{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T02:11:50Z","timestamp":1772676710742,"version":"3.50.1"},"reference-count":51,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2021,4,10]],"date-time":"2021-04-10T00:00:00Z","timestamp":1618012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["NINDS UH3NS107709"],"award-info":[{"award-number":["NINDS UH3NS107709"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["R21 NS096398-02"],"award-info":[{"award-number":["R21 NS096398-02"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000864","name":"Michael J. Fox Foundation for Parkinson's Research","doi-asserted-by":"publisher","award":["9605"],"award-info":[{"award-number":["9605"]}],"id":[{"id":"10.13039\/100000864","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institutes of Health Big Data to Knowledge (BD2K) Center of Excellence Grant","award":["U54EB020405"],"award-info":[{"award-number":["U54EB020405"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Freezing of gait (FOG), a debilitating symptom of Parkinson\u2019s disease (PD), can be safely studied using the stepping in place (SIP) task. However, clinical, visual identification of FOG during SIP is subjective and time consuming, and automatic FOG detection during SIP currently requires measuring the center of pressure on dual force plates. This study examines whether FOG elicited during SIP in 10 individuals with PD could be reliably detected using kinematic data measured from wearable inertial measurement unit sensors (IMUs). A general, logistic regression model (area under the curve = 0.81) determined that three gait parameters together were overall the most robust predictors of FOG during SIP: arrhythmicity, swing time coefficient of variation, and swing angular range. Participant-specific models revealed varying sets of gait parameters that best predicted FOG for each participant, highlighting variable FOG behaviors, and demonstrated equal or better performance for 6 out of the 10 participants, suggesting the opportunity for model personalization. The results of this study demonstrated that gait parameters measured from wearable IMUs reliably detected FOG during SIP, and the general and participant-specific gait parameters allude to variable FOG behaviors that could inform more personalized approaches for treatment of FOG and gait impairment in PD.<\/jats:p>","DOI":"10.3390\/s21082661","type":"journal-article","created":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T05:52:00Z","timestamp":1618206720000},"page":"2661","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Gait Parameters Measured from Wearable Sensors Reliably Detect Freezing of Gait in a Stepping in Place Task"],"prefix":"10.3390","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2364-7996","authenticated-orcid":false,"given":"Cameron","family":"Diep","sequence":"first","affiliation":[{"name":"Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7890-5019","authenticated-orcid":false,"given":"Johanna","family":"O\u2019Day","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA"},{"name":"Department of Bioengineering, Stanford University, Stanford, CA 94305, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasmine","family":"Kehnemouyi","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary","family":"Burnett","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA"},{"name":"Department of Biomedical Data Science, Stanford University, Stanford, CA 94305, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Bronte-Stewart","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA"},{"name":"Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1212\/WNL.42.2.333","article-title":"Motor blocks in Parkinson\u2019s disease","volume":"42","author":"Giladi","year":"1992","journal-title":"Neurology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/S1353-8020(99)00062-0","article-title":"Construction of freezing of gait questionnaire for patients with Parkinsonism","volume":"6","author":"Giladi","year":"2000","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1712","DOI":"10.1212\/WNL.56.12.1712","article-title":"Parkinson Study Group. Freezing of gait in PD: Prospective assessment in the DATATOP cohort","volume":"56","author":"Giladi","year":"2001","journal-title":"Neurology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1002\/mds.20115","article-title":"Falls and freezing of gait in Parkinson\u2019s disease: A review of two interconnected, episodic phenomena","volume":"19","author":"Bloem","year":"2004","journal-title":"Mov. Disord."