{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T23:00:28Z","timestamp":1771455628243,"version":"3.50.1"},"reference-count":40,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2021,3,30]],"date-time":"2021-03-30T00:00:00Z","timestamp":1617062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Korean government (MSIT)","award":["NRF-2016M3A9F1941984"],"award-info":[{"award-number":["NRF-2016M3A9F1941984"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Stooped posture, which is usually aggravated during walking, is one of the typical postural deformities in patients with parkinsonism. However, the degree of stooped posture is difficult to quantitatively measure during walking. Furthermore, continuous feedback on posture is also difficult to provide. The purpose of this study is to measure the degree of stooped posture during gait and to investigate whether vibration feedback from sensor modules can improve a patient\u2019s posture. Parkinsonian patients with stooped posture were recruited for this study. Two wearable sensors with three-axis accelerometers were attached, one at the upper neck and the other just below the C7 spinous process of the patients. After being calibrated in the most upright posture, the sensors continuously recorded the sagittal angles at 20 Hz and averaged the data at every second during a 6 min walk test. In the control session, the patients walked with the sensors as usual. In the vibration session, sensory feedback was provided through vibrations from the neck sensor module when the sagittal angle exceeded a programmable threshold value. Data were collected and analyzed successfully in a total of 10 patients. The neck flexion and back flexion were slightly aggravated during gait, although the average change was &lt;10\u00b0 in most patients in both measurement sessions. Therefore, it was difficult to evaluate the effect of sensory feedback through vibration. However, some patients showed immediate response to the feedback and corrected their posture during gait. In conclusion, this preliminary study suggests that stooped posture could be quantitatively measured during gait by using wearable sensors in patients with parkinsonism. Sensory feedback through vibration from sensor modules may help in correcting posture during gait in selected patients.<\/jats:p>","DOI":"10.3390\/s21072379","type":"journal-article","created":{"date-parts":[[2021,3,30]],"date-time":"2021-03-30T03:29:45Z","timestamp":1617074985000},"page":"2379","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Measurement and Correction of Stooped Posture during Gait Using Wearable Sensors in Patients with Parkinsonism: A Preliminary Study"],"prefix":"10.3390","volume":"21","author":[{"given":"Se Hoon","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul 03080, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2142-0472","authenticated-orcid":false,"given":"Seo Jung","family":"Yun","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul 03080, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1439-0241","authenticated-orcid":false,"given":"Quoc Khanh","family":"Dang","sequence":"additional","affiliation":[{"name":"MKS Instruments Korea, 543 Beonji, Daedeok Techno Valley, Yongsan-dong, Yuseong-gu, Daejeon 34028, Korea"},{"name":"School of Electrical Engineering, Biomedical Engineering, College of Engineering, University of Ulsan, Ulsan 44610, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youngjoon","family":"Chee","sequence":"additional","affiliation":[{"name":"School of Electrical Engineering, Biomedical Engineering, College of Engineering, University of Ulsan, Ulsan 44610, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sun Gun","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul 03080, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9353-7541","authenticated-orcid":false,"given":"Byung-Mo","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul 03080, Korea"},{"name":"National Traffic Injury Rehabilitation Hospital, Yangpyeong-gun 12564, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6597-578X","authenticated-orcid":false,"given":"Keewon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul 03080, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6904-7542","authenticated-orcid":false,"given":"Han Gil","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul 03080, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/S1474-4422(11)70067-9","article-title":"Postural deformities in Parkinson\u2019s disease","volume":"10","author":"Doherty","year":"2011","journal-title":"Lancet Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1002\/mds.20948","article-title":"Dropped head syndrome in Parkinson\u2019s disease","volume":"21","author":"Kashihara","year":"2006","journal-title":"Mov. Disord."},{"key":"ref_3","first-page":"75","article-title":"Camptocormia in Parkinson\u2019s disease: Definition, epidemiology, pathogenesis and treatment modalities","volume":"87","author":"Srivanitchapoom","year":"2016","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_4","first-page":"812","article-title":"Quantitative assessment of Parkinson\u2019s disease deficits","volume":"112","author":"Zhang","year":"1999","journal-title":"Chin. Med. