Effect of Bout Length on Gait Measures in People with and without Parkinson’s Disease during Daily Life
Although the use of wearable technology to characterize gait disorders in daily life is increasing, there is no consensus on which specific gait bout length should be used to characterize gait. Clinical trialists using daily life gait quality as study outcomes need to understand how gait bout length...
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| Abstract | Although the use of wearable technology to characterize gait disorders in daily life is increasing, there is no consensus on which specific gait bout length should be used to characterize gait. Clinical trialists using daily life gait quality as study outcomes need to understand how gait bout length affects the sensitivity and specificity of measures to discriminate pathological gait as well as the reliability of gait measures across gait bout lengths. We investigated whether Parkinson’s disease (PD) affects how gait characteristics change as bout length changes, and how gait bout length affects the reliability and discriminative ability of gait measures to identify gait impairments in people with PD compared to neurotypical Old Adults (OA). We recruited 29 people with PD and 20 neurotypical OA of similar age for this study. Subjects wore 3 inertial sensors, one on each foot and one over the lumbar spine all day, for 7 days. To investigate which gait bout lengths should be included to extract gait measures, we determined the range of gait bout lengths available across all subjects. To investigate if the effect of bout length on each gait measure is similar or not between subjects with PD and OA, we used a growth curve analysis. For reliability and discriminative ability of each gait measure as a function of gait bout length, we used the intraclass correlation coefficient (ICC) and area under the curve (AUC), respectively. Ninety percent of subjects walked with a bout length of less than 53 strides during the week, and the majority (>50%) of gait bouts consisted of less than 12 strides. Although bout length affected all gait measures, the effects depended on the specific measure and sometimes differed for PD versus OA. Specifically, people with PD did not increase/decrease cadence and swing duration with bout length in the same way as OA. ICC and AUC characteristics tended to be larger for shorter than longer gait bouts. Our findings suggest that PD interferes with the scaling of cadence and swing duration with gait bout length. Whereas control subjects gradually increased cadence and decreased swing duration as bout length increased, participants with PD started with higher than normal cadence and shorter than normal stride duration for the smallest bouts, and cadence and stride duration changed little as bout length increased, so differences between PD and OA disappeared for the longer bout lengths. Gait measures extracted from shorter bouts are more common, more reliable, and more discriminative, suggesting that shorter gait bouts should be used to extract potential digital biomarkers for people with PD. |
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| AbstractList | Although the use of wearable technology to characterize gait disorders in daily life is increasing, there is no consensus on which specific gait bout length should be used to characterize gait. Clinical trialists using daily life gait quality as study outcomes need to understand how gait bout length affects the sensitivity and specificity of measures to discriminate pathological gait as well as the reliability of gait measures across gait bout lengths. We investigated whether Parkinson’s disease (PD) affects how gait characteristics change as bout length changes, and how gait bout length affects the reliability and discriminative ability of gait measures to identify gait impairments in people with PD compared to neurotypical Old Adults (OA). We recruited 29 people with PD and 20 neurotypical OA of similar age for this study. Subjects wore 3 inertial sensors, one on each foot and one over the lumbar spine all day, for 7 days. To investigate which gait bout lengths should be included to extract gait measures, we determined the range of gait bout lengths available across all subjects. To investigate if the effect of bout length on each gait measure is similar or not between subjects with PD and OA, we used a growth curve analysis. For reliability and discriminative ability of each gait measure as a function of gait bout length, we used the intraclass correlation coefficient (ICC) and area under the curve (AUC), respectively. Ninety percent of subjects walked with a bout length of less than 53 strides during the week, and the majority (>50%) of gait bouts consisted of less than 12 strides. Although bout length affected all gait measures, the effects depended on the specific measure and sometimes differed for PD versus OA. Specifically, people with PD did not increase/decrease cadence and swing duration with bout length in the