize postural strategies and at
investigating the ability of PD subjects to appropriately integrate
altered sensory information in comparison with control subjects.
This is a preliminary study with a small cohort of patients that will
be expanded by running experiments.
Methods: Five subjects with PD, able to stand and walk independently, were tested OFF medication (range of UPDRS Motor
subsection: 13–53; mean: 34). Three age-matched control subjects
were also considered. Participants remained quietly on a moveable
force plate with a moveable visual surround (Neurocom Balance
Master), secured in a safety harness. They performed 3 repetitions
in the six SOT conditions: – SOT1 (eyes open), SOT2 (eyes closed),
SOT3 (sway referenced visual surround) with a stable base; – SOT4
(eyes open), SOT5 (eyes closed), SOT6 (sway-referenced visual surround) with a moveable sway-referenced base. Data from 2 inertial
sensors (ADPM Inc.) mounted on the shank and on the trunk (L5)
were considered. Accelerometer signals were aligned with respect
to gravity [3], low-pass filtered at 2 Hz to simulate inclinometer
data. Afterward the coordination between the upper and lower
segments of the body was investigated considering the covariance of the two signals in the anteroposterior direction (sagittal
plane), normalized by the variance of the two signals (Covariance Index, CI). A positive CI value close to 1 indicates that trunk
and leg are swaying in-phase, while a negative CI, in counterphase. CI toward zero indicates no linear relation between the two
signals.
Results: In control subjects the CI was sensible to the different SOT conditions. CI value was near 1 in SOT condition 5 and
6. Instead, CI was lower in the other SOT conditions reaching the
lowest values in SOT condition 3 and 4, suggesting a decoupling of
trunk and legs movements. On the contrary, PD subjects showed
less variability across conditions compared to controls. In fact, CI
was close to 1 across all 6 conditions, with very few exceptions
(one subject in SOT4), suggesting a single segment strategy in all
conditions.
http://dx.doi.org/10.1016/j.gaitpost.2012.12.041
C30
Covariance analysis of accelerometer signals reveals altered
postural strategies during the sensory organization test in
patients with Parkinson’s disease
C. Baston 1 , M. Mancini 2 , B. Schoneburg 2 , F.B. Horak 2 , L. Rocchi 1
1
Department of Electronics, Computer Science and System, University
of Bologna, Bologna, Italy
2 Department of Neurology, Oregon Health and Science University,
Portland, OR, USA
Introduction: The control of balance relies on the integration
of different sensory information, and the disruption of one of these
might lead to changes in the postural strategy used to maintain
stability [1]. The Sensory Organization Test (SOT) provides six sensory conditions, each one corresponding to an increasing level of
difficulty, in which either visual or somatosensory information or
both are disrupted. In the present study, the SOT was applied to
patients with Parkinson’s disease (PD), which have a modified balance control [2], to investigate their ability to correctly integrate
altered sensory inputs and to eventually perform an appropriate
strategy to maintain balance, quantified by means of inertial sen-
Discussion: Our preliminary results indicate that patients with
PD use different strategies than controls to maintain balance during the different SOT conditions. Surprisingly, PD patients seem to
prefer a single segment strategy in the simplest eyes open standing as well as in the more challenging conditions. Trunk and leg
move in phase more in the most challenging conditions (compared to the simplest), hence the body behaves probably as a single
segment. This is may be related to an increased stiffness in these
conditions, during which the subjects try to minimize their sway.
For PD subjects we can hypothesize a difficulty in appropriately
integrate the different and sometime contrasting sensory information without decoupling the trunk from the legs in any condition.
These results encourage further analyses to investigate the postural
strategies used to respond to contrasting sensory information, possibly leading to a significant contribution in the study of the sensory
integration in PD subjects.
Abstracts / Gait & Posture 37 (2013) S1–S31
S17
References
[1] Kuo AD, et al. Exp Brain Res 1998;122(2):185–95.
[2] Mancini M, Rocchi L, et al. Clin Biomech (Bristol, Avon) 2008;23(4):450–8.
