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Clavijo-Buendía S, Molina-Rueda F, Martín-Casas P, Ortega-Bastidas P, Monge-Pereira E, Laguarta-Val S, Morales-Cabezas M, Cano-de-la-Cuerda R. Construct validity and test-retest reliability of a free mobile application for spatio-temporal gait analysis in Parkinson's disease patients. Gait Posture 2020; 79:86-91. [PMID: 32361658 DOI: 10.1016/j.gaitpost.2020.04.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 04/07/2020] [Accepted: 04/09/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Mobile applications may be used to assess gait pattern deviation through mobile smartphones in people with Parkinson's disease (PD). However, few studies have investigated their psychometrics properties. RESEARCH QUESTION To study the construct validity and test-retest reliability of the RUNZI® free mobile application in people with mild to moderate PD. METHODS Thirty individuals were evaluated with the RUNZI® app and with the 10-meter walking test (10 MW), simultaneously. In addition, the Timed Up & Go test (TUG), Tinetti scale, and the Berg Balance Scale (BBS) were used to study the construct validity. Also, test-retest reliability of the mobile for spatio-temporal gait parameters was explored. RESULTS The correlation indices of the 10 MW test with the RUNZI® app at fast speeds was moderate to excellent (r = .588-.957). At a comfortable speed, the correlation was excellent for walking speed (r = 0.944), moderate for steps (r = 0.780) and stride length (r = 0.760), and poor for cadence (r = .424). Results showed significant correlations between TUG and spatio-temporal gait parameters at fast and comfortable speeds. There were no significant correlations or consistent associations between Tinetti and BBS and RUNZI®. The test-retest reliability was good to excellent for parameters measured with the RUNZI®. SIGNIFICANCE Our findings highlight specific opportunities for a free smartphone-based spatio-temporal gait analysis to serve as a complement to conventional gait analysis methods in clinical practice with a moderate to excellent construct validity with the 10 MW test and good to excellent test-retest reliability in PD patients.
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Affiliation(s)
- Sergio Clavijo-Buendía
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - Francisco Molina-Rueda
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - Patricia Martín-Casas
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | | | - Esther Monge-Pereira
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Madrid, Spain.
| | - Sofía Laguarta-Val
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - Matilde Morales-Cabezas
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - Roberto Cano-de-la-Cuerda
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Madrid, Spain
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Abstract
Neurological disorders are the leading cause of global disability. However, for most people around the world, current neurological care is poor. In low-income countries, most individuals lack access to proper neurological care, and in high-income countries, distance and disability limit access. With the global proliferation of smartphones, teleneurology - the use of technology to provide neurological care and education remotely - has the potential to improve and increase access to care for billions of people. Telestroke has already fulfilled this promise, but teleneurology applications for chronic conditions are still in their infancy. Similarly, few studies have explored the capabilities of mobile technologies such as smartphones and wearable sensors, which can guide care by providing objective, frequent, real-world assessments of patients. In low-income settings, teleneurology can increase the capacity of local care systems through professional development, diagnostic support and consultative services. In high-income settings, teleneurology is likely to promote the expansion and migration of neurological care away from institutions, incorporate systems of asynchronous communication (such as e-mail), integrate clinicians with diverse skill sets and reach new populations. Inertia, outdated policies and social barriers - especially the digital divide - will slow this progress at considerable cost. However, a future increasingly will be possible in which neurological care can be accessed by anyone, anywhere. Here, we examine the emerging evidence regarding the benefits of teleneurology for chronic conditions, its role and risks in low-income countries and the promise of mobile technologies to measure disease status and deliver care. We conclude by discussing the future trends, barriers and timing for the adoption of teleneurology.
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Bryant MS, Hou JGG, Workman CD, Protas EJ. Predictive ability of functional tests for postural instability and gait difficulty in Parkinson's disease. Eur Geriatr Med 2018; 9:83-88. [PMID: 34654285 DOI: 10.1007/s41999-017-0021-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 12/16/2017] [Indexed: 11/29/2022]
Abstract
The objective of this study is to identify clinical determinants for postural instability and gait difficulty in persons with Parkinson's disease (PD). Ninety-one persons (68 males; 74.7%) with PD were studied. Their mean age was 68.73 ± 8.74 years. The average time since diagnosis was 7.69 ± 5.23 years. The average Hoehn and Yahr stage was 2.43 ± 0.44. Age, gender, disease duration, disease severity and motor impairment were recorded. Participants were asked to perform timed clinical mobility tests that included a 5-step test, turns, forward walk, backward walk, and a sideways walk. The mobility tests were investigated for their contribution to predict the postural instability and gait difficulty (PIGD) score (falling, freezing, walking, gait and postural stability) of the Unified Parkinson Disease Rating Scale (UPDRS). PIGD score was significantly correlated with age, disease duration, Hoehn and Yahr score, comorbidity, UPDRS motor score, gait speed of forward, backward and sideways walks, and time to turn. PIGD score was marginally significantly correlated with timed 5-step test. After controlling for age, disease duration, disease severity, comorbidity, and motor impairment, sideway gait speed (β = - 0.335; p = 0.024), timed 5-step test (β = - 0.397; p = 0.003) and time to turn (β = 0.289; p = 0.028) significantly predicted postural instability and gait difficulty. Walking sideways, 5-step test, and turning are significant predictors of PIGD score. These simple mobility tests can be quickly applied in clinical practice to determine postural instability and gait problems in persons with PD.
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Affiliation(s)
- Mon S Bryant
- Research Service, Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd., Mail Code 153, Houston, TX, 77030, USA. .,Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA. .,School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA.
| | - Jyh-Gong Gabriel Hou
- Lehigh Neurology, Lehigh Valley Health Network, Allentown, PA, USA.,Department of Neurology, University of South Florida, Tampa, FL, USA
| | - Craig D Workman
- Research Service, Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd., Mail Code 153, Houston, TX, 77030, USA.,Department of Health and Human Performance, Center for Neuromotor and Biomechanics Research, University of Houston, Houston, TX, USA
| | - Elizabeth J Protas
- School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA
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