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1155\/2008\/456298","article-title":"The factors that induce or overcome freezing of gait in Parkinson\u2019s disease","volume":"19","author":"Rahman","year":"2008","journal-title":"Behav. Neurol."},{"key":"ref_6","first-page":"453","article-title":"Fear of falling has greater influence than other aspects of gait disorders on quality of life in patients with Parkinson\u2019s disease","volume":"30","author":"Brozova","year":"2009","journal-title":"Neuro Endocrinol. Lett."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"S16","DOI":"10.1080\/02688690802448376","article-title":"The challenge of evaluating freezing of gait in patients with Parkinson\u2019s disease","volume":"22","author":"Nieuwboer","year":"2008","journal-title":"Br. J. Neurosurg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.neuroscience.2016.11.045","article-title":"The clinical significance of freezing while turning in Parkinson\u2019s disease","volume":"343","author":"Mancini","year":"2017","journal-title":"Neuroscience"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"O\u2019Day, J., Syrkin-Nikolau, J., Anidi, C., Kidzinski, L., Delp, S., and Bronte-Stewart, H. (2020). The turning and barrier course reveals gait parameters for detecting freezing of gait and measuring the efficacy of deep brain stimulation. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0231984"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/j.gaitpost.2011.05.020","article-title":"Repetitive stepping in place identifies and measures freezing episodes in subjects with Parkinson\u2019s disease","volume":"34","author":"Nantel","year":"2011","journal-title":"Gait Posture"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1007\/s11517-015-1395-3","article-title":"Detecting freezing of gait with a tri-axial accelerometer in Parkinson\u2019s disease patients","volume":"54","author":"Ahlrichs","year":"2016","journal-title":"Med. Biol. Eng. Comput."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Ashour, A.S., El-Attar, A., Dey, N., El-Naby, M.M.A., and El-Kader, H.A. (2018, January 20\u201322). Patient-dependent Freezing of Gait Detection using Signals from Multi-accelerometer Sensors in Parkinson\u2019s Disease. Proceedings of the 9th Cairo International Biomedical Engineering Conference, CIBEC, Cairo, Egypt.","DOI":"10.1109\/CIBEC.2018.8641809"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.gaitpost.2016.08.018","article-title":"A smartphone-based architecture to detect and quantify freezing of gait in Parkinson\u2019s disease","volume":"50","author":"Capecci","year":"2016","journal-title":"Gait Posture"},{"key":"ref_14","first-page":"5649","article-title":"Detecting freezing-of-gait during unscripted and unconstrained activity","volume":"2011","author":"Cole","year":"2011","journal-title":"Annu. Int. Conf. IEEE Eng. Med. Biol. Soc."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1109\/TNSRE.2013.2287241","article-title":"Automatic identification and classification of freezing of gait episodes in Parkinson\u2019s disease patients","volume":"22","author":"Jovicic","year":"2014","journal-title":"IEEE Trans. Neural. Syst. Rehabil. Eng."},{"key":"ref_16","first-page":"3751","article-title":"Unconstrained detection of freezing of gait in Parkinson\u2019s disease patients using smartphone","volume":"2015","author":"Kim","year":"2015","journal-title":"Annu. Int. Conf. IEEE Eng. Med. Biol. Soc."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Mancini, M., Shah, V.V., Stuart, S., Curtze, C., Horak, F.B., Safarpour, D., and Nutt, J.G. (2021). Measuring freezing of gait during daily-life: An open-source, wearable sensors approach. J. NeuroEng. Rehabil., 18.","DOI":"10.1186\/s12984-020-00774-3"},{"key":"ref_18","first-page":"127","article-title":"Comparison of features, window sizes and classifiers in detecting freezing of gait in patients with Parkinson\u2019s disease through a Waist-Worn Accelerometer","volume":"288","author":"Martin","year":"2016","journal-title":"Front. Artif. Intell. Appl."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"394","DOI":"10.3389\/fneur.2017.00394","article-title":"Identification of characteristic motor patterns preceding freezing of gait in Parkinson\u2019s disease using wearable sensors","volume":"8","author":"Palmerini","year":"2017","journal-title":"Front. Neurol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Sigcha, L., Costa, N., Pav\u00f3n, I., Costa, S., Arezes, P., L\u00f3pez, J.M., and De Arcas, G. (2020). Deep Learning Approaches for Detecting Freezing of Gait in Parkinson\u2019s Disease Patients through On-Body Acceleration Sensors. Sensors, 20.","DOI":"10.3390\/s20071895"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.cmpb.2012.10.016","article-title":"Automatic detection of freezing of gait events in patients with Parkinson\u2019s disease","volume":"110","author":"Tripoliti","year":"2013","journal-title":"Comput. Methods Programs Biomed."