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Place Université Paris Cité
Mona MICHAUD
Long-term quantification of ambulatory gait. Application to Parkinson’s disease and exploratory study of post-concussion syndrome.
Abstract
Mild traumatic brain injuries (mTBIs) are common incidents among the civilian and military populations. mTBIs are associated, in about 30% of cases, with chronic sequelae called post-concussion syndrome (PCS), which have a significant impact on the quality of life of the affected individuals, despite the absence of immediate clinical signs of severity.
The quantification of gait and the study of the gait cycle using portable devices containing inertial sensors, which measure angular velocity and acceleration, followed by algorithmic processing to extract digital features from the signal, have proven relevant for analyzing the gait of patients with neurological injuries in a controlled environment. Over the past decade, the use of this approach has become possible for long durations in an outpatient setting, thus offering a more natural and representative assessment of gait in patients not subjected to the biases of the white coat effect and the Hawthorne effect.
The objective of this thesis is to analyze and validate the gait of patients with PCS in an outpatient setting and, to do so, to define a study method initially developed for a much more documented model neurological condition in the scientific literature: Parkinson’s disease. This condition, whose motor symptoms are stereotyped and well-documented, is commonly studied in an outpatient setting using portable inertial sensors.
After a systematic review of the literature on the analysis of gait in an outpatient setting for patients with Parkinson’s disease using inertial wearable devices, this thesis proposes an evaluation of gait in an outpatient setting within the framework of a clinical study, using an inertial wearable device worn daily for a month by three groups of participants: those suffering from Parkinson’s disease, those suffering from PCS, and a group of healthy subjects.
After examining the use of portable inertial sensors in an outpatient setting for the study of gait in Parkinson’s patients, a validation of the measurement system and its clinical relevance is carried out by comparing the digital features obtained during outpatient recording with the measurements taken in the hospital in a controlled environment. Finally, an intra-individual analysis is conducted by examining the daily evolution of the walking speed of outpatient patients for patients with Parkinson’s disease and patients affected by PCS.
Supervision
- Matthieu Robert, PU-PH, directeur de thèse
- Laurent Oudre, PU, co-directeur de thèse
Jury
- Régine LE BOUQUIN JEANNES, PU: Rapporteuse
- Bertrand DEGOS, PU-PH: Rapporteur
- France MOUREY, PU: Examinatrice
- Nasser REZZOUG, MDC: Examinateur
- Laurence VAIVRE-DOURET, PU: Examinatrice
- Damien RICARD, PU-PH: Examinateur