Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, 300070, China; Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin Neurosurgical Institute, Tianjin, 300350, China.
College of Artificial Intelligence, Nankai University, Tianjin, 300350, China; Tianjin Key Laboratory of Intelligent Robotics, Nankai University, Tianjin, 300350, China.
Parkinsonism Relat Disord. 2022 Aug;101:49-56. doi: 10.1016/j.parkreldis.2022.06.012. Epub 2022 Jun 30.
Gait disorders are common in patients with Parkinson's disease (PD), and objective, quantifiable, and portable evaluation methods are needed in clinical practice. We assessed the differences in gait characteristics between patients with PD and healthy controls (HCs) using two-dimensional (2D) video and explored the diagnostic value of 2D video for early-stage PD.
Sixty-eight patients with PD and 48 HCs were recruited. All participants walked a standard 5-m track while recorded using mobile phones. The differences in gait characteristics between the groups and gait parameters of patients with early-stage PD were analyzed. Receiver operating characteristic analysis was used to evaluate the discrimination activity of gait parameters.
Compared with HCs, patients with PD had shorter step length (S/M, p < 0.001/0.001), faster cadence (p = 0.044), slower walking speed (p < 0.001), smaller arm-swing angle (S/M, p < 0.001/0.001), slower arm-swing velocity (S/M, p < 0.001/0.001), and greater variability and asymmetry. The patients with early-stage PD had similar characteristics. After combined step length and variability and asymmetry of arm-swing angle, diagnostic sensitivity and specificity reached 84.6% and 89.6%, respectively, and an area under the curve of 0.91 (0.84-0.97).
We proposed a new method to improve the sensitivity of early-stage PD diagnosis using 2D video, which, as a portable and objective method, could be used to evaluate gait disorders in PD, including in early-stage PD. Combined diagnostic analysis of step length and variability and asymmetry of arm-swing angle could improve the sensitivity of PD diagnosis and was helpful in distinguishing patients with early-stage PD from HCs.
步态障碍在帕金森病（PD）患者中很常见，临床实践中需要客观、可量化和便携的评估方法。我们使用二维（2D）视频评估 PD 患者与健康对照组（HCs）之间的步态特征差异，并探讨 2D 视频对早期 PD 的诊断价值。
招募了 68 名 PD 患者和 48 名 HCs。所有参与者在手机记录下走标准的 5 米轨道。分析了两组之间的步态特征差异以及早期 PD 患者的步态参数。使用接收者操作特征分析评估步态参数的区分活动。
与 HCs 相比，PD 患者的步长更短（S/M，p<0.001/0.001），步频更快（p=0.044），步行速度更慢（p<0.001），手臂摆动角度更小（S/M，p<0.001/0.001），手臂摆动速度更慢（S/M，p<0.001/0.001），且变异性和不对称性更大。早期 PD 患者具有相似的特征。结合步长和手臂摆动角度的变异性和不对称性后，诊断的敏感性和特异性分别达到 84.6%和 89.6%，曲线下面积为 0.91（0.84-0.97）。
我们提出了一种使用 2D 视频提高早期 PD 诊断敏感性的新方法，作为一种便携和客观的方法，可用于评估 PD 中的步态障碍，包括早期 PD。步长和手臂摆动角度的变异性和不对称性的联合诊断分析可以提高 PD 诊断的敏感性，有助于将早期 PD 患者与 HCs 区分开来。
