title: Freezing of gait and fall detection in Parkinson's disease using wearable sensors: a systematic review.
abstract: Despite the large number of studies that have investigated the use of wearable sensors to detect gait disturbances such as Freezing of gait (FOG) and falls, there is little consensus regarding appropriate methodologies for how to optimally apply such devices. Here, an overview of the use of wearable systems to assess FOG and falls in Parkinson's disease (PD) and validation performance is presented. A systematic search in the PubMed and Web of Science databases was performed using a group of concept key words. The final search was performed in January 2017, and articles were selected based upon a set of eligibility criteria. In total, 27 articles were selected. Of those, 23 related to FOG and 4 to falls. FOG studies were performed in either laboratory or home settings, with sample sizes ranging from 1 PD up to 48 PD presenting Hoehn and Yahr stage from 2 to 4. The shin was the most common sensor location and accelerometer was the most frequently used sensor type. Validity measures ranged from 73-100% for sensitivity and 67-100% for specificity. Falls and fall risk studies were all home-based, including samples sizes of 1 PD up to 107 PD, mostly using one sensor containing accelerometers, worn at various body locations. Despite the promising validation initiatives reported in these studies, they were all performed in relatively small sample sizes, and there was a significant variability in outcomes measured and results reported. Given these limitations, the validation of sensor-derived assessments of PD features would benefit from more focused research efforts, increased collaboration among researchers, aligning data collection protocols, and sharing data sets.
authors.affiliation: Radboud university medical center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands. ana.silvadelima@radboudumc.nl.|Department of Neurology, Radboud university medical center, Nijmegen, The Netherlands. ana.silvadelima@radboudumc.nl.|CAPES Foundation, Ministry of Education of Brazil, Brasília, DF, Brazil. ana.silvadelima@radboudumc.nl.
authors.forename: Ana Lígia
authors.initials: AL
authors.lastname: Silva de Lima
authors.affiliation: Department of Neurology, Radboud university medical center, Nijmegen, The Netherlands.
authors.forename: Luc J W
authors.initials: LJW
authors.lastname: Evers
authors.affiliation: Department of Neurology, Radboud university medical center, Nijmegen, The Netherlands.
authors.forename: Tim
authors.initials: T
authors.lastname: Hahn
authors.affiliation: Michael J Fox Foundation for Parkinson's Research, New York, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Bataille
authors.affiliation: Michael J Fox Foundation for Parkinson's Research, New York, USA.
authors.forename: Jamie L
authors.initials: JL
authors.lastname: Hamilton
authors.affiliation: Aston University, Birmingham, UK.|Media Lab, Massachusetts Institute of Technology, Cambridge, USA.
authors.forename: Max A
authors.initials: MA
authors.lastname: Little
authors.affiliation: Department of Neurology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Okuma
authors.affiliation: Radboud university medical center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands.|Department of Neurology, Radboud university medical center, Nijmegen, The Netherlands.
authors.forename: Bastiaan R
authors.initials: BR
authors.lastname: Bloem
authors.affiliation: Department of Neurology, Radboud university medical center, Nijmegen, The Netherlands.|Radboud university medical center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare, Nijmegen, The Netherlands.
authors.forename: Marjan J
authors.initials: MJ
authors.lastname: Faber
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D020233:Gait Disorders, Neurologic / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D006801:Humans; D018670:Monitoring, Ambulatory / Q000295:instrumentation*; D010300:Parkinson Disease / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000534:rehabilitation; D000076251:Wearable Electronic Devices
keywords: Ambulatory monitoring; Parkinson’s disease; Validation studies; Wearable sensors