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Can Digital Mobility Assessment Enhance the Clinical Assessment of Disease Severity in Parkinson’s Disease?

Lookup NU author(s): Dr Cameron KirkORCiD, Dr Rana RehmanORCiD, Dr Brook Galna, Dr Lisa AlcockORCiD, Professor Lynn RochesterORCiD, Dr Silvia Del DinORCiD, Professor Alison Yarnall

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Abstract

Background: Real-world walking speed (RWS) measured using wearable devices has the potential to complement the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS III) for motor assessment in Parkinson’s disease (PD). Objective: Explore cross-sectional and longitudinal differences in RWS between PD and older adults (OAs), and whether RWS was related to motor disease severity cross-sectionally, and if MDS-UPDRS III was related to RWS, longitudinally. Methods: 88 PD and 111 OA participants from ICICLE-GAIT (UK) were included. RWS was evaluated using an accelerometer at four time points. RWS was aggregated within walking bout (WB) duration thresholds. Between-group-comparisons in RWS between PD and OAs were conducted cross-sectionally, and longitudinally with mixed effects models (MEMs). Cross-sectional association between RWS and MDS-UPDRS III was explored using linear regression, and longitudinal association explored with MEMs. Results: RWS was significantly lower in PD (1.04m/s) in comparison to OAs (1.10 m/s) cross-sectionally. RWS significantly decreased over time for both cohorts and decline was more rapid in PD by 0.02 m/s per year. Significant negative relationship between RWS and the MDS-UPDRS III only existed at a specific WB threshold (30 to 60 seconds, β = -3.94 points, P = 0.047). MDS-UPDRS III increased significantly by 1.84 points per year, which was not related to change in RWS. Conclusions: Digital mobility assessment of gait may add unique information to quantify disease progression remotely, but further validation in research and clinical settings is needed.


Publication metadata

Author(s): Kirk C, Rehman R, Galna B, Alcock L, Ranciati S, Palmerini L, Garcia-Aymerich J, Hansen C, Schaeffer E, Berg D, Maetzler W, Rochester L, Del Din S, Yarnall A

Publication type: Article

Publication status: Published

Journal: Journal of Parkinson's Disease

Year: 2023

Volume: 13

Issue: 6

Pages: 999-1009

Online publication date: 31/07/2023

Acceptance date: 03/07/2023

Date deposited: 09/08/2023

ISSN (print): 1877-7171

ISSN (electronic): 1877-718X

Publisher: IOS Press

URL: https://doi.org/10.3233/JPD-230044

DOI: 10.3233/JPD-230044


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Funding

Funder referenceFunder name
820820
BRC
European Union Horizon 2020
European Federation of Pharmaceutical Industries and Associations (EFPIA)
G-1301
J-0802Parkinson`s UK (formerly Parkinson`s Disease Society)
nnovative Medicines Initiative 2 Joint Undertaking (JU)
NIHR
Parkinson’s UK
Wellcome Trust

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