Impact of motor fluctuations on real-life gait in Parkinson’s patients


Background people with PD (PWP) have an increased risk of becoming inactive. Wearable sensors can provide insights into daily physical activity and walking patterns. Research questions (1) is the severity of motor fluctuations associated with sensor-derived average daily walking quantity? (2) is the severity of motor fluctuations associated with the amount of change in sensor-derived walking quantity after levodopa intake? Methods 304 Dutch PWP from the Parkinson@Home study were included. At baseline, all participants received a clinical examination. During the follow-up period (median: 97 days; 25-Interquartile range-IQR: 91 days, 75-IQR: 188 days), participants used the Fox Wearable Companion app and streamed smartwatch accelerometer data to a cloud platform. The first research question was assessed by linear regression on the sensor-derived mean time spent walking/day with the severity of fluctuations (MDS-UPDRS item 4.4) as independent variable, controlled for age and MDS-UPDRS part-III score. The second research question was assessed by linear regression on the sensor-derived mean post-levodopa walking quantity, with the sensor-derived mean pre-levodopa walking quantity and severity of fluctuations as independent variables, controlled for mean time spent walking per day, age and MDS-UPDRS part-III score. Results PWP spent most time walking between 8am and 1pm, summing up to 72 ± 39 (mean ± standard deviation) minutes of walking/day. The severity of motor fluctuations did not influence the mean time spent walking (B = 2.4 ± 1.9, p = 0.20), but higher age (B = −1.3 ± 0.3, p = < 0.001) and greater severity of motor symptoms (B = −0.6 ± 0.2, p < 0.001) was associated with less time spent walking (F(3,216) = 14.6, p<.001, R2 =.17). The severity of fluctuations was not associated with the amount of change in time spent walking in relation to levodopa intake in any part of the day. Significance Analysis of sensor-derived gait quantity suggests that the severity of motor fluctuations is not associated with changes in real-life walking patterns in mildly to moderate affected PWP.

Publication DOI:
Divisions: College of Engineering & Physical Sciences > Systems analytics research institute (SARI)
Additional Information: © 2018, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
Uncontrolled Keywords: Parkinson’s disease,Ambulatory monitoring,Gait quantity,Wearable devices,Motor fluctuations
Publication ISSN: 1879-2219
Last Modified: 27 Jun 2024 09:31
Date Deposited: 29 Mar 2018 07:15
Full Text Link:
Related URLs: https://www.sci ... 966636218302832 (Publisher URL)
PURE Output Type: Article
Published Date: 2018-03-28
Accepted Date: 2018-03-27
Authors: Silva de Lima, Ana Lígia
Evers, Luc J.W.
Hahn, Tim
De Vries, Nienke M.
Daeschler, Margaret
Boroojerdi, Babak
Terricabras, Dolors
Little, Max A (ORCID Profile 0000-0002-1507-3822)
Bloem, Bastiaan R.
Faber, Marjan J.

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