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"21329","DOI":"10.3390\/s141121329","article-title":"PERFORM: A system for monitoring, assessment and management of patients with Parkinson\u2019s disease","volume":"14","author":"Tzallas","year":"2014","journal-title":"Sensors"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"88","DOI":"10.3414\/ME09-02-0003","article-title":"A wearable system to assist walking of Parkinson\u2019s disease patients","volume":"49","author":"Bachlin","year":"2010","journal-title":"Methods Inf. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"6819","DOI":"10.3390\/s140406819","article-title":"Detection of Freezing of Gait in Parkinson Disease: Preliminary Results","volume":"14","author":"Coste","year":"2014","journal-title":"Sensors"},{"key":"ref_25","first-page":"1709","article-title":"A practical method for the detection of freezing of gait in patients with Parkinson\u2019s disease","volume":"9","author":"Kwon","year":"2014","journal-title":"Clin. Interv. Aging"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Mazilu, S., Blanke, U., Hardegger, M., Troster, G., Gazit, E., and Hausdorff, J.M. (2014). GaitAssist: A Daily-Life Support and Training System for Parkinson\u2019s Disease Patients with Freezing of Gait. Proceedings of the 32nd Annual ACM Conference on Human Factors in Computing Systems, Toronto, ON, Canada, 26 April\u20131 May 2014, ACM.","DOI":"10.1145\/2556288.2557278"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Mazzetta, I., Zampogna, A., Suppa, A., Gumiero, A., Pessione, M., and Irrera, F. (2019). Wearable Sensors System for an Improved Analysis of Freezing of Gait in Parkinson\u2019s Disease Using Electromyography and Inertial Signals. Sensors, 19.","DOI":"10.3390\/s19040948"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/1743-0003-10-19","article-title":"Autonomous identification of freezing of gait in Parkinson\u2019s disease from lower-body segmental accelerometry","volume":"10","author":"Moore","year":"2013","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/j.jneumeth.2007.08.023","article-title":"Ambulatory monitoring of freezing of gait in Parkinson\u2019s disease","volume":"167","author":"Moore","year":"2008","journal-title":"J. Neurosci. Methods"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1016\/j.parkreldis.2012.03.001","article-title":"A comparison of clinical and objective measures of freezing of gait in Parkinson\u2019s disease","volume":"18","author":"Morris","year":"2012","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Niazmand, K., Tonn, K., Zhao, Y., Fietzek, U., Schroeteler, F., Ziegler, K., Ceballos-Baumann, A., and Lueth, T. (2011, January 10\u201312). Freezing of Gait detection in Parkinson\u2019s disease using accelerometer based smart clothes. Proceedings of the IEEE Biomedical Circuits and Systems Conference (BioCAS), San Diego, CA, USA.","DOI":"10.1109\/BioCAS.2011.6107762"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"11612","DOI":"10.1109\/JSEN.2019.2932584","article-title":"A Smart Inertial System for 24h Monitoring and Classification of Tremor and Freezing of Gait in Parkinson\u2019s Disease","volume":"19","author":"Pierleoni","year":"2019","journal-title":"IEEE Sens. J."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Rezvanian, S., and Lockhart, T. (2016). Towards Real-Time Detection of Freezing of Gait Using Wavelet Transform on Wireless Accelerometer Data. Sensors, 16.","DOI":"10.3390\/s16040475"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.1016\/j.parkreldis.2015.09.051","article-title":"Identifying freezing of gait in Parkinson\u2019s disease during freezing provoking tasks using waist-mounted accelerometry","volume":"21","author":"Zach","year":"2015","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_35","first-page":"5151","article-title":"deFOG\u2013a real time system for detection and unfreezing of gait of Parkinson\u2019s patients","volume":"2009","author":"Jovanov","year":"2009","journal-title":"Annu. Int. Conf. IEEE Eng. Med. Biol. Soc."