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1007\/s00221-005-2346-2","article-title":"Can stooped posture explain multidirectional postural instability in patients with Parkinson\u2019s disease?","volume":"166","author":"Jacobs","year":"2005","journal-title":"Exp. Brain Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1212\/WNL.26.5.423","article-title":"Primary sensory symptoms in parkinsonism","volume":"26","author":"Snider","year":"1976","journal-title":"Neurology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1038\/nrneurol.2012.54","article-title":"Pains in Parkinson disease\u2014Many syndromes under one umbrella","volume":"8","author":"Wasner","year":"2012","journal-title":"Nat. Rev. Neurol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1093\/ptj\/69.11.932","article-title":"A model for multisystem evaluation treatment of individuals with Parkinson\u2019s disease","volume":"69","author":"Schenkman","year":"1989","journal-title":"Phys. Ther."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1016\/j.pmrj.2016.05.001","article-title":"Acute and Long-Term Effects of Multidirectional Treadmill Training on Gait and Balance in Parkinson Disease","volume":"8","author":"Bryant","year":"2016","journal-title":"PM R"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1016\/j.apmr.2014.01.020","article-title":"Postural rehabilitation and Kinesio taping for axial postural disorders in Parkinson\u2019s disease","volume":"95","author":"Capecci","year":"2014","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.gaitpost.2015.05.015","article-title":"Beneficial effect of levodopa therapy on stooped posture in Parkinson\u2019s disease","volume":"42","author":"Benninger","year":"2015","journal-title":"Gait Posture"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1136\/jnnp-2014-307651","article-title":"Immediate effect of spinal magnetic stimulation on camptocormia in Parkinson\u2019s disease","volume":"85","author":"Arii","year":"2014","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"72","DOI":"10.2340\/16501977-1888","article-title":"An examination of camptocormia assessment by dynamic quantification of sagittal posture","volume":"47","author":"Guillaud","year":"2015","journal-title":"J. Rehabil. Med."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Pasluosta, C.F., Barth, J., Gassner, H., Klucken, J., and Eskofier, B.M. (2015, January 25\u201329). Pull Test estimation in Parkinson\u2019s disease patients using wearable sensor technology. Proceedings of the 2015 37th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, Milan, Italy.","DOI":"10.1109\/EMBC.2015.7319050"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/j.gaitpost.2014.11.008","article-title":"The effect of levodopa on postural stability evaluated by wearable inertial measurement units for idiopathic and vascular Parkinson\u2019s disease","volume":"41","author":"Gago","year":"2015","journal-title":"Gait Posture"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.parkreldis.2015.11.004","article-title":"Feasibility and effects of home-based smartphone-delivered automated feedback training for gait in people with Parkinson\u2019s disease: A pilot randomized controlled trial","volume":"22","author":"Ginis","year":"2016","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1682\/JRRD.2009.10.0165","article-title":"At-home training with closed-loop augmented-reality cueing device for improving gait in patients with Parkinson disease","volume":"47","author":"Espay","year":"2010","journal-title":"J. Rehabil. Res. Dev."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Dang, Q.K., Seo, H.G., Pham, D.D., and Chee, Y. (2019). Wearable Sensor Based Stooped Posture Estimation in Simulated Parkinson\u2019s Disease Gaits. Sensors, 19.","DOI":"10.3390\/s19020223"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"S42","DOI":"10.1016\/j.pmrj.2009.01.018","article-title":"Rehabilitation interventions in Parkinson disease","volume":"1","author":"Moroz","year":"2009","journal-title":"PM R"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1097\/01.PHM.0000130032.97113.E0","article-title":"Effect of one single auditory cue on movement kinematics in patients with Parkinson\u2019s disease","volume":"83","author":"Ma","year":"2004","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Muthukrishnan, N., Abbas, J.J., Shill, H.A., and Krishnamurthi, N. (2019). Cueing paradigms to improve gait and posture in Parkinson\u2019s disease: A narrative review. Sensors, 19.","DOI":"10.3390\/s19245468"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1136\/jnnp.55.3.181","article-title":"Accuracy of clinical diagnosis of idiopathic Parkinson\u2019s disease: A clinico-pathological study of 100 cases","volume":"55","author":"Hughes","year":"1992","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1212\/01.wnl.0000324625.00404.15","article-title":"Second consensus statement on the diagnosis of multiple system atrophy","volume":"71","author":"Gilman","year":"2008","journal-title":"Neurology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1002\/mds.22340","article-title":"Movement Disorder Society-sponsored revision of the Unified Parkinson\u2019s Disease Rating Scale (MDS-UPDRS): Scale presentation and clinimetric testing results","volume":"23","author":"Goetz","year":"2008","journal-title":"Mov. Disord."