d'Alencar M1, Oliveira J1, Okamoto E1, Miranda J2, Piemonte M1
1Universidade de São Paulo (USP), FOFITO, São Paulo, Brazil, 2Universidade Federal da Bahia, Physics Institute, Biosystems Lab, Salvador, Brazil
Background: Gait is one of the most complex human movements, sometimes requiring high-tech, high-cost analytical systems. In addition to the clinical limitations of this type of system regarding the cost and physical space for installation, the laboratory environment and procedures may interfere with the participant´s performance, especially in people with neurodegenerative diseases susceptible to stress. CvMob is free software capable of achieving a reliable qualitative assessment of gait by videos captured by a GoPro camera, never tested on people with Parkinson´s disease (PPD).
Purpose: To compare the sensibility of CvMob to assess the gait performance under single (ST) and dual-task (DT) condition with an usual quantitative test (10-meter walking test - 10mWT) in people living with Parkinson's disease.
Methods: 138 PPD diagnosed according to London Brain Bank criteria, without dementia according to MoCA (cut-off 23), divided in early PD group (EPD) with 33 PPD in stage 1, mild PD group (MPD) with 61 PPD in stage 2 and intermediate PD group (IPD) with 44 in stage 3 of disease progression according to H&Y classification. The gait performance was assessed under ST condition, i.e., without a concurrent task, and under two distinct DT conditions, i.e., with a concurrent mathematical task (MDT) and concurrent verbal fluency task (VFDT). In the novel test (CvMob test) the participants were asked to walk in their usual speed in a 6-meter distance. During the test a GoPro camera fixed in an adequate position captured the images in a 120 frame per second which were analyzed after the end of test by a computer using the CvMob free software. In the usual test the participants were asked to walk in their usual speed in a 10-meter distance (10MWT). The test was timed by a digital chronometer. The sequence of test conditions (ST, MDT and VFDT) was randomly defined for each participant before the start of test. All participants were tested in ON period of dopaminergic medication.
Results: The results were analyzed by 4 repeated measure ANOVA, three for CvMob (speed, time and step's number) and one 10mWT (time in seconds), using condition (ST, MDT and VFDT) as repeated measure for three groups (EPD, MPD and IPD). There were a significant interactions between condition and groups for all variables (speed: F(4,98) = 3,4046, p = ,01; time: F(4,98) = 3,5539, p=,009; number of steps: F(4,98) = 3,9759, p = ,004) confirmed by Tukey post-hoc test which showed inter and intra groups significant differences. In contrast, the result obtained with 10mWT showed no significant interaction, found only significant effect of condition (ST = MDT VFT) and group (EPD = MPD IPD).
Conclusion(s): In conclusion, the qualitative gait evaluation by CvMob was more sensitive than a quantitative usual gait test to identify the gait impairments under DT condition in people in early and mild stage of PD.
Implications: The CvMob can be considered a reliable test to identify early decline in DT gait performance opening a novel therapeutic windows for early intervention to overcome the gait impairments during daily living activities.
Keywords: Parkinson''s disease, Gait Disorders
Funding acknowledgements: Funding acknowledgments to NeuroMat, funded by the Foundation for Research Support of the State of São Paulo (Scholarships 2013/07699-0).
Purpose: To compare the sensibility of CvMob to assess the gait performance under single (ST) and dual-task (DT) condition with an usual quantitative test (10-meter walking test - 10mWT) in people living with Parkinson's disease.
Methods: 138 PPD diagnosed according to London Brain Bank criteria, without dementia according to MoCA (cut-off 23), divided in early PD group (EPD) with 33 PPD in stage 1, mild PD group (MPD) with 61 PPD in stage 2 and intermediate PD group (IPD) with 44 in stage 3 of disease progression according to H&Y classification. The gait performance was assessed under ST condition, i.e., without a concurrent task, and under two distinct DT conditions, i.e., with a concurrent mathematical task (MDT) and concurrent verbal fluency task (VFDT). In the novel test (CvMob test) the participants were asked to walk in their usual speed in a 6-meter distance. During the test a GoPro camera fixed in an adequate position captured the images in a 120 frame per second which were analyzed after the end of test by a computer using the CvMob free software. In the usual test the participants were asked to walk in their usual speed in a 10-meter distance (10MWT). The test was timed by a digital chronometer. The sequence of test conditions (ST, MDT and VFDT) was randomly defined for each participant before the start of test. All participants were tested in ON period of dopaminergic medication.
Results: The results were analyzed by 4 repeated measure ANOVA, three for CvMob (speed, time and step's number) and one 10mWT (time in seconds), using condition (ST, MDT and VFDT) as repeated measure for three groups (EPD, MPD and IPD). There were a significant interactions between condition and groups for all variables (speed: F(4,98) = 3,4046, p = ,01; time: F(4,98) = 3,5539, p=,009; number of steps: F(4,98) = 3,9759, p = ,004) confirmed by Tukey post-hoc test which showed inter and intra groups significant differences. In contrast, the result obtained with 10mWT showed no significant interaction, found only significant effect of condition (ST = MDT VFT) and group (EPD = MPD IPD).
Conclusion(s): In conclusion, the qualitative gait evaluation by CvMob was more sensitive than a quantitative usual gait test to identify the gait impairments under DT condition in people in early and mild stage of PD.
Implications: The CvMob can be considered a reliable test to identify early decline in DT gait performance opening a novel therapeutic windows for early intervention to overcome the gait impairments during daily living activities.
Keywords: Parkinson''s disease, Gait Disorders
Funding acknowledgements: Funding acknowledgments to NeuroMat, funded by the Foundation for Research Support of the State of São Paulo (Scholarships 2013/07699-0).
Topic: Neurology: Parkinson's disease; Human movement analysis
Ethics approval required: Yes
Institution: Universidade de São Paulo
Ethics committee: CEP FM-USP
Ethics number: CAAE 67388816.2.0000.0065
All authors, affiliations and abstracts have been published as submitted.
