Accelerometer-based gait assessment: Pragmatic deployment on an international scale

Gait is emerging as a powerful tool to detect early disease and monitor progression across a number of pathologies. Typically quantitative gait assessment has been limited to specialised laboratory facilities. However, measuring gait in home and community settings may provide a more accurate reflection of gait performance because: (1) it will not be confounded by attention which may be heightened during formal testing; and (2) it allows performance to be captured over time. This work addresses the feasibility and challenges of measuring gait characteristics with a single accelerometer based wearable device during free-living activity. Moreover, it describes the current methodological and statistical processes required to quantify those sensitive surrogate markers for ageing and pathology. A unified framework for large scale analysis is proposed. We present data and workflows from healthy older adults and those with Parkinson's disease (PD) while presenting current algorithms and scope within modern pervasive healthcare. Our findings suggested that free-living conditions heighten between group differences showing greater sensitivity to PD, and provided encouraging results to support the use of the suggested framework for large clinical application.