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Background <p>Although many patients with Parkinson’s disease (PD) report experiencing episodes of freezing of gait (FOG) at home under ON medication (“On-meds”) conditions, objective and accurate diagnosis of different types of FOG events remains an extremely challenging task.</p> Methods <p>We conducted an observational, case–control study enrolling 75 consecutive PD patients, who were classified into “freezer” (<i>n</i> = 50) and “non-freezer” (<i>n</i> = 25) group, based on responses to the FOG Questionnaire and clinical confirmation. A modified timed up and go (TUG) protocol comprised one single‑task TUG (sTUG) and two dual‑task TUGs (cognitive, manual). Synchronized video and a single wearable sensor (Ambulosono) provided parallel capture for real‑time detection and subtyping of FOG.</p> Results <p>In the “freezers” group, 337 FOG episodes occurred during TUG testing, whereas none were recorded in the “non‑freezers” group (<i>p</i> &lt; 0.01). The mean frequency was 2.25 FOG episodes per person per test. Compared with the sTUG test (74 FOG episodes), dual-task trials identified 263 FOG episodes, representing a 255% increase (<i>p</i> &lt; 0.01). Trembling, shuffling and akinetic subtypes were identifiable on the device display (GMGI), with sensitivity 87.2% and specificity 89.5% versus video. Wearable data also localized subtypes by gait phase (initiation, turning, midway and ending).</p> Conclusions <p><b>“</b>On-meds” FOGs can be objectively diagnosed among self-reported freezers using a dual task protocol during gait tests. Parallel video and wearable sensor recordings facilitate the real-time detection and subtyping of “On-meds” FOGs, which can substantially improve the current clinical practice.</p>

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Real-time detection and subtyping of “On-meds” freezing of gait in Parkinson’s disease using lower-limb acceleration data

  • 期刊论文

  • 发表日期：

    2026年1月27日

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  • Wenbiao Xian,
  • Bin Hu,
  • Taylor Chomiak,
  • Fengjuan Su,
  • Zhong Pei

摘要

Background

Although many patients with Parkinson’s disease (PD) report experiencing episodes of freezing of gait (FOG) at home under ON medication (“On-meds”) conditions, objective and accurate diagnosis of different types of FOG events remains an extremely challenging task.

Methods

We conducted an observational, case–control study enrolling 75 consecutive PD patients, who were classified into “freezer” (n = 50) and “non-freezer” (n = 25) group, based on responses to the FOG Questionnaire and clinical confirmation. A modified timed up and go (TUG) protocol comprised one single‑task TUG (sTUG) and two dual‑task TUGs (cognitive, manual). Synchronized video and a single wearable sensor (Ambulosono) provided parallel capture for real‑time detection and subtyping of FOG.

Results

In the “freezers” group, 337 FOG episodes occurred during TUG testing, whereas none were recorded in the “non‑freezers” group (p < 0.01). The mean frequency was 2.25 FOG episodes per person per test. Compared with the sTUG test (74 FOG episodes), dual-task trials identified 263 FOG episodes, representing a 255% increase (p < 0.01). Trembling, shuffling and akinetic subtypes were identifiable on the device display (GMGI), with sensitivity 87.2% and specificity 89.5% versus video. Wearable data also localized subtypes by gait phase (initiation, turning, midway and ending).

Conclusions

“On-meds” FOGs can be objectively diagnosed among self-reported freezers using a dual task protocol during gait tests. Parallel video and wearable sensor recordings facilitate the real-time detection and subtyping of “On-meds” FOGs, which can substantially improve the current clinical practice.