As a prominent symptom of Parkinson's disease (PD), turning impairment is evaluated through parameters such as turning angle, duration, and particularly, the number of steps required to complete a turn, which directly reflects motor dysfunction. Accurate step counting is challenging due to variability in real-world turning movements and atypical shuffling patterns in parkinsonian gait. Existing methods are predominantly wearable-based, requiring users to wear and manage dedicated devices, which can be inconvenient for continuous daily use. To address this, we propose a passive, video-based framework that estimates step count in a coarse-to-fine manner using diverse motion representations. Specifically, an initial step count is estimated from foot movement signals derived from 3D human mesh recovery, providing high-level motion structures. To incorporate fine-grained motion details, a motion encoder learns complementary gait dynamics from mesh and optical flow to refine the initial estimate. In this process, coarse foot movement signals query the pixel-level motion cues via cross attention to capture subtle parkinsonian gait dynamics. To handle varying video lengths, we partition each video into clips and integrate clip-wise motion embeddings via multiple instance learning (MIL) for step count residual prediction. Extensive experiments show our method consistently outperforms existing step counting methods on real-world PD turning datasets.
Understanding motion in daily living requires context beyond kinematics, because similar inertial patterns during activities of daily living (ADLs) can reflect intentional stopping, object interaction, or pathological movement impairment. Egocentric vision provides task-related context that may help disambiguate these cases. We investigate this challenge through freezing of gait (FOG) detection in Parkinson's disease (PD), a symptom strongly influenced by contextual factors during ADLs. Using synchronized egocentric video, wearable IMUs, and expert-annotated FOG labels collected from 13 PD participants in their homes, we evaluate frozen representations from pretrained ego-video and time-series foundation models, alongside an IMU-based TCN trained from scratch, under leave-one-subject-out evaluation. The IMU-based TCN achieved the strongest event-detection performance, reaching 42.3 F1 and 83.0 AUROC, compared with 32.6 F1 and 77.2 AUROC for V-JEPA2 ego-video features. Although ego-video alone did not outperform IMU-based sensing, it showed above-chance discrimination, and qualitative analyses suggest that egocentric vision may capture FOG-relevant information independent of IMUs. Together, these results support the use of pretrained ego-video representations to add contextual information to wearable-sensor-based clinical motion understanding in daily living.
Parkinson's disease is a progressive neurodegenerative disorder characterised by gradual deterioration of movement control. Automated freezing-of-gait (FOG) detection supports the objective assessment of gait-related motor impairment. Two common approaches are used for FOG prediction: (i) analysing video recordings of the patient's movements and (ii) analysing data collected using inertial measurement unit (IMU) wearable sensors attached to the patient's lower limbs. Video-based approaches may suffer detection errors during continuous turning-in-place tasks because the lower limbs undergo substantial geometric self-occlusion, degrading pose-estimation accuracy. IMU-based approaches are generally less affected by visual occlusion; however, they are difficult to deploy outside clinical or laboratory settings, as the sensors must be attached securely and remain in place throughout the assessment. Motivated by this, we propose a cross-modal subspace distillation framework to mitigate the limitations of unimodal FOG detection by combining IMU accuracy with video-based practicality. We extract invariant latent topologies from a pre-trained kinematic oracle to structurally supervise a non-encoded visual architecture during training. To resolve periods of severe spatial occlusion, a dual-stream visual model probabilistically fuses skeletal graph nodes and continuous spatial pixels, dynamically shifting reliance to uninterrupted pixel boundaries as joint tracking confidence drops. Evaluated against a public, multi-modal sequence dataset of Parkinson's individuals executing continuous 360∘ turns, empirical results demonstrate that applying sensory boundary topologies strictly mitigates tracking evaluation entropy. Our constrained optimisation confirms that highly precise FOG prediction bounds can be achieved over zero-wearable inference environments.
Objective assessment of Freezing of Gait (FoG) in Parkinson's disease (PD) relies predominantly on wearable Inertial Measurement Units (IMUs). While IMUs provide optimal kinematic precision, mandatory sensor attachment restricts continuous clinical deployment. Conversely, unobtrusive vision-based alternatives suffer substantial classification errors during turning-in-place tasks, where geometric self-occlusion degrades deterministic skeletal coordinates and obscures the high-frequency precursors required for FoG detection. To resolve these physical observation limits, we propose a supervised cross-modal subspace distillation framework. During optimisation, pre-trained kinematic data from IMU sensors and contextual clinical metadata act as oracles to guide a deployable visual architecture. By incorporating joint velocity and acceleration derivatives, utilising a confidence-based gating mechanism, the visual model mitigates some of the tracking errors during occlusion events. Empirical evaluations confirm this latent alignment transfers the predictive fidelity of hardware sensors directly into the visual representation, yielding 85.5% accuracy, and 82.4% balanced accuracy. All the while maintaining a vision only model at inference.