Objective: Parkinson’s disease (PD) is characterized by gait impairments, impacting patient mobility and quality of life. This study compares a reference gait measurement system, GAITRite (GR) against digital insoles, Moticon ReGo (MR), for measuring spatial and temporal gait characteristics in PD patients, with potential as indicators of disease progression.

Background: While most PD gait research to date has relied on inertial measurement unit-derived characteristics, the novel application of pressure sensor insoles necessitates validation.

Method: We conducted a comparative analysis on 21 PD patients using the GR reference gait system and MR digital insoles during a single on-site visit, in both Off and On levodopa medication states. Gait cadence, gait speed, stride length, stance, swing, and double support time were assessed with both devices. Measurement reliability was evaluated using the absolute agreement intraclass correlation (ICC). Mixed models were used to estimate mean differences by medication state and test for associations with Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) III.

Results: PD subjects were enrolled across two sites. 10 subjects were female (48%) with a mean age of 64 years (SD=11), a mean disease duration of 10 years (SD=6), and a mean MDS-UPDRS III of 43 (SD=18). Mean differences between devices were minuscule across all parameters. Cadence, speed, and stride length showed excellent reliability, with ICCs between 0.93 and 0.97. The remaining characteristics exhibited moderate reliability (ICCs from 0.48 to 0.57). All characteristics, except for cadence, showed nominally significant mean differences between On and Off levodopa medication. MDS-UDPRS III score correlated with both speed and stride length as measured by both MR and GR: MDS-UDPRS III decreased by 12% (=0.01) in MR and 11% (=0.01) in GR per speed SD, and it decreased by 11% (=0.01) in MR and 10% (=0.03) in GR per stride length SD.

Conclusion: ​​​​These findings support the potential use of digital insoles for comprehensive active task gait analysis in PD patients, which may serve complementary to other types of sensor modality measurements in PD. The portable nature of this instrument and high sensitivity to levodopa treatment to gait characteristics supports the use of digital insoles for at-home active task assessments of gait.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/comparative-analysis-of-gaitrite-and-moticon-digital-insoles-for-gait-assessment-in-parkinsons-disease-patients-before-and-after-levodopa-administration/