same way as OA. ICC and AUC characteristics tended to be larger for shorter than longer gait bouts. Our findings suggest that PD interferes with the scaling of cadence and swing duration with gait bout length. Whereas control subjects gradually increased cadence and decreased swing duration as bout length increased, participants with PD started with higher than normal cadence and shorter than normal stride duration for the smallest bouts, and cadence and stride duration changed little as bout length increased, so differences between PD and OA disappeared for the longer bout lengths. Gait measures extracted from shorter bouts are more common, more reliable, and more discriminative, suggesting that shorter gait bouts should be used to extract potential digital biomarkers for people with PD. Although the use of wearable technology to characterize gait disorders in daily life is increasing, there is no consensus on which specific gait bout length should be used to characterize gait. Clinical trialists using daily life gait quality as study outcomes need to understand how gait bout length affects the sensitivity and specificity of measures to discriminate pathological gait as well as the reliability of gait measures across gait bout lengths. We investigated whether Parkinson's disease (PD) affects how gait characteristics change as bout length changes, and how gait bout length affects the reliability and discriminative ability of gait measures to identify gait impairments in people with PD compared to neurotypical Old Adults (OA). We recruited 29 people with PD and 20 neurotypical OA of similar age for this study. Subjects wore 3 inertial sensors, one on each foot and one over the lumbar spine all day, for 7 days. To investigate which gait bout lengths should be included to extract gait measures, we determined the range of gait bout lengths available across all subjects. To investigate if the effect of bout length on each gait measure is similar or not between subjects with PD and OA, we used a growth curve analysis. For reliability and discriminative ability of each gait measure as a function of gait bout length, we used the intraclass correlation coefficient (ICC) and area under the curve (AUC), respectively. Ninety percent of subjects walked with a bout length of less than 53 strides during the week, and the majority (>50%) of gait bouts consisted of less than 12 strides. Although bout length affected all gait measures, the effects depended on the specific measure and sometimes differed for PD versus OA. Specifically, people with PD did not increase/decrease cadence and swing duration with bout length in the same way as OA. ICC and AUC characteristics tended to be larger for shorter than longer gait bouts. Our findings suggest that PD interferes with the scaling of cadence and swing duration with gait bout length. Whereas control subjects gradually increased cadence and decreased swing duration as bout length increased, participants with PD started with higher than normal cadence and shorter than normal stride duration for the smallest bouts, and cadence and stride duration changed little as bout length increased, so differences between PD and OA disappeared for the longer bout lengths. Gait measures extracted from shorter bouts are more common, more reliable, and more discriminative, suggesting that shorter gait bouts should be used to extract potential digital biomarkers for people with PD.Although the use of wearable technology to characterize gait disorders in daily life is increasing, there is no consensus on which specific gait bout length should be used to characterize gait. Clinical trialists using daily life gait quality as study outcomes need to understand how gait bout length affects the sensitivity and specificity of measures to discriminate pathological gait as well as the reliability of gait measures across gait bout lengths. We investigated whether Parkinson's disease (PD) affects how gait characteristics change as bout length changes, and how gait bout length affects the reliability and discriminative ability of gait measures to identify gait impairments in people with PD compared to neurotypical Old Adults (OA). We recruited 29 people with PD and 20 neurotypical OA of similar age for this study. Subjects wore 3 inertial sensors, one on each foot and one over the lumbar spine all day, for 7 days. To investigate which gait bout lengths should be included to extract gait measures, we determined the range of gait bout lengths available across all subjects. To investigate if the effect of bout length on each gait measure is similar or not between subjects with PD and OA, we used a growth curve analysis. For reliability and discriminative ability of each gait measure as a function of gait bout length, we used the intraclass correlation coefficient (ICC) and area under the curve (AUC), respectively. Ninety percent of subjects walked with a bout length of less than 53 strides during the week, and the majority (>50%) of gait bouts consisted of less than 