[3] Moe-Nilssen R. Clin Biomech 1998;13:320–7.
http://dx.doi.org/10.1016/j.gaitpost.2012.12.042
C32
Robotic gait training is not superior to conventional treadmill
training in Parkinson’s Disease: A single-blind randomized controlled trial
S. Carda 1 , M. Invernizzi 2 , A. Baricich 2 , C. Comi 3 , A. Croquelois 1 ,
C. Cisari 2
1
Neuropsychology and Neurorehabilitation Unit, CHUV, Lausanne,
Switzerland
2 UO Medicina Fisica e Riabilitativa, AOU “Maggiore della Carità”,
Novara, Italy
3 Clinica Neurologica, AOU “Maggiore della Carità”, Novara, Italy
Background: The use of robots to assist gait training in Parkinson’s disease (PD), but no evidence points to an advantage over the
standard treadmill.
Methods: In this randomized, single-blind controlled trial, participants aged
Abstracts / Gait & Posture 37 (2013) S1–S31
Methods:
Study design: RCT.
Subjects: 18 patients with a diagnosis of PD.
Inclusion criteria: evidence of motor deficit in one lower limb,
age between 18 and 79 years. Exclusion criteria: Association of
neurological, orthopaedic or cardiopulmonary pathologies. Psychiatric disorders reducing patient collaboration. At the beginning of
the treatment and after 20 sessions, optocynematic analysis of gait
and clinical scales Hoehn and Yahr, were delivered. Treatment: all
patients will receive traditional treatment (Physiotherapy, Occupational Therapy and Speech Therapy). All subjects excepted will
undergo inpatient rehabilitation consisting of a treatment cycle
using the G-EO system (Reha Technologies) or treadmill device
GAIT TRAINER, according to individually tailored exercise scheduling. (Group A and CG.) All the treatment consists of 20 sessions
for the lower limbs, each lasting 45 min, 5 days a week for 4 weeks.
Results: The clinical characteristic of the experimental groups
were: Hoehn and Yahr Stage range 2–3 median 3, age 70.00 ± 8.396
yrs, weight 70.22 ± 17.14 kg, height 159.6 ± 9.13 cm. The clinical
characteristic of the control groups were: Hoehn and Yahr Stage
range 2–3 median 3, age 70 ± 10.2 yrs, weight 85.11 ± 19.27 kg,
height 162 ± 11 cm. The ones treated with GEO showed a significative improvement of Barthel (45 vs 62) and FIM (57 vs 86) scores at
discharge compared to admittance. No statistical difference at T0
were found. The spatio-temporal parameter (mean velocity, stride
length, stance and swing time) showed a statistical improvement
in Robot group.
Discussion: Our preliminary results show that G-EO system
treatment is well tolerated by patients with a statistical improvement of intra group performance and compared to Treadmill group.
References
[1] Sale P, De Pandis MF, Vimercati SL, Sova I, Foti C, Tenore N, et al. The relation
between Parkinson’s disease and ageing – comparison of the gait patterns of
young Parkinson’s disease subjects with healthy elderly subjects. Eur J Phys
Rehabil Med 2012;(May).
[2] Sale P, Semprini R, Foti C, Fini M, Franceschini M. Gait impairment
in neurological disorders: a new technological approach. Funct Neurol
2009;24(October–December (4)):179–83.
[3] Lo AC, Chang VC, Gianfrancesco MA, Friedman JH, Patterson TS, Benedicto DF.
Reduction of freezing of gait in Parkinson’s disease by repetitive robot-assisted
treadmill training: a pilot study. J Neuroeng Rehabil 2010;7(October):51.
sors. To our knowledge, this is the first study that integrates SOT and
inertial sensors information. This study aims at verifying if inertial
sensors might be used to characterize postural strategies and at
investigating the ability of PD subjects to appropriately integrate
altered sensory information in comparison with control subjects.
This is a preliminary study with a small cohort of patients that will
be expanded by running experiments.
