title: Using ecological whole body kinematics to evaluate effects of medication adjustment in Parkinson disease.
abstract: BACKGROUND
  Functional motor impairments including mobility are major reasons for clinical intervention and medication adjustment in symptomatic therapy for Parkinson's disease (PD). Outcome measures used to assess the impact of medication are mostly based on patients' memory or diaries which, considering the gaps between visits, are neither objective nor very reliable.
  
  
  OBJECTIVE
  Investigating the feasibility of using movement features extracted from ecological whole-body kinematics recordings to measure the quantitative and qualitative changes in multiple aspects of mobility after medication changes in PD.
  
  
  METHODS
  Eleven patients with PD (PwPD) performed mobility tasks in their own home, wearing a full body wireless inertial sensing based motion capture system. Three scripted walking tasks (walking, fast walking, and walk turns) were examined at baseline and two weeks after medication changes. Clinical scales, including investigator-rated clinical global impression of improvement (CGI-I), were collected at both visits.
  
  
  RESULTS
  Out of 59 recorded body joint variables, five were identified as pertinent. Changes were represented in vector space as a plot of mean versus peak amplitude. Regression analysis was used to predict clinical improvement or worsening based on these vector features. The predictors were able to explain (>98.5% of variance) patients' clinical global impression of improvement, thus correctly predicting 5 cases of improvement and 2 cases of worsening.
  
  
  CONCLUSIONS
  This study provided a method of extracting clinically meaningful reports from ecological kinematic data showing changes after drug adjustments. The results are presented using a novel concept called change space that may be more understandable for clinical staff.
authors: London Health Sciences Centre, Department of Clinical Neurological Sciences, ON, Canada Department of Electrical Engineering, University of Bonab, Bonab, Iran.
authors: Fariborz
authors: F
authors: Rahimi
authors: London Health Sciences Centre, Department of Clinical Neurological Sciences, ON, Canada.
authors: Carina
authors: C
authors: Bee
authors: Centre de recherche Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC, Canada.
authors: Christian
authors: C
authors: Duval
authors: Department of Surgery, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada.
authors: Patrick
authors: P
authors: Boissy
authors: Department of Mathematics and Statistics, University of Victoria, Victoria, BC, Canada.
authors: Roderick
authors: R
authors: Edwards
authors: London Health Sciences Centre, Department of Clinical Neurological Sciences, ON, Canada.
authors: Mandar
authors: M
authors: Jog
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D001696:Biomechanical Phenomena / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation; D009043:Motor Activity / Q000187:drug effects / Q000502:physiology*; D010300:Parkinson Disease / Q000188:drug therapy* / Q000503:physiopathology*; D012720:Severity of Illness Index; D016138:Walking / Q000502:physiology; D059015:Wireless Technology
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa
keywords: Parkinson's disease (PD); biomedical engineering; follow-up studies; kinematics; mobility limitations