Abate Filomena, Russo Michela, Ricciardi Carlo, Tepedino Maria Francesca, Romano Maria, Erro Roberto, Pellecchia Maria Teresa, Amboni Marianna, Barone Paolo, Picillo Marina
Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, 84131, Salerno, Italy.
University of Naples Federico II, Department of Electrical Engineering and Information Technology, 80125, Naples, Italy.
Parkinsonism Relat Disord. 2023 Apr;109:105345. doi: 10.1016/j.parkreldis.2023.105345. Epub 2023 Feb 24.
Progressive supranuclear palsy (PSP) is an atypical parkinsonism characterized by prominent gait and postural impairment. The PSP rating scale (PSPrs) is a clinician-administered tool to evaluate disease severity and progression. More recently, digital technologies have been used to investigate gait parameters. Therefore, object of this study was to implement a protocol using wearable sensors evaluating disease severity and progression in PSP.
Patients were evaluated with the PSPrs as well as with three wearable sensors located on the feet and lumbar area. Spearman coefficient was used to assess the relationship between PSPrs and quantitative measurements. Furthermore, sensor parameters were included in a multiple linear regression model to assess their ability in predicting the PSPrs total score and sub-scores. Finally, differences between baseline and three-month follow-up were calculated for PSPrs and each quantitative variable. The significance level in all analyses was set at ≤ 0.05.
Fifty-eight evaluations from thirty-five patients were analyzed. Quantitative measurements showed multiple significant correlations with the PSPrs scores (r between 0.3 and 0.7; p < 0.05). Linear regression models confirmed the relationships. After three months visit, significant worsening from baseline was observed for cadence, cycle duration and PSPrs item 25, while PSPrs item 10 showed a significant improvement.
We propose wearable sensors can provide an objective, sensitive quantitative evaluation and immediate notification of gait changes in PSP. Our protocol can be easily introduced in outpatient and research settings as a complementary tool to clinical measures as well as an informative tool on disease severity and progression in PSP.
进行性核上性麻痹（PSP）是一种非典型帕金森病，其特征为明显的步态和姿势障碍。PSP评定量表（PSPrs）是一种由临床医生使用的评估疾病严重程度和进展的工具。最近，数字技术已被用于研究步态参数。因此，本研究的目的是实施一种使用可穿戴传感器评估PSP疾病严重程度和进展的方案。
使用PSPrs以及位于足部和腰部区域的三个可穿戴传感器对患者进行评估。使用Spearman系数评估PSPrs与定量测量之间的关系。此外，将传感器参数纳入多元线性回归模型，以评估它们预测PSPrs总分和子分数的能力。最后，计算PSPrs和每个定量变量在基线和三个月随访之间的差异。所有分析的显著性水平设定为≤0.05。
分析了来自35名患者的58次评估。定量测量显示与PSPrs评分存在多个显著相关性（r在0.3至0.7之间；p<0.05）。线性回归模型证实了这些关系。在三个月的随访后，观察到步频、周期持续时间和PSPrs项目25较基线有显著恶化，而PSPrs项目10有显著改善。
我们提出可穿戴传感器可以提供客观、敏感的定量评估，并即时通知PSP患者的步态变化。我们的方案可以很容易地在门诊和研究环境中引入，作为临床测量的补充工具以及关于PSP疾病严重程度和进展的信息工具。