},{"key":"ref_25","unstructured":"Carnegie Mellon University (2021, March 01). CMU Graphics Lab Motion Capture Database. Available online: http:\/\/mocap.cs.cmu.edu."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1093\/brain\/119.2.551","article-title":"Stride length regulation in Parkinson\u2019s disease: Normalization strategies and underlying mechanisms","volume":"119","author":"Morris","year":"1996","journal-title":"Brain"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1532","DOI":"10.1136\/jnnp.57.12.1532","article-title":"Ability to modulate walking cadence remains intact in Parkinson\u2019s disease","volume":"57","author":"Morris","year":"1994","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"S478","DOI":"10.1016\/S1353-8020(08)70053-1","article-title":"Impact of physical therapy for Parkinson\u2019s disease: A critical review of the literature","volume":"13","author":"Kwakkel","year":"2007","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"128","DOI":"10.5535\/arm.2015.39.1.128","article-title":"Correction of camptocormia using a cruciform anterior spinal hyperextension brace and back extensor strengthening exercise in a patient with Parkinson disease","volume":"39","author":"Ye","year":"2015","journal-title":"Ann. Rehabil. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1002\/mds.22909","article-title":"Backpack treatment for camptocormia","volume":"25","author":"Gerton","year":"2010","journal-title":"Mov. Disord."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1016\/j.parkreldis.2006.02.003","article-title":"Alleviation of camptocormia by bilateral subthalamic nucleus stimulation in a patient with Parkinson\u2019s disease","volume":"12","author":"Yamada","year":"2006","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2027","DOI":"10.1002\/mds.22676","article-title":"Goal attainment after treatment of parkinsonian camptocormia with botulinum toxin","volume":"24","author":"Fietzek","year":"2009","journal-title":"Mov. Disord."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1136\/jnnp.2008.152736","article-title":"Thoracolumbar spinal fixation for camptocormia in Parkinson\u2019s disease","volume":"80","author":"Peek","year":"2009","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Serio, F., Minosa, C., De Luca, M., Conte, P., Albani, G., and Peppe, A. (2019). Focal Vibration Training (Equistasi\u00ae) to Improve Posture Stability. A Retrospective Study in Parkinson\u2019s Disease. Sensors, 19.","DOI":"10.3390\/s19092101"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.clinph.2009.10.018","article-title":"Alternate rhythmic vibratory stimulation of trunk muscles affects walking cadence and velocity in Parkinson\u2019s disease","volume":"121","author":"Grasso","year":"2010","journal-title":"Clin. Neurophysiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1152\/jn.00263.2020","article-title":"Contributions of exercise-induced fatigue versus intertrial tendon vibration on visual-proprioceptive weighting for goal-directed movement","volume":"124","author":"Manzone","year":"2020","journal-title":"J. Neurophysiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"562","DOI":"10.4103\/jnrp.jnrp_154_17","article-title":"Clinical Profile of Cognitive Decline in Patients with Parkinson\u2019s Disease, Progressive Supranuclear Palsy, and Multiple System Atrophy","volume":"8","author":"Sulena","year":"2017","journal-title":"J. Neurosci. Rural Pr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2602","DOI":"10.1007\/s00415-018-9038-x","article-title":"Comparative cognitive and neuropsychiatric profiles between Parkinson\u2019s disease, multiple system atrophy and progressive supranuclear palsy","volume":"265","author":"Santangelo","year":"2018","journal-title":"J. Neurol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"S57","DOI":"10.1016\/j.parkreldis.2017.07.024","article-title":"Sensor assisted self-management in Parkinson\u2019s disease: A feasibility study of ambulatory posture detection and feedback to treat stooped posture","volume":"46","author":"Kwakkel","year":"2018","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1111\/ejn.13481","article-title":"The perception of affective touch in Parkinson\u2019s disease and its relation to small fibre neuropathy","volume":"45","author":"Leung","year":"2017","journal-title":"Eur. J. Neurosci."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/21\/7\/2379\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:55:35Z","timestamp":1760363735000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/21\/7\/2379"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,30]]},"references-count":40,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,4]]}},"alternative-id":["s21072379"],"URL":"https:\/\/doi.org\/10.3390\/s21072379","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,30]]}}}