Methods: Five subjects with PD, able to stand and walk independently, were tested OFF medication (range of UPDRS Motor
subsection: 13–53; mean: 34). Three age-matched control subjects
were also considered. Participants remained quietly on a moveable
force plate with a moveable visual surround (Neurocom Balance
Master), secured in a safety harness. They performed 3 repetitions
in the six SOT conditions: – SOT1 (eyes open), SOT2 (eyes closed),
SOT3 (sway referenced visual surround) with a stable base; – SOT4
(eyes open), SOT5 (eyes closed), SOT6 (sway-referenced visual surround) with a moveable sway-referenced base. Data from 2 inertial
sensors (ADPM Inc.) mounted on the shank and on the trunk (L5)
were considered. Accelerometer signals were aligned with respect
to gravity [3], low-pass filtered at 2 Hz to simulate inclinometer
data. Afterward the coordination between the upper and lower
segments of the body was investigated considering the covariance of the two signals in the anteroposterior direction (sagittal
plane), normalized by the variance of the two signals (Covariance Index, CI). A positive CI value close to 1 indicates that trunk
and leg are swaying in-phase, while a negative CI, in counterphase. CI toward zero indicates no linear relation between the two
signals.
Results: In control subjects the CI was sensible to the different SOT conditions. CI value was near 1 in SOT condition 5 and
6. Instead, CI was lower in the other SOT conditions reaching the
lowest values in SOT condition 3 and 4, suggesting a decoupling of
trunk and legs movements. On the contrary, PD subjects showed
less variability across conditions compared to controls. In fact, CI
was close to 1 across all 6 conditions, with very few exceptions
(one subject in SOT4), suggesting a single segment strategy in all
conditions.
http://dx.doi.org/10.1016/j.gaitpost.2012.12.041
C30
Covariance analysis of accelerometer signals reveals altered
postural strategies during the sensory organization test in
patients with Parkinson’s disease
C. Baston 1 , M. Mancini 2 , B. Schoneburg 2 , F.B. Horak 2 , L. Rocchi 1
1
Department of Electronics, Computer Science and System, University
of Bologna, Bologna, Italy
2 Department of Neurology, Oregon Health and Science University,
Portland, OR, USA
Introduction: The control of balance relies on the integration
of different sensory information, and the disruption of one of these
might lead to changes in the postural strategy used to maintain
stability [1]. The Sensory Organization Test (SOT) provides six sensory conditions, each one corresponding to an increasing level of
difficulty, in which either visual or somatosensory information or
both are disrupted. In the present study, the SOT was applied to
patients with Parkinson’s disease (PD), which have a modified balance control [2], to investigate their ability to correctly integrate
altered sensory inputs and to eventually perform an appropriate
strategy to maintain balance, quantified by means of inertial sen-
Discussion: Our preliminary results indicate that patients with
PD use different strategies than controls to maintain balance during the different SOT conditions. Surprisingly, PD patients seem to
prefer a single segment strategy in the simplest eyes open standing as well as in the more challenging conditions. Trunk and leg
move in phase more in the most challenging conditions (compared to the simplest), hence the body behaves probably as a single
segment. This is may be related to an increased stiffness in these
conditions, during which the subjects try to minimize their sway.
For PD subjects we can hypothesize a difficulty in appropriately
integrate the different and sometime contrasting sensory information without decoupling the trunk from the legs in any condition.
These results encourage further analyses to investigate the postural
strategies used to respond to contrasting sensory information, possibly leading to a significant contribution in the study of the sensory
integration in PD subjects.
Abstracts / Gait & Posture 37 (2013) S1–S31
S17
References
[1] Kuo AD, et al. Exp Brain Res 1998;122(2):185–95.
[2] Mancini M, Rocchi L, et al. Clin Biomech (Bristol, Avon) 2008;23(4):450–8.
[3] Moe-Nilssen R. Clin Biomech 1998;13:320–7.
http://dx.doi.org/10.1016/j.gaitpost.2012.12.042
C32
Robotic gait training is not superior to conventional treadmill
training in Parkinson’s Disease: A single-blind randomized controlled trial
S. Carda 1 , M. Invernizzi 2 , A. Baricich 2 , C. Comi 3 , A. Croquelois 1 ,
C. Cisari 2
1
Neuropsychology and Neurorehabilitation Unit, CHUV, Lausanne,
Switzerland
2 UO Medicina Fisica e Riabilitativa, AOU “Maggiore della Carità”,
Novara, Italy
3 Clinica Neurologica, AOU “Maggiore della Carità”, Novara, Italy
Background: The use of robots to assist gait training in Parkinson’s disease (PD), but no evidence points to an advantage over the
standard treadmill.
Methods: In this randomized, single-blind controlled trial, participants aged