The transition between turning and sitting in patients with Parkinson's disease: A wearable device detects an unexpected sequence of events
Aner Weiss, Talia Herman, Anat Mirelman, Shirley Shema Shiratzky, Nir Giladi, Lisa L. Barnes, David A. Bennett, Aron S. Buchman, Jeffrey M. Hausdorff
Background: When older adults turn to sit, about 80% of the subjects complete the turn before starting to sit i.e., a distinct-strategy, while in about 20%, part of the turning and sitting take place concurrently, i.e., an overlapping-strategy. A prolonged duration of the separation between tasks in the distinct-strategy (D-interval) and a prolonged duration of the overlap interval in overlapping-strategy (O-interval) are related to worse motor symptoms and poorer cognition. In the present study, we evaluated what strategy is employed by patients with Parkinson's disease (PD) when they transition from turning to sitting. Methods: 96 participants with PD performed turn to sit as part of the Timed Up and Go test, both with and without medications, while wearing a body-fixed sensor. We quantified the turn-to-sit transition and determined which strategy (distinct or overlapping) was employed. We then stratified the cases and used regression models adjusted for age, gender, height, and weight to examine the associations of the D-interval or O-interval with parkinsonian features and cognition. Results: Most patients (66%) employed the overlapping-strategy, both off and on anti-parkinsonian medications. Longer O-intervals were associated with longer duration of PD, more severe PD motor symptoms, a higher postural-instability-gait-disturbance (PIGD) score, and worse freezing of gait. Longer D-intervals were not associated with disease duration or PD motor symptoms. Neither the D- nor O-intervals were related to cognitive function. Individuals who employed the overlapping-strategy had more severe postural instability (i.e., higher PIGD scores), as compared to those who used the distinct-strategy. Significance: In contrast to older adults without PD, most patients with PD utilize the overlapping strategy. Poorer postural and gait control are associated with the strategy choice and with the duration of concurrent performance of turning and sitting. Additional work is needed to further explicate the mechanisms underlying these strategies and their clinical implications.
Gait and Posture
https://doi.org/10.1016/j.gaitpost.2018.10.018
Body-fixed sensor
10.1016/j.gaitpost.2018.10.018
Dive into the research topics of 'The transition between turning and sitting in patients with Parkinson's disease: A wearable device detects an unexpected sequence of events'. Together they form a unique fingerprint.
Wearable Electronic Devices Medicine & Life Sciences 100%
Sitting Position Medicine & Life Sciences 72%
Gait Medicine & Life Sciences 37%
Cognition Medicine & Life Sciences 23%
Postural Balance Medicine & Life Sciences 11%
Freezing Medicine & Life Sciences 10%
Weights and Measures Medicine & Life Sciences 6%
Weiss, A., Herman, T., Mirelman, A., Shiratzky, S. S., Giladi, N., Barnes, L. L., Bennett, D. A., Buchman, A. S., & Hausdorff, J. M. (2019). The transition between turning and sitting in patients with Parkinson's disease: A wearable device detects an unexpected sequence of events. Gait and Posture, 67, 224-229. https://doi.org/10.1016/j.gaitpost.2018.10.018
Weiss, Aner ; Herman, Talia ; Mirelman, Anat ; Shiratzky, Shirley Shema ; Giladi, Nir ; Barnes, Lisa L. ; Bennett, David A. ; Buchman, Aron S. ; Hausdorff, Jeffrey M. / The transition between turning and sitting in patients with Parkinson's disease : A wearable device detects an unexpected sequence of events. In: Gait and Posture. 2019 ; Vol. 67. pp. 224-229.
