Concurrent validity of instrumented insoles measuring gait and balance metrics in Parkinson's disease

Sophia A. Watkinson, Anthony J. Anderson, Michael Caiola, David Eguren, Michael Gonzalez, Laureano Moro-Velázquez, Najim Dehak, Chelsey Motley, Emile Moukheiber, Kelly Mills, Brittney C, Muir, Ankur A. Butala, Kimberly Kontson

Abstract: Several commercially available instrumented insole systems have been examined for validity and repeatability, but very few studies have focused on validation of the Moticon OpenGo sensor insoles in measuring gait and balance parameters in a clinical population. Given the paucity of studies examining the validity of these novel technologies in PD, there were two main goals of this research: (1) assess the concurrent validity of the Moticon OpenGo sensor insoles for gait and balance assessment in people with PD using a pressure-sensitive electronic walkway (Protokinetics Zeno™ walkway) as a reference system and (2) compare the gait metrics derived from the insole and walkway systems during a walking and turning task in order to assess the output of the systems under more real-world conditions. Twelve participants (5F/7M; mean age 71.3 ± 6.8 years) with a diagnosis of Parkinson’s disease and a score of 2.5 or 3 on the Modified Hoehn & Yahr score performing straight-line walking, walking with turning, and balance tasks were included in this analysis. Differences in the estimated gait metrics from each system were evaluated through Bland-Altman analysis and calculation of Pearson’s correlation coefficient (r). Results showed strong agreement between the insoles and the reference walkway system during both self-selected pace and hurried pace walking tasks. Although agreement is not as strong when estimating spatial metrics, the limits of agreement (LOA) still indicate that clinically important differences can be seen. Additional investigation into the insole derived center of pressure metrics from the insole sensor systems may be necessary as well as investigation into improved algorithms for capturing gait metrics during more real-world conditions in both types of systems.