Balance testing with inertial sensors in patients with Parkinson's disease: assessment of motor subtypes

In this study, the use of an instrumented balance test based on inertial sensors was evaluated in patients with Parkinson's disease (PD). We aimed to objectively characterize motor subtypes of PD [tremor dominant (TD) and postural instability gait difficulty (PIGD)], to help to quantitatively classify the PD subjects into motor subtypes. Subjects were studied performing postural tests, while wearing a device including a tri-axial accelerometer on the lower back, in four different experimental conditions that depended on feet position (feet-together or semi-tandem) and vision (eyes open or closed). Postural measures, after a reliability check, were tested to identify their sensitivity to the disease, to the PD subtypes, and to the experimental conditions. The results highlight the possibility of distinguishing between the TD and PIGD subtypes by means of objective postural measures that are able to detect tremor and PIGD features and are able to classify a subject as TD or PIGD with good accuracy. Feet position influences frequency measures, whereas eyes closure influences the displacement measures and enhances differences between PD and control subjects, suggesting that postural displacement measures may be capable of detecting different adaptation processes to external sensory conditions between patients with PD and control subjects.