An accelerometry-based study of lower and upper limb tremor in Parkinson’s disease
Abstract
Over the past two decades, several studies have aimed to quantify the kinetic properties of tremor with primary focus on the upper limbs. However, there is a lack of investigation into the properties of tremor in the lower limbs. The objective of this preliminary study was to investigate the properties of oscillatory movement, at rest and in posture, in both the upper and lower limbs of Parkinson's disease (PD) patients with clinically undetectable to modest rest/postural tremor and healthy controls. PD patients (N = 16) and controls (N = 8) were examined clinically by a movement disorders specialist and oscillatory movements in all four extremities were evaluated using a portable biaxial accelerometer. While tremor intensity and frequency did not differ between groups, the intraindividual variability of rest and postural tremor frequency in the dexterity-dominant lower limb was lower in people living with PD than in healthy adults. Additionally, rest tremor frequency was discrepant between upper and lower limbs in PD. Our work introduces the possibility that minute variations in lower limb movements, which are imperceptible upon expert clinical exam, can be used to differentiate a diseased sample from a healthy one. These preliminary findings suggest that additional work using objective tremor measurement may improve our understanding of lower limb motor dysfunction in PD and lead to the refinement of current, and the development of new, metrics to enhance early diagnosis, differential diagnosis, and symptom quantification.
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In Parkinson's disease, wearables were used to detect and quantify cardinal motor symptoms including bradykinesia, tremor, and postural sway.
“In PD, wearables were used to detect and quantify cardinal motor symptoms including bradykinesia [19], tremor [20, 21], and postural sway [22, 23] as well as medication-evoked adverse symptoms such as dyskinesia [24–27] and motor fluctuations [28, 29].”
From Wearable sensors for clinical applications in epilepsy, Parkinson’s disease, and stroke: A mixed-methods systematic review (2018) · cites this paper as [20]
Measures derived from wearables quantifying tremor, dyskinesia, postural sway, and spatiotemporal gait characteristics discriminated well between individuals with Parkinson's disease and healthy controls.
“Different measures derived from wearables quantifying tremor, dyskinesia, postural sway, and spatiotemporal gait characteristics discriminated well between individuals with PD and healthy controls [20, 22, 24, 26, 31]; dyskinesia measures discriminated also between patients with and without dyskinesia [24, 26].”
From Wearable sensors for clinical applications in epilepsy, Parkinson’s disease, and stroke: A mixed-methods systematic review (2018) · cites this paper as [20]
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- Authors
- Scanlon, B. K., Levin, B. E., Nation, D. A., Katzen, H. L., Guevara-Salcedo, A., Singer, C., & Papapetropoulos, S.
- Affiliations
- VA Palo Alto Health Care System (US)
- University of Miami (US)
- University of California San Diego (US)
- Peoria campus of the University of Illinois System (US)
- Corresponding author
- Scanlon, Blake K.
- Venue
- Journal of Clinical Neuroscience
- Publisher
- Elsevier BV
- Published
- 2013-06
- Volume
- 20
- Issue
- 6
- Pages
- 827-830
- ISSN
- 0967-5868 (ISSN-L)
- OpenAlex
- W2110672886
- Cited by
- 33
- References
- 14
- Citations by year
- 2026: 1 · 2024: 2 · 2022: 4 · 2021: 2 · 2020: 3 · 2019: 5 · 2018: 5 · 2017: 4 · 2016: 4 · 2014: 3
- FWCI
- 1.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Neuroscience (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5k23ns045051-05)
- National Institute of Neurological Disorders and Stroke (K23-NS045051)
- Topics
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Keywords
- Parkinson's disease, tremor, upper limb tremor, resting tremor, postural tremor, tremor frequency, within-person variability, accelerometry, biaxial accelerometer, motor impairment
- MeSH terms
- Aged, Female, Humans, Male, Middle Aged, Parkinson Disease, Posture, Severity of Illness Index, Tremor, Upper Extremity, Lower Extremity, Accelerometry
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