Parkinson's disease monitoring from gait analysis via foot-worn sensors

Background: In Parkinson's disease (PD), neuronal loss in the substantia nigra ultimate in dopaminergic denervation of the stiratum is followed by disarraying of the movements' preciseness, automatism, and agility. Hence, the seminal sign of PD is a change in motor performance of affected individuals. As PD is a neurodegenerative disease, progression of disability in mobility is an inevitable consequence. Indeed, the major cause of morbidity and mortality among patients with PD is the motor changes restricting their functional independence. Therefore, monitoring the manifestations of the disease is crucial to detect any worsening of symptoms timely, in order to maintain and improve the quality of life of these patients. Aim: The changes in motion of patients with PD can be ascertained by the help of wearable sensors attached to the limbs of subjects. Then analysing the recorded data for variation of signals would make it possible to figure an individualized profile of the disease. Advancement of such tools would improve understanding of the disease evolution in the long term and simplify the detection of precipitous changes in gait on a daily basis in the short term. In both cases the apperception of such events would contribute to improve the clinical decision making process with reliable data. To this end, we offer here a computational solution for effective monitoring of PD patients from gait analysis via multiple foot-worn sensors. Methods: We introduce a supervised model that is fed by ground reaction force (GRF) signals acquired from these gait sensors. We offer a hybrid model, called Locally Weighted Random Forest (LWRF), for regression analysis over the numerical features extracted from input signals to predict the severity of PD symptoms in terms of Universal Parkinson Disease Rating Scale (UPDRS) and Hoehn and Yahr (H&Y) scale. From GRF signals sixteen time-domain features and seven frequency-domain features were extracted and used. Results and conclusion: An experimental analysis conducted on a real data acquired from PD patients and healthy controls has shown that the predictions are highly correlated with the clinical annotations. Proposed approach for severity detection has the best correlation coefficient (CC), mean absolute error (MAE) and root mean squared error (RMSE) values with 0.895, 4.462 and 7.382 respectively in terms of UPDRS. The regression results for H&Y Scale discerns that proposed model outperforms other models with CC, MAE and RMSE with values 0.960, 0.168 and 0.306 respectively. In classification setup, proposed approach achieves higher accuracy in comparison with other studies with accuracy and specificity of 99.0% and 99.5% respectively. Main novelty of this approach is the fact that an exact value of the symptom level can be inferred rather than a categorical result that defines the severity of motor disorders. (C) 2018 Nalecz Institute of Biocybernetics and Biomedical Engineering of the Polish Academy of Sciences. Published by Elsevier B.V. All rights reserved.