Feasibility of an instrumented walker to quantify treatment effects on Parkinson's patient gait

The aim of this preliminary study is to assess the feasibility of the Personal Aid for Mobility and Health Monitoring II (PAMMII) to reliably assess gait of Parkinson's Disease (PD) patients pre and post intra-venous Amantadine treatment. This device is an instrumented walker, which provides a quantitative measure of gait and has been proven to assess a patient's condition. The preliminary study involved 20 PD patients whose disease severity was determined by Hoehn and Yahr (H & Y) scores ranging between 2 and 3. The subjects performed a 3m walking clinical protocol, whilst pushing the walker and a variety of kinematic motion signals are recorded. Signal pre­processing techniques are applied and a total of 21 features extracted from the signals acquired by the device. Based on the clinical relevance determined by the neurologists, five features were selected and normalized using a z-score. The average values of these features across the cohort indicated improvement to gait features pre and post Amantadine. However, a significant intra-class variability was observed with approximately 60% of subjects showing response to treatment, whereas other patients improved very little or even declined in terms of these features. Dividing the cohort into 2 groups based on severity yielded that patients with higher H & Y scores (greater PD severity) showed a more significant response in their gait features. Whilst, a larger study is required to validate these results, this preliminary study illustrates the potential of the device to quantitatively assess treatment effect in PD patients based on gait feature changes.