Inertial-Based Gait Metrics During Turning Improve the Detection of Early-Stage Parkinson's Disease Patients.

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Patients with early-stage Parkinson's disease (PD) exhibit various but subtle motor symptoms, especially postural instability and gait disorders (PIGD). Patients show deteriorated gait performance at turns as the complex gait task requires more limb coordination and postural stability control, which may help to discriminate signs of early PIGD. In this study, we firstly proposed an IMU-based gait assessment model for quantifying comprehensive gait variables in both straight walking and turning tasks from five domains: respectively gait spatiotemporal parameters, joint kinematic parameters, variability, asymmetry, and stability. Twenty-one patients with idiopathic Parkinson's disease at the early stage and nineteen age-matched healthy elderly adults were enrolled in the study. Each participant wore a full-body motion analysis system with 11 inertial sensors and walked along a path consisting of straight walking and 180-degree turns at a self-comfortable speed. A total of one hundred and thirty-nine gait parameters were derived for each gait task. We explored the factor effect of group and gait tasks on gait parameters using a two-way mixed analysis of variance. The discriminating ability of gait parameters between PD and the control group was evaluated using receiver operating characteristic analysis. Sensitive gait features were optimally screened (AUC $>$ 0.7) and categorized into 22 groups to classify PD and healthy controls based on a machine learning method. Results demonstrated that PD patients exhibited more gait abnormalities at turns, especially on the RoM and stability of the neck, shoulder, pelvic, and hip joints compared to the healthy control group. These gait metrics have good discriminating abilities to identify early-stage PD (AUC $>$ 0.65). Moreover, the inclusion of gait features at turns can significantly improve the classification accuracy compared to that only used parameters during straight walking. We show that quantitative gait metrics during turning have great potential to be used for enhancing early-stage PD detection.

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