Freezing-of-Gait (FoG) affects over 50% of mid-to-late stage Parkinson's disease (PD) patients, significantly impairing patients' mobility independence and reducing quality of life. FoG is characterized by sudden episodes where walking cannot start or is interrupted, occurring exclusively during standing or walking, and never while sitting or lying down. Current FoG detection systems require extensive patient-specific training data and lack generalization, limiting clinical deployment. To address these issues, we introduce FM-FoG, a real-time foundation model-based wearable system achieving FoG detection in unseen patients without patient-specific training. Our approach combines self-supervised pretraining on diverse Inertial Measurement Unit (IMU) datasets with sensor context integration. Since FoG occurs only during ambulatory activities, a lightweight CNN-LSTM activity classifier selectively activates the foundation model only during walking or standing, avoiding unnecessary computation. Evaluated on the VCU FoG-IMU dataset with 23 PD patients, FM-FoG achieves a 98.5% F1-score when tested on previously unseen patients, substantially outperforming competitive baseline methods. Deployed on a Google Pixel 8a smartphone, the system extends battery life by up to 72% while maintaining sub-20ms intervention latency. The results indicate that our FM-FoG can enable practical, energy-efficient healthcare applications that generalize across patients without individual training requirements.

Deep learning holds tremendous potential in healthcare for uncovering hidden patterns within extensive clinical datasets, aiding in the diagnosis of various diseases. Parkinson's disease (PD) is a neurodegenerative condition characterized by the deterioration of brain function. In the initial stages of PD, automatic diagnosis poses a challenge due to the similarity in behavior between individuals with PD and those who are healthy. Our objective is to propose an effective model that can aid in the early detection of Parkinson's disease. We employed the VGRF gait signal dataset sourced from Physionet for distinguishing between healthy individuals and those diagnosed with Parkinson's disease. This paper introduces a novel deep learning architecture based on the LSTM network for automatically detecting freezing of gait episodes in Parkinson's disease patients. In contrast to conventional machine learning algorithms, this method eliminates manual feature engineering and proficiently captures prolonged temporal dependencies in gait patterns, thereby improving the diagnosis of Parkinson's disease. The LSTM network resolves the issue of vanishing gradients by employing memory blocks in place of self-connected hidden units, allowing for optimal information assimilation. To prevent overfitting, dropout and L2 regularization techniques have been employed. Additionally, the stochastic gradient-based optimizer Adam is used for the optimization process. The results indicate that our proposed approach surpasses current state-of-the-art models in FOG episode detection, achieving an accuracy of 97.71%, sensitivity of 99%, precision of 98%, and specificity of 96%. This demonstrates its potential as a superior classification method for Parkinson's disease detection.

Freezing of gait (FOG) is a debilitating symptom of Parkinson's disease (PD) that impairs mobility and safety. Traditional detection methods face challenges due to intra and inter-patient variability, and most systems are tested in controlled settings, limiting their real-world applicability. Addressing these gaps, we present FOGSense, a novel FOG detection system designed for uncontrolled, free-living conditions. It uses Gramian Angular Field (GAF) transformations and federated deep learning to capture temporal and spatial gait patterns missed by traditional methods. We evaluated our FOGSense system using a public PD dataset, 'tdcsfog'. FOGSense improves accuracy by 10.4% over a single-axis accelerometer, reduces failure points compared to multi-sensor systems, and demonstrates robustness to missing values. The federated architecture allows personalized model adaptation and efficient smartphone synchronization during off-peak hours, making it effective for long-term monitoring as symptoms evolve. Overall, FOGSense achieves a 22.2% improvement in F1-score compared to state-of-the-art methods, along with enhanced sensitivity for FOG episode detection. Code is available: https://github.com/shovito66/FOGSense.

Parkinson's disease (PD) is a progressive neurological disorder that impacts the quality of life significantly, making in-home monitoring of motor symptoms such as Freezing of Gait (FoG) critical. However, existing symptom monitoring technologies are power-hungry, rely on extensive amounts of labeled data, and operate in controlled settings. These shortcomings limit real-world deployment of the technology. This work presents LIFT-PD, a computationally-efficient self-supervised learning framework for real-time FoG detection. Our method combines self-supervised pre-training on unlabeled data with a novel differential hopping windowing technique to learn from limited labeled instances. An opportunistic model activation module further minimizes power consumption by selectively activating the deep learning module only during active periods. Extensive experimental results show that LIFT-PD achieves a 7.25% increase in precision and 4.4% improvement in accuracy compared to supervised models while using as low as 40% of the labeled training data used for supervised learning. Additionally, the model activation module reduces inference time by up to 67% compared to continuous inference. LIFT-PD paves the way for practical, energy-efficient, and unobtrusive in-home monitoring of PD patients with minimal labeling requirements.

