Our retrospective study of falls and resultant trauma in consecutive Parkinson disease (PD) patients seen in one year at the Muhammad Ali Parkinson Clinic found that multiple-fallers could be divided into patients who fell mainly when walking or those who fell mainly when standing. Patients who fell when walking were more likely to visit an emergency room or be admitted to a hospital.
Of 455 consecutive patients who were evaluated over a one-year period, 51 were excluded because they had atypical Parkinson disorders, had multiple risk factors for falling, or were demented. Unified Parkinson Disease Rating Scales and Zeno Walkway results were compared among non-fallers, single-fallers, and multiple-fallers. Among multiple-fallers, comparisons were made between patients who fell mainly when standing and those who fell mainly when walking.
Most patients (197, 49%) did not fall, 142 (35%) fell once, and 65 (16%) fell more than once. Multiple-fallers differed significantly from single-fallers and non-fallers: they had PD significantly longer (p<0.001), were more severely affected (p<0.001), and took shorter steps (p<0.001). Of 65 multiple-fallers, 26 (40%) fell mainly when standing, 28 (43%) fell mainly when walking, and 11 (17%) fell equally often when standing or walking. Falls when walking resulted in more severe injuries. Patients who fell mainly when standing did not realize they could fall when standing; engaged in inappropriate weight shifting, bending, reaching, and multitasking; and failed to use their assistive devices. Such patients would benefit from being counseled about falling when standing. Patients who fell mainly when walking were aware they could fall, despite using an assisted device, and were more likely to have freezing of gait (FOG). They were more likely to sustain a severe injury, and were more likely to be admitted to an emergency room or hospital. Such patients would benefit from reducing, if possible, FOG.
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Subject-Independent Freezing of Gait (FoG) Prediction in Parkinson's Disease Patients
Freezing of gait (FoG), which implies a brief absence or reduction of ability to walk, is one of the most common symptoms of Parkinson's Disease (PD). Predicting FoG episodes in time can prevent their onset by providing specific cues to the patients. This paper presents a deep learning approach to predict FoG episodes using a Long Short-Term Memory network (LSTM). It also identifies key issues and concepts which have not been dwelled upon before in the existing literature, paving the way to a more systematic methodology for future work. We evaluate our approach using a publicly available dataset that includes accelerometer readings from 10 PD patients. We achieve up to 89% prediction accuracy with an average prediction time of 1.42 s using a subject-independent model.
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- Award ID(s):
- 2114499
- PAR ID:
- 10334249
- Date Published:
- Journal Name:
- IEEE Biomedical Circuits and Systems Conference (BioCAS)
- Page Range / eLocation ID:
- 1 to 6
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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- Free Publicly Accessible Full Text
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Accepted Manuscript1.0
- Conference Paper:
- https://doi.org/10.1109/BioCAS49922.2021.9644972