@article{d0e1c314b5cf4d7e9e8f9e0c4811c674,
title = "The transition between turning and sitting in patients with Parkinson's disease: A wearable device detects an unexpected sequence of events",
abstract = "Background: When older adults turn to sit, about 80% of the subjects complete the turn before starting to sit i.e., a distinct-strategy, while in about 20%, part of the turning and sitting take place concurrently, i.e., an overlapping-strategy. A prolonged duration of the separation between tasks in the distinct-strategy (D-interval) and a prolonged duration of the overlap interval in overlapping-strategy (O-interval) are related to worse motor symptoms and poorer cognition. In the present study, we evaluated what strategy is employed by patients with Parkinson's disease (PD) when they transition from turning to sitting. Methods: 96 participants with PD performed turn to sit as part of the Timed Up and Go test, both with and without medications, while wearing a body-fixed sensor. We quantified the turn-to-sit transition and determined which strategy (distinct or overlapping) was employed. We then stratified the cases and used regression models adjusted for age, gender, height, and weight to examine the associations of the D-interval or O-interval with parkinsonian features and cognition. Results: Most patients (66%) employed the overlapping-strategy, both off and on anti-parkinsonian medications. Longer O-intervals were associated with longer duration of PD, more severe PD motor symptoms, a higher postural-instability-gait-disturbance (PIGD) score, and worse freezing of gait. Longer D-intervals were not associated with disease duration or PD motor symptoms. Neither the D- nor O-intervals were related to cognitive function. Individuals who employed the overlapping-strategy had more severe postural instability (i.e., higher PIGD scores), as compared to those who used the distinct-strategy. Significance: In contrast to older adults without PD, most patients with PD utilize the overlapping strategy. Poorer postural and gait control are associated with the strategy choice and with the duration of concurrent performance of turning and sitting. Additional work is needed to further explicate the mechanisms underlying these strategies and their clinical implications.",
keywords = "Accelerometer, Body-fixed sensor, Cognitive function, Parkinson's disease, Wearables",
author = "Aner Weiss and Talia Herman and Anat Mirelman and Shiratzky, {Shirley Shema} and Nir Giladi and Barnes, {Lisa L.} and Bennett, {David A.} and Buchman, {Aron S.} and Hausdorff, {Jeffrey M.}",
note = "Funding Information: This work was supported in part by the Michael J Fox Foundation for Parkinson's Research and NIH grants R01AG056352 , R01AG17917 , RF1AG22018 , RO1NS78009 and R01AG47976 . The funding sources had no involvement in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. Publisher Copyright: {\textcopyright} 2018 Elsevier B.V.",
doi = "10.1016/j.gaitpost.2018.10.018",
journal = "Gait and Posture",
Weiss, A, Herman, T, Mirelman, A, Shiratzky, SS, Giladi, N, Barnes, LL, Bennett, DA, Buchman, AS & Hausdorff, JM 2019, 'The transition between turning and sitting in patients with Parkinson's disease: A wearable device detects an unexpected sequence of events', Gait and Posture, vol. 67, pp. 224-229. https://doi.org/10.1016/j.gaitpost.2018.10.018
The transition between turning and sitting in patients with Parkinson's disease : A wearable device detects an unexpected sequence of events. / Weiss, Aner; Herman, Talia; Mirelman, Anat; Shiratzky, Shirley Shema; Giladi, Nir; Barnes, Lisa L.; Bennett, David A.; Buchman, Aron S.; Hausdorff, Jeffrey M.
In: Gait and Posture, Vol. 67, 01.01.2019, p. 224-229.
T1 - The transition between turning and sitting in patients with Parkinson's disease
T2 - A wearable device detects an unexpected sequence of events
AU - Weiss, Aner
AU - Herman, Talia
AU - Mirelman, Anat
AU - Shiratzky, Shirley Shema
AU - Giladi, Nir
AU - Barnes, Lisa L.
AU - Bennett, David A.
AU - Buchman, Aron S.
AU - Hausdorff, Jeffrey M.
N1 - Funding Information: This work was supported in part by the Michael J Fox Foundation for Parkinson's Research and NIH grants R01AG056352 , R01AG17917 , RF1AG22018 , RO1NS78009 and R01AG47976 . The funding sources had no involvement in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. Publisher Copyright: © 2018 Elsevier B.V.
