Brain and Behavior. 2018;8:e 0 097 7.
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1 | INTRODUCTION
Gait impairment is a major motor symptom of idiopathic
Parkinson’s disease (iPD). It is even more prominent in patients
with atypical parkinsonian disorders (APDs) including multiple sys-
tem atrophy (MSA) and progressive supranuclear palsy (PSP), lead-
ing to an impaired quality of life and shorter latency from symptom
onset to recurrent falls (Wenning et al., 1999). The clinical severity
Sensor- based gait analysis in atypical parkinsonian disorders
* | Heiko Gaßner
* | Sabine Eschlboeck
| Sylvia Boesch
| Klaus Seppi
| Werner Poewe
| Bjoern M. Eskofier
| Gregor Wenning
| Jochen Klucken
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium,
provided the original work is properly cited.
© 2018 The Authors. Brain and Behavior published by Wiley Periodicals, Inc.
*These authors contributed equally to this work.
Department of Neurology, Medical
University of Innsbruck, Innsbruck, Austria
Department of Molecular
Neurology, University Hospital
University Erlangen-Nürnberg (FAU),
Machine Learning and Data Analytics
Lab, Friedrich-Alexander University
Erlangen-Nürnberg (FAU), Erlangen,
Jochen Klucken, Faculty of Medicine,
Department of Molecular Neurology,
Friedrich-Alexander University Erlangen-
Nürnberg (FAU), Erlangen, Germany.
Bavarian State Ministry for Education,
Science and the Arts, Munich, Germany
(MotionLab@Home, E|Home Center).
Emerging Fields Initiative of the Friedrich-
Alexander University Erlangen- Nuernberg,
Germany (EFI Moves, 2 Med 03). Bavarian
Ministry of Economic Affairs and Media,
Energy and Technology, Germany (Medical
Valley Award 2016, Risk- e- Gait). European
Institute of Innovation and Technology
Health (EIT Health, ‘MoveIT’). German
Research Foundation (DFG), Germany,
Heisenberg professorship programme (grant
number ES 434/8- 1). German Research
Foundation (DFG) and Friedrich- Alexander
University Erlangen- Nuernberg (Open
Access Publishing). The Multiple System
Atrophy Coalition, Inc. (Grant No. 2015- 04-
003 and 2016- 09- 008)
Background and Objectives: Gait impairment and reduced mobility are typical fea-
tures of idiopathic Parkinson’s disease (iPD) and atypical parkinsonian disorders
(APD). Quantitative gait assessment may have value in the diagnostic workup of par-
kinsonian patients and as endpoint in clinical trials. The study aimed to identify quan-
titative gait parameter differences in iPD and APD patients using sensor- based gait
analysis and to correlate gait parameters with clinical rating scales.
Subjects and Methods: Patients with iPD and APD including Parkinson variant mul-
tiple system atrophy and progressive supranuclear palsy matched for age, gender,
sessed using standardized clinical rating scales (MDS- UPDRS- 3, UMSARS, PSP-RS).
Gait analysis consisted of inertial sensor units laterally attached to shoes, generating
as objective targets spatiotemporal gait parameters from 4 × 10 m walk tests.
Results: Objective sensor- based gait analysis showed that gait speed and stride
length were markedly reduced in APD compared to iPD patients. Moreover, clinical
ratings significantly correlated with gait speed and stride length in APD patients.
Conclusion: Our findings suggest that patients with APD had more severely impaired
gait parameters than iPD patients despite similar disease severity. Instrumented gait
analysis provides complementary rater independent, quantitative parameters that
can be exploited for clinical trials and care.
atypical parkinsonian disorders, multiple system atrophy, parkinson’s disease, progressive
supranuclear palsy, sensor-based gait analysis