Detecting Postural Instability in Parkinson's Disease From IMU-Based Objective Measures

Parkinson’s Disease (PD) is a progressive neurological disorder that affects both motor and non-motor functions. A critical aspect of PD is postural instability, which is associated with a higher risk of falls and a significant decline in mobility. The onset of postural instability is frequently ide...

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Autores: Smith, Kendal, Torricelli, Diego, Gonzalez Sanchez, Miguel, Pérez-Sánchez, Javier Ricardo, Luque Buzo, Elisa, Grandas, Francisco, Marin, Juan Miguel, Gomez Garcia, Jorge Andrés
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Consejo Superior de Investigaciones Científicas (CSIC)
Repositorio:DIGITAL.CSIC. Repositorio Institucional del CSIC
OAI Identifier:oai:digital.csic.es:10261/417733
Acceso en línea:http://hdl.handle.net/10261/417733
Access Level:acceso abierto
Palabra clave:Accelerometer
H&Y
Hoehn and Yahr
IMU
inertial measurement unit
Parkinson’s disease
postural instability
postural reactions
pull test
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spelling Detecting Postural Instability in Parkinson's Disease From IMU-Based Objective MeasuresSmith, KendalTorricelli, DiegoGonzalez Sanchez, MiguelPérez-Sánchez, Javier RicardoLuque Buzo, ElisaGrandas, FranciscoMarin, Juan MiguelGomez Garcia, Jorge AndrésAccelerometerH&YHoehn and YahrIMUinertial measurement unitParkinson’s diseasepostural instabilitypostural reactionspull testParkinson’s Disease (PD) is a progressive neurological disorder that affects both motor and non-motor functions. A critical aspect of PD is postural instability, which is associated with a higher risk of falls and a significant decline in mobility. The onset of postural instability is frequently identified through subjective clinical assessments such as the pull test, which aligns with the transition from Stage II to Stage III on the Hoehn and Yahr (H&Y) scale, a measure of general motor impairment. This study aims to pinpoint this transition by providing an objective quantification of the pull test, to prevent falls and manage severe motor symptoms via early detection. Sixty objective metrics were characterised from acceleration data using inertial measurement units (IMU) during pull tests conducted with 30 PD patients to differentiate between H&Y Stages II and III. Significant differences in feature distributions were identified, with two features achieving a ROC AUC of 0.95: chest to lumbar maximum acceleration ratio, and power ratio of 8-12 Hz versus total acceleration power. This paper demonstrates the ability of certain IMU-derived features to distinguish between H&Y Stages II and III, presenting more straightforward and objective measurements compared to conventional pull test metrics. Furthermore, the study explores the inconsistencies in the administration of the pull test by different examiners and shows that even with these inconsistencies, objective measures can still effectively differentiate between stages. To the best of our knowledge, this work represents the first extensive attempt to objectively quantify the pull test for this type of classification.This work was supported in part by the AI4HealthyAging through Spanish Ministry of Economy and Digital transformation under Grant MIA.2021.M02.0007, in part by European Union NextGenerationEU/Plan de Recuperación, Transformación y Resiliencia (PRTR), and in part by the Ministerio de Ciencia, Innovación y Universidades (MCIN)/Agencia Estatal de Investigaciones (AEI)/10.13039/501100011033 through NEUROMARK Project under Grant PID2020-120491RA-I00.Peer reviewedInstitute of Electrical and Electronics EngineersMinisterio de Economía y Competitividad (España)Ministerio de Ciencia e Innovación (España)Agencia Estatal de Investigación (España)Smith, Kendal [0009-0006-2178-6235]Torricelli, Diego [0000-0001-8767-3395]Gonzalez Sanchez, Miguel [0000-0001-5076-5077]Perez Sanchez, Javier Ricardo [0000-0001-9292-9471]Luque Buzo, Elisa [0000-0002-7983-9268]Grandas, Francisco [0000-0001-6547-7617]Marin, Juan Miguel [0000-0002-6744-6475]Gomez Garcia, Jorge Andrés [0000-0002-6060-387X]Consejo Superior de Investigaciones Científicas [https://ror.org/02gfc7t72]202620262025info:eu-repo/semantics/articlehttp://purl.org/coar/resource_type/c_6501Publisher's versioninfo:eu-repo/semantics/publishedVersionhttp://hdl.handle.net/10261/417733reponame:DIGITAL.CSIC. Repositorio Institucional del CSICinstname:Consejo Superior de Investigaciones Científicas (CSIC)Inglés#PLACEHOLDER_PARENT_METADATA_VALUE#https://doi.org/10.1109/tnsre.2025.3573455Síinfo:eu-repo/semantics/openAccessoai:digital.csic.es:10261/4177332026-05-22T06:33:51Z
dc.title.none.fl_str_mv Detecting Postural Instability in Parkinson's Disease From IMU-Based Objective Measures
title Detecting Postural Instability in Parkinson's Disease From IMU-Based Objective Measures
