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

Ana Lígia Silva de Lima, Luc J.W. Evers, Tim Hahn, Nienke M. De Vries, Margaret Daeschler, Babak Boroojerdi, Dolors Terricabras, Max A Little, Bastiaan R. Bloem, Marjan J. Faber

Research output: Contribution to journalArticle

Abstract

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.
Original languageEnglish
Pages (from-to)388-394
JournalGait and Posture
Volume62
DOIs
Publication statusPublished - 28 Mar 2018

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Gait
Walking
Levodopa
Linear Models
Research
Exercise

Bibliographical note

© 2018, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/

Keywords

  • Parkinson’s disease
  • Ambulatory monitoring
  • Gait quantity
  • Wearable devices
  • Motor fluctuations

Cite this

Silva de Lima, A. L., Evers, L. J. W., Hahn, T., De Vries, N. M., Daeschler, M., Boroojerdi, B., ... Faber, M. J. (2018). Impact of motor fluctuations on real-life gait in Parkinson’s patients. Gait and Posture, 62, 388-394. https://doi.org/10.1016/j.gaitpost.2018.03.045
Silva de Lima, Ana Lígia ; Evers, Luc J.W. ; Hahn, Tim ; De Vries, Nienke M. ; Daeschler, Margaret ; Boroojerdi, Babak ; Terricabras, Dolors ; Little, Max A ; Bloem, Bastiaan R. ; Faber, Marjan J. / Impact of motor fluctuations on real-life gait in Parkinson’s patients. In: Gait and Posture. 2018 ; Vol. 62. pp. 388-394.
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Silva de Lima, AL, Evers, LJW, Hahn, T, De Vries, NM, Daeschler, M, Boroojerdi, B, Terricabras, D, Little, MA, Bloem, BR & Faber, MJ 2018, 'Impact of motor fluctuations on real-life gait in Parkinson’s patients', Gait and Posture, vol. 62, pp. 388-394. https://doi.org/10.1016/j.gaitpost.2018.03.045

Impact of motor fluctuations on real-life gait in Parkinson’s patients. / Silva de Lima, Ana Lígia; Evers, Luc J.W.; Hahn, Tim; De Vries, Nienke M.; Daeschler, Margaret; Boroojerdi, Babak; Terricabras, Dolors; Little, Max A; Bloem, Bastiaan R.; Faber, Marjan J.

In: Gait and Posture, Vol. 62, 28.03.2018, p. 388-394.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Impact of motor fluctuations on real-life gait in Parkinson’s patients

AU - Silva de Lima, Ana Lígia

AU - Evers, Luc J.W.

AU - Hahn, Tim

AU - De Vries, Nienke M.

AU - Daeschler, Margaret

AU - Boroojerdi, Babak

AU - Terricabras, Dolors

AU - Little, Max A

AU - Bloem, Bastiaan R.

AU - Faber, Marjan J.

N1 - © 2018, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/

PY - 2018/3/28

Y1 - 2018/3/28

N2 - 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.

AB - 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.

KW - Parkinson’s disease

KW - Ambulatory monitoring

KW - Gait quantity

KW - Wearable devices

KW - Motor fluctuations

UR - https://www.sciencedirect.com/science/article/pii/S0966636218302832

U2 - 10.1016/j.gaitpost.2018.03.045

DO - 10.1016/j.gaitpost.2018.03.045

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EP - 394

JO - Gait and Posture

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SN - 0966-6362

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Silva de Lima AL, Evers LJW, Hahn T, De Vries NM, Daeschler M, Boroojerdi B et al. Impact of motor fluctuations on real-life gait in Parkinson’s patients. Gait and Posture. 2018 Mar 28;62:388-394. https://doi.org/10.1016/j.gaitpost.2018.03.045