{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:53:11Z","timestamp":1773190391975,"version":"3.50.1"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Movement Disorder Society Unified Parkinson\u2019s Disease Rating Scale (MDS-UPDRS) is used as a standardized approach to assess motor function in Parkinson\u2019s disease (PD). This assessment is based on the examiner\u2019s subjective judgement and is therefore variable. While quantitative approaches have been evaluated for upper-limb movements, data is scarce on lower-limb movements. Thus, our aim was to implement and assess a setup to quantify lower-limb movements as defined in the MDS-UPDRS in healthy participants introducing new parameters for smoothness and acceleration patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty-three participants (age-range\u202f=\u202f21\u201331\u202fyears) performed five 20-s trials for both lower-limb movement tasks from the MDS-UPDRS-III, i.e., toe tapping (item 3.7) and leg agility (item 3.8). Foot and leg movements were recorded using four inertial measurement units (two per leg: one mounted on the foot and one on the ankle). Biomarkers such as kinematic parameters (e.g., frequency, angular amplitude, movement smoothness, acceleration-based parameters) were extracted to characterize foot-movement dynamics (dominant vs. non-dominant leg), with statistical analyses including linear mixed-effects models applied to four consecutive, non-overlapping 5-s intervals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A paired Wilcoxon test showed no significant differences in parameters for toe tapping and leg agility based on leg dominance. For toe tapping, the relationship between frequency and angle displayed non-linearity, with a clear decrease in angle with 17.41\u00b0 \u22120.83\u00b0\/interval*t (t\u202f=\u202f1\u20134 time intervals) and no clear decrease in frequency with 2.75\u202fHz\u202f\u2212\u202f0.02\u202fHz\/interval*t. The median frequency and angle for toe tapping were 2.8\u202fHz and 16\u00b0 respectively. The median frequency for leg agility was 2.6\u202fHz.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Reference values could be determined for all parameters including smoothness and acceleration patterns. The quantitative assessment of two MDS-UPDRS-III items shows that temporal changes and adaptation-mechanisms significantly influenced leg-movement dynamics. Reducing exercise duration to 10\u202fs and implementing a metronome with defined frequency could enhance measurement accuracy and reliability, offering more precise parameters for future applications in PD-patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1685247","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T06:57:14Z","timestamp":1767769034000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Sensor-based quantification of items used in the MDS-UPDRS-III scale: repetitive lower-limb movements in healthy human participants"],"prefix":"10.3389","volume":"16","author":[{"given":"Sven","family":"Hunziker","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorian","family":"Vogel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denise","family":"Kalt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefanie","family":"Feiler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Hemm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander Andrea","family":"Tarnutzer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2284","DOI":"10.1016\/S0140-6736(21)00218-X","article-title":"Parkinson's disease","volume":"397","author":"Bloem","year":"2021","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"17013","DOI":"10.1038\/nrdp.2017.13","article-title":"Parkinson disease","volume":"3","author":"Poewe","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"ref3","volume-title":"Parkinson disease","author":"Zafar","year":"2025"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1001\/jama.2019.22360","article-title":"Diagnosis and treatment of Parkinson disease: a review","volume":"323","author":"Armstrong","year":"2020","journal-title":"JAMA"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"942","DOI":"10.1212\/WNL.0000000000012868","article-title":"Dopaminergic therapy for motor symptoms in early Parkinson disease practice guideline summary: a report of the AAN guideline subcommittee","volume":"97","author":"Pringsheim","year":"2021","journal-title":"Neurology"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1111\/jnc.13691","article-title":"The clinical symptoms of Parkinson's disease","volume":"139","author":"Sveinbjornsdottir","year":"2016","journal-title":"J Neurochem"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2129","DOI":"10.1002\/mds.22340","article-title":"Movement disorder society-sponsored revision of the unified Parkinson's disease rating scale (MDS-UPDRS): scale presentation and clinimetric testing results","volume":"23","author":"Goetz","year":"2008","journal-title":"Mov Disord"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"100278","DOI":"10.1016\/j.prdoa.2024.100278","article-title":"Inter-rater reliability of hand motor function assessment in Parkinson's disease: impact of clinician training","volume":"11","author":"Kenny","year":"2024","journal-title":"Clin Park Relat Disord"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1901","DOI":"10.3233\/JPD-212683","article-title":"Slow motion analysis of repetitive tapping (SMART) test: measuring bradykinesia in recently diagnosed Parkinson's disease and idiopathic anosmia","volume":"11","author":"Simonet","year":"2021","journal-title":"J Parkinsons Dis"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"2409","DOI":"10.1109\/EMBC46164.2021.9629788","article-title":"Combining inertial sensors and optical flow to assess finger movements: pilot study for telehealth applications","volume":"2021","author":"Zumaeta","year":"2021","journal-title":"Annu Int Conf IEEE Eng Med Biol Soc"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.1007\/s00415-018-8841-8","article-title":"Quantitative assessment of finger tapping characteristics in mild cognitive impairment, Alzheimer's disease, and Parkinson's disease","volume":"265","author":"Roalf","year":"2018","journal-title":"J Neurol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"203","DOI":"10.3390\/s17020203","article-title":"Quantification of finger-tapping angle based on wearable sensors","volume":"17","author":"Djuric-Jovicic","year":"2017","journal-title":"Sensors (Basel)"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"8442","DOI":"10.1109\/ACCESS.2016.2633304","article-title":"A wearable inertial measurement system with complementary filter for gait analysis of patients with stroke or Parkinson\u2019s disease","volume":"4","author":"Chang","year":"2016","journal-title":"IEEE Access"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"2630","DOI":"10.3390\/s20092630","article-title":"A wearable system to objectify assessment of motor tasks for supporting Parkinson's disease diagnosis","volume":"20","author":"Rovini","year":"2020","journal-title":"Sensors (Basel)"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1038\/s41531-023-00581-2","article-title":"Identification of motor progression in Parkinson's disease using wearable sensors and machine learning","volume":"9","author":"Sotirakis","year":"2023","journal-title":"NPJ Parkinsons Dis"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"3902","DOI":"10.3390\/s23083902","article-title":"Evaluating gait impairment in Parkinson's disease from instrumented insole and IMU sensor data","volume":"23","author":"Tsakanikas","year":"2023","journal-title":"Sensors"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1016\/j.humov.2018.02.003","article-title":"How does lower limb dominance influence postural control movements during single leg stance?","volume":"58","author":"Promsri","year":"2018","journal-title":"Hum Mov Sci"},{"key":"ref18","volume-title":"Xsens MTw Awinda: Miniature wireless inertial-magnetic motion tracker for highly accurate 3D kinematic applications","author":"Paulich","year":"2018"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"111637","DOI":"10.1016\/j.jbiomech.2023.111637","article-title":"Concurrent validation of the Xsens IMU system of lower-body kinematics in jump-landing and change-of-direction tasks","volume":"154","author":"Nijmeijer","year":"2023","journal-title":"J Biomech"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1186\/s12984-015-0090-9","article-title":"On the analysis of movement smoothness","volume":"12","author":"Balasubramanian","year":"2015","journal-title":"J Neuroeng Rehabil"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1763","DOI":"10.1213\/ANE.0000000000002864","article-title":"Correlation coefficients: appropriate use and interpretation","volume":"126","author":"Schober","year":"2018","journal-title":"Anesth Analg"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1685247\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T06:57:15Z","timestamp":1767769035000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1685247\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,7]]},"references-count":21,"alternative-id":["10.3389\/fneur.2025.1685247"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1685247","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,7]]},"article-number":"1685247"}}