spellingShingle Detecting Postural Instability in Parkinson's Disease From IMU-Based Objective Measures
Smith, Kendal
Accelerometer
H&Y
Hoehn and Yahr
IMU
inertial measurement unit
Parkinson’s disease
postural instability
postural reactions
pull test
title_short Detecting Postural Instability in Parkinson's Disease From IMU-Based Objective Measures
title_full Detecting Postural Instability in Parkinson's Disease From IMU-Based Objective Measures
title_fullStr Detecting Postural Instability in Parkinson's Disease From IMU-Based Objective Measures
title_full_unstemmed Detecting Postural Instability in Parkinson's Disease From IMU-Based Objective Measures
title_sort Detecting Postural Instability in Parkinson's Disease From IMU-Based Objective Measures
dc.creator.none.fl_str_mv Smith, Kendal
Torricelli, Diego
Gonzalez Sanchez, Miguel
Pérez-Sánchez, Javier Ricardo
Luque Buzo, Elisa
Grandas, Francisco
Marin, Juan Miguel
Gomez Garcia, Jorge Andrés
author Smith, Kendal
author_facet Smith, Kendal
Torricelli, Diego
Gonzalez Sanchez, Miguel
Pérez-Sánchez, Javier Ricardo
Luque Buzo, Elisa
Grandas, Francisco
Marin, Juan Miguel
Gomez Garcia, Jorge Andrés
author_role author
author2 Torricelli, Diego
Gonzalez Sanchez, Miguel
Pérez-Sánchez, Javier Ricardo
Luque Buzo, Elisa
Grandas, Francisco
Marin, Juan Miguel
Gomez Garcia, Jorge Andrés
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Ministerio de Economía y Competitividad (España)
Ministerio de Ciencia e Innovación (España)
Agencia Estatal de Investigación (España)
Smith, Kendal [0009-0006-2178-6235]
Torricelli, Diego [0000-0001-8767-3395]
Gonzalez Sanchez, Miguel [0000-0001-5076-5077]
Perez Sanchez, Javier Ricardo [0000-0001-9292-9471]
Luque Buzo, Elisa [0000-0002-7983-9268]
Grandas, Francisco [0000-0001-6547-7617]
Marin, Juan Miguel [0000-0002-6744-6475]
Gomez Garcia, Jorge Andrés [0000-0002-6060-387X]
Consejo Superior de Investigaciones Científicas [https://ror.org/02gfc7t72]
dc.subject.none.fl_str_mv Accelerometer
H&Y
Hoehn and Yahr
IMU
inertial measurement unit
Parkinson’s disease
postural instability
postural reactions
pull test
topic Accelerometer
H&Y
Hoehn and Yahr
IMU
inertial measurement unit
Parkinson’s disease
postural instability
postural reactions
pull test
description Parkinson’s Disease (PD) is a progressive neurological disorder that affects both motor and non-motor functions. A critical aspect of PD is postural instability, which is associated with a higher risk of falls and a significant decline in mobility. The onset of postural instability is frequently identified through subjective clinical assessments such as the pull test, which aligns with the transition from Stage II to Stage III on the Hoehn and Yahr (H&Y) scale, a measure of general motor impairment. This study aims to pinpoint this transition by providing an objective quantification of the pull test, to prevent falls and manage severe motor symptoms via early detection. Sixty objective metrics were characterised from acceleration data using inertial measurement units (IMU) during pull tests conducted with 30 PD patients to differentiate between H&Y Stages II and III. Significant differences in feature distributions were identified, with two features achieving a ROC AUC of 0.95: chest to lumbar maximum acceleration ratio, and power ratio of 8-12 Hz versus total acceleration power. This paper demonstrates the ability of certain IMU-derived features to distinguish between H&Y Stages II and III, presenting more straightforward and objective measurements compared to conventional pull test metrics. Furthermore, the study explores the inconsistencies in the administration of the pull test by different examiners and shows that even with these inconsistencies, objective measures can still effectively differentiate between stages. To the best of our knowledge, this work represents the first extensive attempt to objectively quantify the pull test for this type of classification.
publishDate 2025
dc.date.none.fl_str_mv 2025
2026
2026
dc.type.none.fl_str_mv info:eu-repo/semantics/article
http://purl.org/coar/resource_type/c_6501
Publisher's version
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10261/417733
url http://hdl.handle.net/10261/417733
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv #PLACEHOLDER_PARENT_METADATA_VALUE#
https://doi.org/10.1109/tnsre.2025.3573455

dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Institute of Electrical and Electronics Engineers
publisher.none.fl_str_mv Institute of Electrical and Electronics Engineers
dc.source.none.fl_str_mv reponame:DIGITAL.CSIC. Repositorio Institucional del CSIC
instname:Consejo Superior de Investigaciones Científicas (CSIC)
instname_str Consejo Superior de Investigaciones Científicas (CSIC)
reponame_str DIGITAL.CSIC. Repositorio Institucional del CSIC
collection DIGITAL.CSIC. Repositorio Institucional del CSIC
repository.name.fl_str_mv
repository.mail.fl_str_mv
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