Initial Validity and Clinical Utility of the Moticon Insole System for Assessing Gait in Parkinson’s Disease
Deborah Hall1, Kimberly Kwei2, Nicollette Purcell3, Emily Timm1, Rolando Acosta4, Bharatkumar Koyani4, Erin Robertson-Dick4, Matthew Wipperman4, Oren Levy4, Joanne O'Keefe1
1Rush University, 2Neurological Institute, 3Illinois College of Optometry, 4Regeneron
Objective:
To establish the clinical validity of digital insoles against a gold standard gait analysis system for measuring select spatiotemporal gait parameters in patients with PD and explore how these relate to overall disease severity and responsiveness to dopaminergic therapy.
Background:
The measurement of gait abnormalities in Parkinson’s disease (PD) have traditionally used gait labs and equipment, which are expensive and require specific training in analysis. Digital gait technologies that may be more user-friendly, and cost-effective than traditional gait analysis systems.
Design/Methods:
A comparative analysis between digital insoles (Moticon ReGoTM) and the GAITRite system was conducted on patients with PD during a single on-site visit. Patients were assessed the OFF and ON levodopa states by neurologists. Gait cadence, speed, stride length, and stance, swing and double support time were measured simultaneously with both systems during two 10-meter walk tests (self-selected pace); agreement was evaluated using ICCs. Linear mixed models were used to estimate mean differences in gait parameters between the ON/OFF states and test for associations with MDS-UPDRS motor scores.
Results:
Twenty-one patients with PD and a mean age of 64.2±10.5 years, disease duration of 9.6±5.7 years, and MDS-UPDRS motor score of 43.4±18.3 (OFF) were enrolled across two sites. Analytical validation for gait cadence, speed, and stride length showed excellent agreement (ICCs: 0.93–0.97). Stance, swing, and double support times exhibited lower validity with moderate agreement (ICCs: 0.48–0.57). Gait speed and stride length were significantly associated with MDS-UPDRS motor scores. Mean differences in all parameters measured with the insoles except cadence were significantly different between OFF/ON states (p<0.009).
Conclusions:
These findings support the validity of digital insoles for gait cadence, speed, and stride length in PD. The association of select gait parameters with disease severity and dopaminergic ON or OFF states suggests their potential use as a quantitative outcome measure in PD.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.