A New Methodological Approach Integrating Motion Capture and Pressure-Sensitive Gait Data to Assess Functional Mobility in Parkinson’s Disease: A Two-Phase Study

Abstract

Highlights: What are the main findings? We report the development of a novel measure of functional mobility (FMA-P) that provides detailed insight into symptom-related movement impairments in Parkinson’s disease. By integrating motion capture and pressure-sensitive gait mat technology, the FMA-P evaluates multiple aspects of mobility—including balance, posture, gait, sit-to-stand transitions, turning, and reaching—that are often overlooked by standard assessments focused primarily on task duration. What is the implication of the main findings? Specific movement tasks, particularly those involving yaw rotation, are sensitive indicators of changes in Parkinson’s disease symptom severity. Rehabilitation programs should prioritize these tasks, as targeting them may optimize functional gains and better monitor disease progression. Existing clinical assessments of Parkinson’s disease (PD) primarily focus on stratifying symptom severity or progression rate, which limits their ability to capture changes in functional mobility—an important factor in evaluating rehabilitation outcomes. To address this gap, we developed a novel methodology, the Functional Mobility Assessment for Parkinson’s (FMA-P), which integrates motion capture and pressure-sensitive gait analysis to explore key aspects of functional mobility. Study 1. To develop the FMA-P, we conducted a pilot study involving 12 individuals with PD and 12 age-matched healthy controls, who each completed the FMA-P sequence three times. The sequence included the following tasks: rising from a chair, walking through a doorway, turning, bending to pick up and place an object, and returning to a seated position. Results from Study 1 demonstrated that the FMA-P is a sensitive tool for identifying functional impairments in PD. In particular, significant differences between people with Parkinson’s (PwP) and controls were observed during chair rise (higher peak trunk inclination, p = 0.006; lower mean trunk jerk, p = 0.003) and turning task (longer task duration, p = 0.026 and lower mean heel strike angle, p = 0.007), providing critical insights into postural stability. Study 2. To assess changes in functional mobility over time, we conducted a 12-week repeated-measures intervention study with 12 participants with PD. Results from Study 2 indicated notable improvements in turning stability and balance. Participants demonstrated reduced turning time (p = 0.006) and increased yaw rotation in the head (p = 0.001), trunk (p = 0.002), and pelvis (p = 0.012). In contrast, no significant changes were observed in standard clinical measures (i.e., Timed Up and Go and task duration). The FMA-P offers fine-grained insights into movement quality, making it a valuable tool for early diagnosis, monitoring intervention efficacy, and guiding rehabilitation strategies in individuals with PD.