12 strides. Although bout length affected all gait measures, the effects depended on the specific measure and sometimes differed for PD versus OA. Specifically, people with PD did not increase/decrease cadence and swing duration with bout length in the same way as OA. ICC and AUC characteristics tended to be larger for shorter than longer gait bouts. Our findings suggest that PD interferes with the scaling of cadence and swing duration with gait bout length. Whereas control subjects gradually increased cadence and decreased swing duration as bout length increased, participants with PD started with higher than normal cadence and shorter than normal stride duration for the smallest bouts, and cadence and stride duration changed little as bout length increased, so differences between PD and OA disappeared for the longer bout lengths. Gait measures extracted from shorter bouts are more common, more reliable, and more discriminative, suggesting that shorter gait bouts should be used to extract potential digital biomarkers for people with PD. |
| Author | Shah, Vrutangkumar V. Mancini, Martina Curtze, Carolin Nutt, John G. Carlson-Kuhta, Patricia Harker, Graham Horak, Fay B. El-Gohary, Mahmoud McNames, James |
| AuthorAffiliation | 3 APDM Wearable Technologies, Portland, OR 97201, USA; mahmoud.e@apdm.com 1 Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA; harkerg@ohsu.edu (G.H.); mancinim@ohsu.edu (M.M.); carlsonp@ohsu.edu (P.C.-K.); nuttj@ohsu.edu (J.G.N.); horakf@ohsu.edu (F.B.H.) 4 Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE 68182, USA; ccurtze@unomaha.edu 2 Department of Electrical and Computer Engineering, Portland State University, Portland, OR 97207, USA; mcnames@pdx.edu |
| AuthorAffiliation_xml | – name: 2 Department of Electrical and Computer Engineering, Portland State University, Portland, OR 97207, USA; mcnames@pdx.edu – name: 4 Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE 68182, USA; ccurtze@unomaha.edu – name: 1 Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA; harkerg@ohsu.edu (G.H.); mancinim@ohsu.edu (M.M.); carlsonp@ohsu.edu (P.C.-K.); nuttj@ohsu.edu (J.G.N.); horakf@ohsu.edu (F.B.H.) – name: 3 APDM Wearable Technologies, Portland, OR 97201, USA; mahmoud.e@apdm.com |
| Author_xml | – sequence: 1 givenname: Vrutangkumar V. surname: Shah fullname: Shah, Vrutangkumar V. – sequence: 2 givenname: James surname: McNames fullname: McNames, James – sequence: 3 givenname: Graham surname: Harker fullname: Harker, Graham – sequence: 4 givenname: Martina surname: Mancini fullname: Mancini, Martina – sequence: 5 givenname: Patricia orcidid: 0000-0002-5794-4155 surname: Carlson-Kuhta fullname: Carlson-Kuhta, Patricia – sequence: 6 givenname: John G. surname: Nutt fullname: Nutt, John G. – sequence: 7 givenname: Mahmoud orcidid: 0000-0002-2678-8823 surname: El-Gohary fullname: El-Gohary, Mahmoud – sequence: 8 givenname: Carolin orcidid: 0000-0001-5394-4628 surname: Curtze fullname: Curtze, Carolin – sequence: 9 givenname: Fay B. surname: Horak fullname: Horak, Fay B. |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33053703$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1016_j_gaitpost_2024_06_011 crossref_primary_10_1038_s41598_024_51766_5 crossref_primary_10_1007_s42979_025_03895_5 crossref_primary_10_3389_fneur_2024_1455692 crossref_primary_10_1155_2022_4753732 crossref_primary_10_3390_s21248286 crossref_primary_10_1038_s41598_021_98359_0 crossref_primary_10_1007_s12311_023_01625_2 crossref_primary_10_1016_j_ahr_2025_100240 crossref_primary_10_3389_fneur_2023_1096401 crossref_primary_10_1186_s12984_025_01578_z crossref_primary_10_3389_fneur_2025_1544453 crossref_primary_10_1186_s12984_020_00781_4 crossref_primary_10_1038_s41531_025_00897_1 crossref_primary_10_1016_j_clinbiomech_2024_106332 crossref_primary_10_3389_fnagi_2022_808518 crossref_primary_10_1016_j_gaitpost_2021_10_029 crossref_primary_10_1080_17434440_2023_2298342 crossref_primary_10_3389_fnagi_2023_1279722 crossref_primary_10_1002_mds_30230 crossref_primary_10_1007_s00391_023_02230_y crossref_primary_10_3390_app142210189 crossref_primary_10_1371_journal_pdig_0000120 crossref_primary_10_1097_NPT_0000000000000440 crossref_primary_10_1038_s41598_024_70312_x crossref_primary_10_3233_JPD_202471 crossref_primary_10_3390_s21123974 |
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| Keywords | daily life mobility wearable sensors bout length Parkinson’s disease |
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| SubjectTerms | Adult Algorithms bout length daily life Data collection Female Gait Growth models Humans Laboratories Male mobility Movement disorders Muscle function Parkinson Disease - diagnosis Parkinson's disease Reproducibility of Results Sensors Walking Wearable computers Wearable Electronic Devices wearable sensors |
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| Title | Effect of Bout Length on Gait Measures in People with and without Parkinson’s Disease during Daily Life |
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