Table 2_The use of single-point magneto-inertial measurement for gait and dynamic balance assessment of patients with Parkinson’s disease and Parkinsonisms: a systematic review with critical appraisal of clinical applications and quality of reporting.xlsx

IntroductionGait and balance impairments are among the most disabling motor symptoms of Parkinson’s disease (PD) and parkinsonisms. Traditional clinical assessments are practical but often lack sensitivity to detect subtle functional changes and to monitor disease progression. Wearable magneto-inertial measurement units (mIMUs) offer an objective, portable, and low-cost alternative. Single-point mIMUs, positioned over the lower trunk, are particularly promising for clinical integration due to their simplicity. This systematic review critically evaluates how single-point mIMUs are used to assess functional mobility in PD and atypical parkinsonisms, and examines the quality and clinical transferability of current evidence.
MethodsFollowing PRISMA 2020 guidelines, a systematic search was conducted in Medline, CINAHL, Embase, and Scopus (January 2025). Eligible studies included adults with PD or atypical parkinsonisms assessed with a single wearable sensor during straight-line walking and/or the Timed Up and Go test. Data extraction included clinical characteristics, assessment protocols, sensor specifications, and computed parameters. A customized critical appraisal tool evaluated five domains: methodology, clinical aspects, assessment protocol, technical aspects, and clinical transferability. Studies were classified as high-, medium-, or low-quality.
ResultsFrom 3,812 records, 41 studies met inclusion criteria, involving 395 participants (mean age 66 ± 5.9 years). Fourteen studies used the instrumented TUG, and 27 evaluated straight-line walking. Most studies were observational (90%). Only 12% achieved a high-quality rating, while 80% were medium-quality. “Technical aspects” was the best-rated domain, whereas “clinical aspects” and “assessment protocol” scored lowest, mainly due to incomplete reporting of sensor placement, acquisition conditions, computational methods, and clinical characterization of participants. Frequently reported outcomes included gait speed, step length, cadence, and TUG duration; however, methodological heterogeneity hindered cross-study comparability.
DiscussionSingle-point mIMUs can detect clinically relevant gait and mobility impairments and hold potential for monitoring disease progression, evaluating treatment effects, and distinguishing patient subgroups. Nevertheless, the overall quality of evidence is moderate, and insufficient methodological transparency currently limits clinical translation. Standardization of sensor placement, task instructions, data processing, and reporting—along with clearer clinical rationale and sample characterization—is needed to support reproducibility and facilitate adoption in routine practice.
Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251025333.

引言：步态与平衡障碍是帕金森病（Parkinson’s disease, PD）及帕金森综合征（parkinsonisms）最具致残性的运动症状之一。传统临床评估虽具备实用性，但往往难以检测细微的功能变化、无法有效监测疾病进展。可穿戴磁惯性测量单元（magneto-inertial measurement units, mIMUs）为临床评估提供了客观、便携且低成本的替代方案。置于躯干下段的单点式mIMUs因其操作简便，在临床整合应用中极具前景。本系统综述旨在批判性评估单点式mIMUs在PD及非典型帕金森综合征患者功能活动能力评估中的应用现状，并审视当前研究证据的质量与临床可推广性。
方法：本研究遵循2020年国际系统综述与元分析优先报告条目（PRISMA 2020）指南，于2025年1月在Medline、CINAHL、Embase及Scopus数据库中开展系统检索。纳入研究的对象为PD或非典型帕金森综合征成年患者，且研究采用单台可穿戴传感器对其进行直线行走和/或计时起立行走试验（Timed Up and Go Test）评估。数据提取内容涵盖患者临床特征、评估方案、传感器参数及计算得到的运动参数。本研究采用自定义的批判性评价工具，从方法学、临床维度、评估方案、技术维度及临床可推广性五个领域对纳入研究进行质量评估，并将研究划分为高质量、中等质量及低质量三类。
结果：本研究从3812条文献记录中筛选出41项符合纳入标准的研究，共纳入395名受试者（平均年龄66±5.9岁）。其中14项研究采用了带传感器的计时起立行走试验，27项研究评估了直线行走能力。绝大多数研究为观察性研究（90%）。仅12%的研究被评为高质量，80%为中等质量。“技术维度”为评分最高的领域，而“临床维度”与“评估方案”得分最低，主要原因在于纳入研究对传感器放置位置、数据采集条件、计算方法及受试者临床特征的报告不够完整。研究中最常报告的结局指标包括步态速度、步长、步频及计时起立行走试验时长，但由于方法学异质性较高，不同研究间的结果可比性较差。
讨论：单点式mIMUs能够检测出具有临床意义的步态与活动能力障碍，且在监测疾病进展、评估治疗效果及区分患者亚组方面具备应用潜力。但当前证据整体质量为中等水平，且方法学透明度不足，限制了其临床转化应用。未来需要统一传感器放置位置、试验任务指导语、数据处理流程及报告规范，并明确临床研究依据与受试者特征描述，以提升研究可重复性，推动其在临床常规实践中的应用。
系统综述注册信息：https://www.crd.york.ac.uk/PROSPERO/view/CRD420251025333。