FOG affects between 50% and 80% of people with PD (Weiss et al., 2015), and its presence is associated with an increased risk of falls, affecting the quality of life (Moore et al., 2007). When a FOG episode appears, PD patients can present variability in the gait pattern, with a reduction in step length, shuffling steps, trembling of the legs, and total akinesia with a loss of movement of the limbs or trunk (Okuma, 2014). FOG episodes can have a duration of a few seconds (1 second or less for very short episodes and more than 5 seconds for long episodes) and appear more frequently during typical daily-life conditions than during straight walking assessments in clinical and laboratory settings (Okuma, 2014; Nonnekes et al., 2015). FOG assessment involves the identification of the presence (or absence) of FOG episodes and also aims to identify their severity (Mancini et al., 2019). Assessing FOG in the clinical practice is difficult because of the lack of an optimal freezing score, and difficulties related to the clinical assessment often performed on conditions that hinder the appearance of FOG events during evaluation; for example, the assessment is usually made in the ON state, while FOG occurs more often in OFF state (Schaafsma et al., 2003; Mancini et al., 2021). Although the clinical assessment provides relevant indicators for the characterization of FOG, the conditions whereby these are performed do not accurately represent the severity of FOG in daily life (Rahman et al., 2008; Snijders et al., 2008), such as the patients' homes, where FOG events tend to occur more frequently (Nieuwboer et al., 1998).

Freezing of gait (FoG) is one of the most common symptoms of Parkinson's disease, which is a neurodegenerative disorder of the central nervous system impacting millions of people around the world. To address the pressing need to improve the quality of treatment for FoG, devising a computer-aided detection and quantification tool for FoG has been increasingly important. As a non-invasive technique for collecting motion patterns, the footstep pressure sequences obtained from pressure sensitive gait mats provide a great opportunity for evaluating FoG in the clinic and potentially in the home environment. In this study, FoG detection is formulated as a sequential modelling task and a novel deep learning architecture, namely Adversarial Spatio-temporal Network (ASTN), is proposed to learn FoG patterns across multiple levels. A novel adversarial training scheme is introduced with a multi-level subject discriminator to obtain subject-independent FoG representations, which helps to reduce the over-fitting risk due to the high inter-subject variance. As a result, robust FoG detection can be achieved for unseen subjects. The proposed scheme also sheds light on improving subject-level clinical studies from other scenarios as it can be integrated with many existing deep architectures. To the best of our knowledge, this is one of the first studies of footstep pressure-based FoG detection and the approach of utilizing ASTN is the first deep neural network architecture in pursuit of subject-independent representations. Experimental results on 393 trials collected from 21 subjects demonstrate encouraging performance of the proposed ASTN for FoG detection with an AUC 0.85.

Freezing of gait (FoG) is a common gait disability in Parkinson's disease, that usually appears in its advanced stage. Freeze episodes are associated with falls, injuries, and psychological consequences, negatively affecting the patients' quality of life. For detecting FoG episodes automatically, a highly accurate detection method is necessary. This paper presents an approach for detecting FoG episodes utilizing a deep recurrent neural network (RNN) on 3D-accelerometer measurements. We investigate suitable features and feature combinations extracted from the sensors' time series data. Specifically, for detecting FoG episodes, we apply a deep RNN with Long Short-Term Memory cells. In our experiments, we perform both user dependent and user independent experiments, to detect freeze episodes. Our experimental results show that the frequency domain features extracted from the trunk sensor are the most informative feature group in the subject independent method, achieving an average AUC score of 93%, Specificity of 90% and Sensitivity of 81%. Moreover, frequency and statistical features of all the sensors are identified as the best single input for the subject dependent method, achieving an average AUC score of 97%, Specificity of 96% and Sensitivity of 87%. Overall, in a comparison to state-of-the-art approaches from literature as baseline methods, our proposed approach outperforms these significantly.