Clinical Study
The Parkinsonian Gait Spatiotemporal Parameters Quantified
by a Single Inertial Sensor before and after
Automated Mechanical Peripheral Stimulation Treatment
Ana Kleiner,
1,2
Manuela Galli,
1,3
Maria Gaglione,
4
Daniela Hildebrand,
5
Patrizio Sale,
3
Giorgio Albertini,
3
Fabrizio Stocchi,
3
and Maria Francesca De Pandis
4
1
Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milano, Lombardia, Italy
2
Movement Analysis and Neuroscience-Neurological Rehabilitation Laboratories, University of Health Sciences of Porto Alegre,
90050-170 Porto Alegre, RS, Brazil
3
IRCCS San Rafaele Pisana Tosinvest Sanit´ a, 00163 Roma, Lazio, Italy
4
San Rafaele Cassino Hospital Tosinvest Sanit´ a, 03043 Roma, Lazio, Italy
5
UNIMED Hospital, 13500-391 Rio Claro, SP, Brazil
Correspondence should be addressed to Ana Kleiner; anafrkleiner@gmail.com
Received 29 May 2015; Revised 5 August 2015; Accepted 2 September 2015
Academic Editor: Talia Herman
Copyright © 2015 Ana Kleiner et al. Tis is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Tis study aims to evaluate the change in gait spatiotemporal parameters in subjects with Parkinson’s disease (PD) before and
afer Automated Mechanical Peripheral Stimulation (AMPS) treatment. Tirty-fve subjects with PD and 35 healthy age-matched
subjects took part in this study. A dedicated medical device (Gondola) was used to administer the AMPS. All patients with PD were
treated in of levodopa phase and their gait performances were evaluated by an inertial measurement system before and afer the
intervention. Te one-way ANOVA for repeated measures was performed to assess the diferences between pre- and post-AMPS
and the one-way ANOVA to assess the diferences between PD patients and the control group. Spearman’s correlations assessed the
associations between patients with PD clinical status (H&Y) and the percentage of improvement of the gait variables afer AMPS
( < 0.05 for all tests). Te PD group had an improvement of 14.85% in the stride length; 14.77% in the gait velocity; and 29.91% in
the gait propulsion. Te correlation results showed that the higher the H&Y classifcation, the higher the stride length percentage of
improvement. Te treatment based on AMPS intervention seems to induce a better performance in the gait pattern of PD patients,
mainly in intermediate and advanced stages of the condition.
1. Introduction
Te most typical gait pattern of Parkinson’s disease (PD) is
a short-stepped shufing gait. It is characterized by reduced
stride length and walking speed [1, 2]. Tese gait disorders
worsen progressively, as the disease advances, and are related
to the risk of falling among the Parkinsonians [3]. Terefore,
it is not surprising that gait impairment in PD is the major
contributor to decreased patients’ quality of life [4].
Te management of PD was traditionally centered on
drug therapy, with levodopa being its “gold standard” treat-
ment [5]. Several studies have demonstrated the ability of
levodopa to decrease stride length and improve walk speed
[6]. However, as the disease progresses, chronic levodopa
treatment can be associated with response decrease and with
development of motor complications, including wearing-of
episodes and dyskinesia [5].
To reduce these motor fuctuations, new treatments based
on peripheral stimulation of the sensory-motor system, called
bottom-up stimulation, have been inspiring new rehabili-
tation approaches in PD [7, 8]. Recently, new approaches
have been developed to recover the gait impairment such as
the Automated Mechanical Peripheral Stimulation (AMPS)
treatment [9, 10]. Te AMPS is delivered by a dedicated
device, known as Gondola (Gondola Medical Technologies
SA, Switzerland), and consists in the application of a pressure
Hindawi Publishing Corporation
Parkinson’s Disease
Volume 2015, Article ID 390512, 6 pages
http://dx.doi.org/10.1155/2015/390512