{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T15:51:38Z","timestamp":1792165898067,"version":"4.4.0"},"reference-count":38,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"PNRR-MR1-2022-12376921, Next Generation EU (PNRR M6C2) Investment 2.1 Enhancement and strengthening of biomedical research of the NHS"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Parkinson\u2019s disease (PD) is a disorder that causes a decrease in motor skills. Among the symptoms that have been observed, the most significant is the occurrence of Freezing of Gait (FoG), which manifests as an abrupt cessation of walking. This study investigates the impact of spatiotemporal gait parameters using wearable inertial measurement units (IMUs). Notably, 30 PD patients (15 with FoG, 15 without) and 20 healthy controls were enrolled. Gait data were acquired using two foot-mounted IMUs and key parameters such as stride time, gait phase distribution, cadence, stride length, speed, and foot clearance were extracted. Results indicated a tangible decline in motor abilities in PD patients, especially in those with FoG. Differences were observed in the segmentation of gait phases, with diminished swing phase duration observed in patients, and in the diminished spatial parameters of stride length, velocity, and foot clearance. Additionally, to validate the results, the accuracy of IMU-derived clearance measurements was validated against an optoelectronic system. While the IMUs accurately detected maximum points, the minimum clearance showed a higher measurement error. These findings support the use of wearable IMUs as a reliable and low-cost alternative to laboratory systems for the assessment of gait abnormalities in PD. Moreover, they highlight the potential for early detection and monitoring of FoG in both clinical and home settings.<\/jats:p>","DOI":"10.3390\/s25165054","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T15:44:21Z","timestamp":1755186261000},"page":"5054","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Uncovering the Kinematic Signature of Freezing of Gait in Parkinson\u2019s Disease Through Wearable Inertial Sensors"],"prefix":"10.3390","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3783-7272","authenticated-orcid":false,"given":"Francesco","family":"Castelli Gattinara Di Zubiena","sequence":"first","affiliation":[{"name":"Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0227-1993","authenticated-orcid":false,"given":"Alessandro","family":"Zampogna","sequence":"additional","affiliation":[{"name":"Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy"},{"name":"IRCCS Neuromed, 86077 Pozzilli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Patera","sequence":"additional","affiliation":[{"name":"Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Cusolito","sequence":"additional","affiliation":[{"name":"Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4249-5596","authenticated-orcid":false,"given":"Ludovica","family":"Apa","sequence":"additional","affiliation":[{"name":"Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1064-7962","authenticated-orcid":false,"given":"Ilaria","family":"Mileti","sequence":"additional","affiliation":[{"name":"Department of Engineering, University Niccol\u00f2 Cusano, 00166 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7374-851X","authenticated-orcid":false,"given":"Antonio","family":"Cannuli","sequence":"additional","affiliation":[{"name":"Department of Engineering, University of Messina, 98122 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9903-5550","authenticated-orcid":false,"given":"Antonio","family":"Suppa","sequence":"additional","affiliation":[{"name":"Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy"},{"name":"IRCCS Neuromed, 86077 Pozzilli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0947-9711","authenticated-orcid":false,"given":"Marco","family":"Paoloni","sequence":"additional","affiliation":[{"name":"Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6057-7774","authenticated-orcid":false,"given":"Zaccaria","family":"Del