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In-Home Posture Evaluation and Visual Feedback Training to Improve Posture with a Kinect-Based System in Parkinson��?s Disease

Yohei Okada, Tomohiro Shibata, Tomoya Tamei, Yasuyuki Orito, Hiroyuki Funaya, Chihiro Obayashi, Kazushi Ikeda, Makoto Hiyamizu and Shu Morioka

Purpose: We tested a Kinect-based system for in-home posture evaluation and visual feedback training in an individual with Parkinson’s disease with moderate postural abnormality and evaluated the test-retest reliability of the anterior and lateral bending angles during standing in healthy subjects. Methods: Eleven healthy subjects performed two sets of measurements of average anterior and lateral bending angles with the Kinect-based system, and we calculated the test-retest reliability of the anterior and lateral bending angles with the intraclass correlation coefficient and standard error of measurement. An individual with Parkinson’s disease with moderate thoracolumbar flexion participated to test the Kinect-based system. The study lasted 3 weeks. During the 1st and 3rd weeks, the participant performed only in-home posture evaluations. During the 2nd week he executed both visual feedback training and posture evaluations. Results: The anterior bending angle showed good reliability (intraclass correlation coefficient ≥ 0.88). The lateral bending angle during standing showed fair to poor reliability (intraclass correlation coefficient=0.46-0.78). Standard error of measurement values for the anterior and lateral bending angles were low (0.35-0.63). The individual with Parkinson’s disease completed almost all sessions of in-home posture evaluation and visual feedback training without any adverse effects. His anterior bending angle was significantly improved immediately after the visual feedback training, and significant short-term improvement was observed during the second week. Conclusion: Posture evaluation with the Kinect-based system was more relatively reliable in the sagittal plane than in the frontal plane and absolutely reliable in both planes in the healthy subjects. In the individual with Parkinson’s disease with moderate postural abnormality, the in-home posture evaluation and visual feedback training with the Kinectbased system was feasible, and the visual feedback training improved the anterior bending angle immediately and in the short term in an individual with Parkinson’s disease with moderate postural abnormality.