Impaired bed mobility in Parkinson’s disease: quantitative torque analysis with axial inertial sensors

Written by Roongroj Bhidayasiri , Jirada Sringean & Chusak Thanawattano

Difficulty in turning in bed is rated as the most troublesome night-time symptom among Parkinson’s disease (PD) patients. Aim: To develop a practical objective method for home assessment of a patient’s ability to turn in bed. Methods: Nocturnal parameters and torque of self-turning in bed from 17 PD couples were assessed and compared using a wearable axial sensor for two nights in their homes. Results: The torque of axial rotation which indicates the ability of PD patients to turn in bed was significantly less than their spouses (p < 0.001). Significant correlations were observed between the torque of turning in bed and total unified Parkinson’s Disease Rating Scale score (r = 0.71; p = 0.001), and total Nocturnal Akinesia Dystonia and Cramp score (r = 0.634; p = 0.006). Conclusion: Our study confirms a decreased ability in turning in PD.
According to the original survey of night-time symptoms in Parkinson’s disease (PD), an inability to turn in bed was rated by patients as the most troublesome symptom experienced by two-thirds of the studied population [1]. This subjective complaint of impaired bed mobility is often medically referred as nocturnal hypokinesia [2]. While most patients attributed this difficulty to general movement problems, slowness, pain and weaknesses, axial motor stiffness or rigidity during the night are considered to play a significant role, with many patients using more than one strategy (e.g., hip-hitching, sitting up) to overcome this problem [3]. Indeed, one study has demonstrated a significant association between failure to turn in bed and the severity of both axial rigidity and whole body bradykinesia during the ‘off’ state of PD symptoms [4].

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