Prete","sequence":"additional","affiliation":[{"name":"Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3213-8261","authenticated-orcid":false,"given":"Eduardo","family":"Palermo","sequence":"additional","affiliation":[{"name":"Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Russo, M., Amboni, M., Pisani, N., Volzone, A., Calderone, D., Barone, P., Amato, F., Ricciardi, C., and Romano, M. (2025). Biomechanics Parameters of Gait Analysis to Characterize Parkinson\u2019s Disease: A Scoping Review. Sensors, 25.","DOI":"10.3390\/s25020338"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Jiao, Y., Liu, Z., Li, J., Su, Y., and Chen, X. (2024). Knowledge Mapping of Freezing of Gait in Parkinson\u2019s Disease: A Bibliometric Analysis. Front. Neurosci., 18.","DOI":"10.3389\/fnins.2024.1388326"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Conde, C.I., Lang, C., Baumann, C.R., Easthope, C.A., Taylor, W.R., and Ravi, D.K. (2023). Triggers for Freezing of Gait in Individuals with Parkinson\u2019s Disease: A Systematic Review. Front. Neurol., 14.","DOI":"10.3389\/fneur.2023.1326300"},{"key":"ref_4","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_5","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s40035-020-00191-5","article-title":"Freezing of Gait in Parkinson\u2019s Disease: Pathophysiology, Risk Factors and Treatments","volume":"9","author":"Gao","year":"2020","journal-title":"Transl. Neurodegener."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1038\/s41531-021-00224-4","article-title":"A Systematic Review on Exercise and Training-Based Interventions for Freezing of Gait in Parkinson\u2019s Disease","volume":"7","author":"Gilat","year":"2021","journal-title":"npj Park. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1002\/mds.27936","article-title":"Effectiveness of Physiotherapy on Freezing of Gait in Parkinson\u2019s Disease: A Systematic Review and Meta-Analyses","volume":"35","author":"Cosentino","year":"2020","journal-title":"Mov. Disord."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Bonacina, D., Tosatto, D., Ugolini, A., Rossi, F., Corno, I., Pellicciari, L., Perin, C., Col\u00f3n-Semenza, C., and Piscitelli, D. (2024). Spatiotemporal, Kinematic and Kinetic Gait Characteristics in Parkinson\u2019s Disease Compared to Healthy Individuals: A Systematic Review with Meta-Analysis. Clin. Biomech., 120.","DOI":"10.1016\/j.clinbiomech.2024.106359"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Franco, A., Russo, M., Amboni, M., Ponsiglione, A.M., Di Filippo, F., Romano, M., Amato, F., and Ricciardi, C. (2024). The Role of Deep Learning and Gait Analysis in Parkinson\u2019s Disease: A Systematic Review. Sensors, 24.","DOI":"10.3390\/s24185957"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Schlachetzki, J.C.M., Barth, J., Marxreiter, F., Gossler, J., Kohl, Z., Reinfelder, S., Gassner, H., Aminian, K., Eskofier, B.M., and Winkler, J. (2017). Wearable Sensors Objectively Measure Gait Parameters in Parkinson\u2019s Disease. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0183989"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Atri, R., Urban, K., Marebwa, B., Simuni, T., Tanner, C., Siderowf, A., Frasier, M., Haas, M., and Lancashire, L. (2022). Deep Learning for Daily Monitoring of Parkinson\u2019s Disease Outside the Clinic Using Wearable Sensors. Sensors, 22.","DOI":"10.3390\/s22186831"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Castelli Gattinara Di Zubiena, F., Menna, G., Mileti, I., Zampogna, A., Asci, F., Paoloni, M., Suppa, A., Del Prete, Z., and Palermo, E. (2022). Machine Learning and Wearable Sensors for the Early Detection of Balance Disorders in Parkinson\u2019s Disease. Sensors, 22.","DOI":"10.3390\/s22249903"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12984-020-00774-3","article-title":"Measuring Freezing of Gait during Daily-Life: An Open-Source, Wearable Sensors Approach","volume":"18","author":"Mancini","year":"2021","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_14","first-page":"5","article-title":"Role of Wearable Sensors with Machine Learning Approaches in Gait Analysis for Parkinson\u2019s Disease Assessment: A Review","volume":"19","author":"Balakrishnan","year":"2022","journal-title":"Eng. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Bouchouras, G., Sofianidis, G., and Kotis, K. (2025). Predicting Freezing of Gait in Parkinson\u2019s Disease: A Machine Learning-Based Approach in ON and OFF Medication States. J. Clin. Med., 14.","DOI":"10.20944\/preprints202503.0205.v1"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1186\/s12984-022-01025-3","article-title":"Automated Freezing of Gait Assessment with Marker-Based Motion Capture and Multi-Stage Spatial-Temporal Graph Convolutional Neural Networks","volume":"19","author":"Filtjens","year":"2022","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"87","DOI":"10.14802\/jmd.24210","article-title":"Spatiotemporal Gait Parameters During Turning and Imbalance in Parkinson\u2019s Disease: Video-Based Analysis From a Single Camera","volume":"18","author":"Jeon","year":"2025","journal-title":"J. Mov. Disord."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Fehr, K.H., Bartloff, J.N., Wang, Y., Hetzel, S., and Adamczyk, P.G. (2024). Estimation of Minimum Foot Clearance Using a Single Foot-Mounted Inertial Sensor and Personalized Foot Geometry Scan. Sci. Rep., 14.","DOI":"10.1038\/s41598-024-63124-6"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Di Zubiena, F.C.G., Zampognav, A., Patera, M., Cusolito, G., Mileti, I., Cannuli, A., Suppa, A., Paoloni, M., Del Prete, Z., and Palermo, E. (2024, January 26\u201328). Stride Length and Foot Clearance Measurements in Parkinson Patients through IMU Wearable Sensors. Proceedings of the 2024 IEEE International Symposium on Medical Measurements and Applications (MeMeA), Eindhoven, The Netherlands.","DOI":"10.1109\/MeMeA60663.2024.10596852"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Zampogna, A., Borz\u00ec, L., Rinaldi, D., Artusi, C.A., Imbalzano, G., Patera, M., Lopiano, L., Pontieri, F., Olmo, G., and Suppa, A. (2024). Unveiling the Unpredictable in Parkinson\u2019s Disease: Sensor-Based Monitoring of Dyskinesias and Freezing of Gait in Daily Life. Bioengineering, 11.","DOI":"10.3390\/bioengineering11050440"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Lin, P.H., Lai, Y.R., Lien, C.Y., Huang, C.C., Chiang, Y.F., Kung, C.F., Chen, C.J., and Lu, C.H. (2024). Investigating Spatiotemporal and Kinematic Gait Parameters in Individuals with Parkinson\u2019s Disease with a History of Freezing of Gait and Exploring the Effects of Dopaminergic Therapy on Freezing of Gait Subtypes. Front. Neurosci., 18.","DOI":"10.3389\/fnins.2024.1404613"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Zhao, J., Liu, C., Wan, Y., Zhu, X., Song, L., Liu, Z., and Gan, J. (2025). Do the Gait Domains Change in PD Patients with Freezing of Gait during Their \u201cinterictal\u201d Period?. BMC Geriatr., 25.","DOI":"10.1186\/s12877-024-05673-z"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.neures.2021.06.007","article-title":"Forward Gait Instability in Patients with Parkinson\u2019s Disease with Freezing of Gait","volume":"173","author":"Urakami","year":"2021","journal-title":"Neurosci. Res."},{"key":"ref_24","first-page":"963","article-title":"Gait Declines Differentially in, and Improves Prediction of, People with Parkinson\u2019s Disease Converting to a Freezing of Gait Phenotype","volume":"13","author":"Virmani","year":"2023","journal-title":"J. Park. Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e3440","DOI":"10.1002\/brb3.3440","article-title":"Analysis of Gait Characteristics and Related Factors in Patients with Parkinson\u2019s Disease Based on Wearable Devices","volume":"14","author":"Tang","year":"2024","journal-title":"Brain Behav."