N2 - Background: When older adults turn to sit, about 80% of the subjects complete the turn before starting to sit i.e., a distinct-strategy, while in about 20%, part of the turning and sitting take place concurrently, i.e., an overlapping-strategy. A prolonged duration of the separation between tasks in the distinct-strategy (D-interval) and a prolonged duration of the overlap interval in overlapping-strategy (O-interval) are related to worse motor symptoms and poorer cognition. In the present study, we evaluated what strategy is employed by patients with Parkinson's disease (PD) when they transition from turning to sitting. Methods: 96 participants with PD performed turn to sit as part of the Timed Up and Go test, both with and without medications, while wearing a body-fixed sensor. We quantified the turn-to-sit transition and determined which strategy (distinct or overlapping) was employed. We then stratified the cases and used regression models adjusted for age, gender, height, and weight to examine the associations of the D-interval or O-interval with parkinsonian features and cognition. Results: Most patients (66%) employed the overlapping-strategy, both off and on anti-parkinsonian medications. Longer O-intervals were associated with longer duration of PD, more severe PD motor symptoms, a higher postural-instability-gait-disturbance (PIGD) score, and worse freezing of gait. Longer D-intervals were not associated with disease duration or PD motor symptoms. Neither the D- nor O-intervals were related to cognitive function. Individuals who employed the overlapping-strategy had more severe postural instability (i.e., higher PIGD scores), as compared to those who used the distinct-strategy. Significance: In contrast to older adults without PD, most patients with PD utilize the overlapping strategy. Poorer postural and gait control are associated with the strategy choice and with the duration of concurrent performance of turning and sitting. Additional work is needed to further explicate the mechanisms underlying these strategies and their clinical implications.
AB - Background: When older adults turn to sit, about 80% of the subjects complete the turn before starting to sit i.e., a distinct-strategy, while in about 20%, part of the turning and sitting take place concurrently, i.e., an overlapping-strategy. A prolonged duration of the separation between tasks in the distinct-strategy (D-interval) and a prolonged duration of the overlap interval in overlapping-strategy (O-interval) are related to worse motor symptoms and poorer cognition. In the present study, we evaluated what strategy is employed by patients with Parkinson's disease (PD) when they transition from turning to sitting. Methods: 96 participants with PD performed turn to sit as part of the Timed Up and Go test, both with and without medications, while wearing a body-fixed sensor. We quantified the turn-to-sit transition and determined which strategy (distinct or overlapping) was employed. We then stratified the cases and used regression models adjusted for age, gender, height, and weight to examine the associations of the D-interval or O-interval with parkinsonian features and cognition. Results: Most patients (66%) employed the overlapping-strategy, both off and on anti-parkinsonian medications. Longer O-intervals were associated with longer duration of PD, more severe PD motor symptoms, a higher postural-instability-gait-disturbance (PIGD) score, and worse freezing of gait. Longer D-intervals were not associated with disease duration or PD motor symptoms. Neither the D- nor O-intervals were related to cognitive function. Individuals who employed the overlapping-strategy had more severe postural instability (i.e., higher PIGD scores), as compared to those who used the distinct-strategy. Significance: In contrast to older adults without PD, most patients with PD utilize the overlapping strategy. Poorer postural and gait control are associated with the strategy choice and with the duration of concurrent performance of turning and sitting. Additional work is needed to further explicate the mechanisms underlying these strategies and their clinical implications.
KW - Accelerometer
KW - Body-fixed sensor
KW - Cognitive function
KW - Parkinson's disease
KW - Wearables
U2 - 10.1016/j.gaitpost.2018.10.018
DO - 10.1016/j.gaitpost.2018.10.018
JO - Gait and Posture
JF - Gait and Posture
Weiss A, Herman T, Mirelman A, Shiratzky SS, Giladi N, Barnes LL et al. The transition between turning and sitting in patients with Parkinson's disease: A wearable device detects an unexpected sequence of events. Gait and Posture. 2019 Jan 1;67:224-229. https://doi.org/10.1016/j.gaitpost.2018.10.018