The ability of the commercial inertial measurement unit-based gait system in determining Parkinson's disease: A systematic review with meta-analysis of cross-sectional studies.

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The purpose of this study was to use the meta-analytic approach to investigate the ability of Inertial Measurement Unit-based commercial system measured gait variability and asymmetry in distinguishing individuals with Parkinson's disease (PD) from healthy controls (HC). Cross-sectional studies included using commercial IMU-based systems measuring gait variability or asymmetry at any stage of PD patients and healthy adults were included. Studies were determined by searching for four electronic databases and cross-referencing. Dual selection and data abstraction of studies were conducted. Hedges' g standardized mean difference was calculated for each variable and pooled using inverse heterogeneity mode. Statistically significant was determined by two tailed z-alpha values ≤0.05 and non-overlapping 95% CI. Heterogeneity was estimated using Q and I2 with alpha values ≤0.10 for Q considered statistically significant. Small-study effects were examined using doi plots and LFK index. A total of 1,725 studies were screened. Eventually, 9 studies representing up to 571 PD patients and 470 HC met the inclusion criteria. Overall gait variability was significantly greater in individuals with PD than in HC (Hedges' g = 0.368, 95% CI 0.139-0.597). The multi-IMU subgroup also showed significantly greater gait variability (Hedges' g = 0.397, 95% CI 0.221-0.574), whereas the one-IMU subgroup did not. However, the between-subgroup difference was not statistically significant, and the multi-IMU prediction interval included null. The primary analysis detected no statistically significant overall difference in gait asymmetry (Hedges' g = 0.180, 95% CI -0.012-0.373). These findings provide preliminary evidence of an average group-level difference in gait variability but hard to establish individual-level discrimination, clinical utility, or the superiority of multi-IMU systems.

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