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"He, Y., Chen, Y., Tang, L., Chen, J., Tang, J., Yang, X., Su, S., Zhao, C., and Xiao, N. (2024). Accuracy Validation of a Wearable IMU-Based Gait Analysis in Healthy Female. BMC Sports Sci. Med. Rehabil., 16.","DOI":"10.1186\/s13102-023-00792-3"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Boutaayamou, M., Pelzer, D., Schwartz, C., Gillain, S., Garraux, G., Croisier, J.L., Verly, J.G., and Br\u00fcls, O. (2025). Toward Convenient and Accurate IMU-Based Gait Analysis. Sensors, 25.","DOI":"10.20944\/preprints202501.0417.v1"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"3591","DOI":"10.1109\/TBME.2022.3172725","article-title":"Validation of a Spatiotemporal Gait Model Using Inertial Measurement Units for Early-Stage Parkinsonas Disease Detection During Turns","volume":"69","author":"Yang","year":"2022","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Alberto, S., Cabral, S., Proen\u00e7a, J., Pona-Ferreira, F., Leit\u00e3o, M., Bou\u00e7a-Machado, R., Kauppila, L.A., Veloso, A.P., Costa, R.M., and Ferreira, J.J. (2021). Validation of Quantitative Gait Analysis Systems for Parkinson\u2019s Disease for Use in Supervised and Unsupervised Environments. BMC Neurol., 21.","DOI":"10.1186\/s12883-021-02354-x"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2542","DOI":"10.1109\/JSEN.2017.2665624","article-title":"An Accurate Wearable Foot Clearance Estimation System: Toward a Real-Time Measurement System","volume":"17","author":"Arami","year":"2017","journal-title":"IEEE Sens. J."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1109\/TBME.2004.840727","article-title":"Assessment of Walking Features from Foot Inertial Sensing","volume":"52","author":"Sabatini","year":"2005","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Mileti, I., Germanotta, M., Di Sipio, E., Imbimbo, I., Pacilli, A., Erra, C., Petracca, M., Id, S.R., Del Prete, Z., and Bentivoglio, A.R. (2018). Measuring Gait Quality in Parkinson \u2019 s Disease through Real-Time Gait Phase Recognition. Sensors, 18.","DOI":"10.3390\/s18030919"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Mileti, I., Taborri, J., D\u2019Alvia, L., Parisi, S., Ditto, M.C., Lisa Peroni, C., Scarati, M., Priora, M., Rossi, S., and Fusaro, E. (June, January 31). Accuracy Evaluation and Clinical Application of an Optimized Solution for Measuring Spatio-Temporal Gait Parameters. Proceedings of the 2020 IEEE International Symposium on Medical Measurements and Applications (MeMeA), Online.","DOI":"10.1109\/MeMeA49120.2020.9137305"},{"key":"ref_34","first-page":"843","article-title":"Gait Kinematic Parameters in Parkinson\u2019s Disease: A Systematic Review","volume":"10","author":"Jalles","year":"2020","journal-title":"J. Park. Dis."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Zanardi, A.P.J., da Silva, E.S., Costa, R.R., Passos-Monteiro, E., dos Santos, I.O., Kruel, L.F.M., and Peyr\u00e9-Tartaruga, L.A. (2021). Gait Parameters of Parkinson\u2019s Disease Compared with Healthy Controls: A Systematic Review and Meta-Analysis. Sci. Rep., 11.","DOI":"10.1038\/s41598-020-80768-2"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1590\/S0004-282X2010000100018","article-title":"Gait Analysis Comparing Parkinson\u2019s Disease with Healthy Elderly Subjects","volume":"68","author":"Walker","year":"2010","journal-title":"Arq. Neuropsiquiatr."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Tunca, C., Pehlivan, N., Ak, N., Arnrich, B., Salur, G., and Ersoy, C. (2017). Inertial Sensor-Based Robust Gait Analysis in Non-Hospital Settings for Neurological Disorders. Sensors, 17.","DOI":"10.3390\/s17040825"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"443","DOI":"10.3390\/s140100443","article-title":"Gait and Foot Clearance Parameters Obtained Using Shoe-Worn Inertial Sensors in a Large-Population Sample of Older Adults","volume":"14","author":"Dadashi","year":"2014","journal-title":"Sensors"}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/25\/16\/5054\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:27:32Z","timestamp":1760034452000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/25\/16\/5054"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,14]]},"references-count":38,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["s25165054"],"URL":"https:\/\/doi.org\/10.3390\/s25165054","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,14]]}}}