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. 2019 May:62:85-90.
doi: 10.1016/j.parkreldis.2019.01.022. Epub 2019 Jan 29.

Associations between daily-living physical activity and laboratory-based assessments of motor severity in patients with falls and Parkinson's disease

Irina Galperin  1 , Inbar Hillel  1 , Silvia Del Din  2 , Esther M J Bekkers  3 , Alice Nieuwboer  3 , Giovanni Abbruzzese  4 , Laura Avanzino  5 , Freek Nieuwhof  6 , Bastiaan R Bloem  7 , Lynn Rochester  8 , Ugo Della Croce  9 , Andrea Cereatti  10 , Nir Giladi  11 , Anat Mirelman  11 , Jeffrey M Hausdorff  12
Affiliations

Associations between daily-living physical activity and laboratory-based assessments of motor severity in patients with falls and Parkinson's disease

Irina Galperin et al. Parkinsonism Relat Disord. 2019 May.

Abstract

Introduction: Recent work suggests that wearables can augment conventional measures of Parkinson's disease (PD). We evaluated the relationship between conventional measures of disease and motor severity (e.g., MDS-UPDRS part III), laboratory-based measures of gait and balance, and daily-living physical activity measures in patients with PD.

Methods: Data from 125 patients (age: 71.7 ± 6.5 years, Hoehn and Yahr: 1-3, 60.5% men) were analyzed. The MDS-UPDRS-part III was used as the gold standard of motor symptom severity. Gait and balance were quantified in the laboratory. Daily-living gait and physical activity metrics were extracted from an accelerometer worn on the lower back for 7 days.

Results: In multivariate analyses, daily-living physical activity and gait metrics, laboratory-based balance, demographics and subject characteristics together explained 46% of the variance in MDS-UPDRS-part III scores. Daily-living measures accounted for 62% of the explained variance, laboratory measures 30%, and demographics and subject characteristics 7% of the explained variance. Conversely, demographics and subject characteristics, laboratory-based measures of gait symmetry, and motor symptom severity together explained less than 30% of the variance in total daily-living physical activity. MDS-UPDRS-part III scores accounted for 13% of the explained variance, i.e., <4% of all the variance in total daily-living activity.

Conclusions: Our findings suggest that conventional measures of motor symptom severity do not strongly reflect daily-living activity and that daily-living measures apparently provide important information that is not captured in a conventional one-time, laboratory assessment of gait, balance or the MDS-UPDRS. To provide a more complete evaluation, wearable devices should be considered.

Keywords: Accelerometers; Daily-living activity; Digital health; Inertial measurement units; Parkinson's disease; Wearable device.

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