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Yungher, D.A., Morris, T.R., Dilda, V., Shine, J., Naismith, S.L., Lewis, S.J.G., and Moore, S.T. (2014). Temporal characteristics of high-frequency lower-limb oscillation during Freezing of Gait in Parkinson\u2019s Disease. Parkinsons Dis.","DOI":"10.1155\/2014\/606427"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/j.nbd.2017.09.002","article-title":"Subthalamic neural entropy is a feature of freezing of gait in freely moving people with Parkinson\u2019s disease","volume":"108","author":"Koop","year":"2017","journal-title":"Neurobiol. Dis."},{"key":"ref_38","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_39","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1002\/mds.21745","article-title":"Validation of the Freezing of Gait Questionnaire in patients with Parkinson\u2019s disease","volume":"24","author":"Giladi","year":"2009","journal-title":"Mov. Disord."},{"key":"ref_40","first-page":"1198","article-title":"Quantifying freezing of gait in Parkinson\u2019s disease during the instrumented timed up and go test","volume":"2012","author":"Mancini","year":"2012","journal-title":"Annu. Int. Conf. IEEE Eng. Med. Biol. Soc."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1642","DOI":"10.1007\/s00415-017-8424-0","article-title":"Freezing of gait and fall detection in Parkinson\u2019s disease using wearable sensors: A systematic review","volume":"264","author":"Evers","year":"2017","journal-title":"J. Neurol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/s00221-002-1354-8","article-title":"Impaired regulation of stride variability in Parkinson\u2019s disease subjects with freezing of gait","volume":"149","author":"Hausdorff","year":"2003","journal-title":"Exp. Brain Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1002\/ana.20452","article-title":"Is freezing of gait in Parkinson\u2019s disease related to asymmetric motor function?","volume":"57","author":"Plotnik","year":"2005","journal-title":"Ann. Neurol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"S444","DOI":"10.1002\/mds.21984","article-title":"The role of gait rhythmicity and bilateral coordination of stepping in the pathophysiology of freezing of gait in Parkinson\u2019s disease","volume":"23","author":"Plotnik","year":"2008","journal-title":"Mov. Disord."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1016\/S1474-4422(11)70143-0","article-title":"Freezing of gait: Moving forward on a mysterious clinical phenomenon","volume":"10","author":"Nutt","year":"2011","journal-title":"Lancet Neurol."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Heremans, E., Nieuwboer, A., and Vercruysse, S. (2013). Freezing of Gait in Parkinson\u2019s Disease: Where Are We Now?. Curr. Neurol. Neurosci. Rep., 13.","DOI":"10.1007\/s11910-013-0350-7"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Wilkins, K.B., Parker, J.E., and Bronte-Stewart, H.M. (2020). Gait variability is linked to the atrophy of the Nucleus Basalis of Meynert and is resistant to STN DBS in Parkinson\u2019s disease. Neurobiol. Dis., 146.","DOI":"10.1016\/j.nbd.2020.105134"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1002\/mds.20998","article-title":"The sequence effect and gait festination in Parkinson disease: Contributors to freezing of gait?","volume":"21","author":"Iansek","year":"2006","journal-title":"Mov. Disord."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1136\/jnnp-2011-300869","article-title":"The relationship between motor planning and freezing of gait in Parkinson\u2019s disease","volume":"83","author":"Knobl","year":"2012","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1837","DOI":"10.1002\/mds.26762","article-title":"Freezing\/festination during motor tasks in early-stage Parkinson\u2019s disease: A prospective study","volume":"31","author":"Delval","year":"2016","journal-title":"Mov. Disord."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1046\/j.1468-1331.2003.00611.x","article-title":"Characterization of freezing of gait subtypes and the response of each to levodopa in Parkinson\u2019s disease","volume":"10","author":"Schaafsma","year":"2003","journal-title":"Eur. J. Neurol."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/21\/8\/2661\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T14:12:15Z","timestamp":1760364735000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/21\/8\/2661"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,10]]},"references-count":51,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2021,4]]}},"alternative-id":["s21082661"],"URL":"https:\/\/doi.org\/10.3390\/s21082661","relation":{"has-preprint":[{"id-type":"doi","id":"10.20944\/preprints202103.0236.v1","asserted-by":"object"}]},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,10]]}}}