Video-Based Quantification of Gait Impairments in Parkinson’s Disease Using Skeleton-Silhouette Fusion Convolution Network

Gait impairments are among the most common hallmarks of Parkinson's disease (PD), usually appearing in the early stage and becoming a major cause of disability with disease progression. Accurate assessment of gait features is critical to personalized rehabilitation for patients with PD, yet difficult to be routinely carried out as clinical diagnosis using rating scales relies heavily on clinical experience. Moreover, the popular rating scales cannot ensure fine quantification of gait impairments for patients with mild symptoms. Developing quantitative assessment methods that can be used in natural and home-based environments is highly demanded. In this study, we address the challenges by developing an automated video-based Parkinsonian gait assessment method using a novel skeleton-silhouette fusion convolution network. In addition, seven network-derived supplementary features, including critical aspects of gait impairment (gait velocity, arm swing, etc.), are extracted to provide continuous measures enhancing low-resolution clinical rating scales. Evaluation experiments were conducted on a dataset collected with 54 patients with early PD and 26 healthy controls. The results show that the proposed method accurately predicted the patients' unified Parkinson's disease rating scale (UPDRS) gait scores (71.25% match on clinical assessment) and discriminated between PD patients and healthy subjects with a sensitivity of 92.6%. Moreover, three proposed supplementary features (i.e., arm swing amplitude, gait velocity, and neck forward bending angle) turned out to be effective gait dysfunction indicators with Spearman correlation coefficients of 0.78, 0.73, and 0.43 matching the rating scores, respectively. Since the proposed system requires only two smartphones, it holds a significant benefit for home-based quantitative assessment of PD, especially for detecting early-stage PD. Furthermore, the proposed supplementary features can enable high-resolution assessments of PD for providing subject-specific accurate treatments.