journal article·2026-03-23Open access

A Contactless Deep Learning Framework for Quantitative Motor Assessment Aligned with the Movement Disorder Society Unified Parkinson’s Disease Rating Scale Part III: A Healthy Baseline Definition Study

Andrea Zanela

Applied Sciences· Volume 16· Issue 6

Abstract

The clinical evaluation of motor impairment in Parkinson’s disease is commonly based on the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part III, which relies on visual assessment and is therefore subject to inter-rater variability. Existing technology-based solutions often require wearable sensors or lack structural alignment with the item-based architecture of the clinical examination. This study presents a fully automated and contactless framework designed to quantitatively describe motor performance in tasks explicitly aligned with MDS-UPDRS Part III. The system integrates stereo vision, deep learning-based pose estimation, and acoustic analysis to derive continuous, standardized quantitative descriptors. Objective Motor Item Indices were defined for 17 of the 18 motor items, excluding rigidity, which cannot be inferred from vision-based measurements. The framework was evaluated in a cohort of healthy subjects to establish an internal reference baseline for feature normalization and index construction. Within this cohort, descriptors exhibited coherent multivariate organization and internally consistent distributions, supporting methodological feasibility at this baseline definition stage. This work represents a methodological and baseline definition phase. Clinical validation in Parkinsonian populations, correlation with neurologist-rated scores, and longitudinal assessment remain necessary to determine diagnostic, severity-related, or early-stage applicability.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Parkinson's Disease Mechanisms and Treatments · Voice and Speech Disorders · Neurological disorders and treatments

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Energy and Data Science Lab, ENEA “Casaccia” Research Centre, I-00123 Rome, Italy

References (62)

Show source-provided references
1. World Health Organization (2022). Ageing and Health, World Health Organization. Available online: https://www.who.int/news-room/fact-sheets/detail/ageing-and-health.
2. European Commission (2023). The Impact of Demographic Change in Europe, European Commission. Available online: https://commission.europa.eu/strategy-and-policy/priorities-2019-2024/new-push-european-democracy/impact-demographic-change-europe_en.
3. Global, regional, and national burden of stroke and its risk factors, 1990–2019: A systematic analysis for the Global Burden of Disease Study 201910.1016/S1474-4422(21)00252-0 ↗
4. The emerging evidence of the Parkinson pandemic
5. The Parkinson pandemic—A call to action10.1016/S1474-4422(18)30295-3 ↗
6. Movement Disorder Society–sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): Scale presentation and clinimetric testing results10.1002/mds.22340 ↗
7. High-Performance Medicine: The Convergence of Human and Artificial Intelligence10.1038/s41591-018-0300-7 ↗
8. Technology in Parkinson disease: Challenges and opportunities10.1002/mds.26642 ↗
9. Free-living gait characteristics in ageing and Parkinson’s disease: Impact of environment and task10.1186/s12984-016-0154-5 ↗
10. Quantitative wearable sensors for objective assessment of Parkinson’s disease10.1002/mds.25628 ↗
11. Cancer Diagnosis10.1038/d41586-020-00840-9 ↗
12. Ranschaert, E.R., Morozov, S., and Algra, P.R. (2019). Artificial Intelligence in Medical Imaging: Opportunities, Applications and Risks, Springer.10.1007/978-3-319-94878-2 ↗
13. Marr, D. (1982). Vision: A Computational Approach, W.H. Freeman & Co.
14. Fisher, M., and Hsu, D. (1987). Computational vision and regularization theory. Readings in Computer Vision, Elsevier.
15. Bishop, C.M., and Nasrabadi, N.M. (2006). Pattern Recognition and Machine Learning, Springer.
16. Deep learning10.1038/nature14539 ↗
17. Goodfellow, I., Bengio, Y., and Courville, A. (2016). Deep Learning, MIT Press.
18. Russell, S., and Norvig, P. (1996). Artificial Intelligence: A Modern Approach, Prentice Hall.
19. Murphy, K.P. (2012). Machine Learning: A Probabilistic Perspective, MIT Press.
20. A practical use of cellular neural networks: The stereo-vision problem as an optimisation10.1007/s001380050107 ↗
21. A cellular neural network based optical range finder10.1002/cta.200 ↗
22. Zanela, A., Schirinzi, T., Mercuri, N.B., Stefani, A., Romagnoli, C., Annino, G., Bonaiuto, V., and Cerroni, R. (2022). Using a Video Device and a Deep Learning-Based Pose Estimator to Assess Gait Impairment in Neurodegenerative Related Disorders: A Pilot Study. Appl. Sci., 12.10.3390/app12094642 ↗
23. Movement Disorder Society (2026, March 15). MDS-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). Available online: https://www.movementdisorders.org/MDS/MDS-Rating-Scales/MDS-Unified-Parkinsons-Disease-Rating-Scale-MDS-UPDRS.htm.
24. OpenPose: Realtime Multi-Person 2D Pose Estimation Using Part Affinity Fields10.1109/TPAMI.2019.2929257 ↗
25. NVIDIA (2026, March 15). CUDA Toolkit. Available online: https://developer.nvidia.com/cuda/toolkit.
26. NVIDIA (2026, March 15). cuDNN. Available online: https://developer.nvidia.com/cudnn.
27. AKG (2026, March 15). C417 PP Microphone (Speech/Spoken Word). Available online: https://www.akg.com/microphones/speech-spoken-word-microphones/C417PP.html.
28. Accurate telemonitoring of Parkinson’s disease progression by noninvasive speech tests10.1109/TBME.2009.2036000 ↗
29. Novel speech signal processing algorithms for high-accuracy classification of Parkinson’s disease10.1109/TBME.2012.2183367 ↗
30. Suitability of dysphonia measurements for telemonitoring of Parkinson’s disease10.1109/TBME.2008.2005954 ↗
31. Kocabas, M., Huang, C.-H.P., Hilliges, O., and Black, M.J. (2021). PARE: Part Attention Regressor for 3D Human Body Estimation. Proceedings of the IEEE/CVF International Conference on Computer Vision (ICCV), Montreal, QC, Canada, 10–17 October 2021, CVF Open Access.10.1109/ICCV48922.2021.01094 ↗
32. Wang, Z., Chen, L., Rathore, S., Shin, D., and Fowlkes, C. (2023). Geometric Pose Affordance: Monocular 3D Human Pose Estimation with Scene Constraints. Computer Vision—ECCV 2022 Workshops, Tel Aviv, Israel, 23–27 October 2022, Springer. LNCS 13806.10.1007/978-3-031-25075-0_1 ↗
33. Modeling Human Motion with Quaternion-Based Neural Networks10.1007/s11263-019-01245-6 ↗
34. Digital Outcomes as Biomarkers of Disease Progression in Early Parkinson’s Disease: A Systematic Review10.1002/mds.30056 ↗
35. A roadmap for implementation of patient-centered digital outcome measures in Parkinson’s disease obtained using mobile health technologies10.1002/mds.27671 ↗
36. Fröhlich, H., Bontridder, N., Petrovska-Delacréta, D., Glaab, E., Kluge, F., Yacoubi, M.E., Marín Valero, M., Corvol, J.-C., Eskofier, B., and Van Gyseghem, J.-M. (2022). Leveraging the Potential of Digital Technology for Better Individualized Treatment of Parkinson’s Disease. Front. Neurol., 13.10.3389/fneur.2022.788427 ↗
37. Long-term unsupervised mobility assessment in movement disorders10.1016/S1474-4422(19)30397-7 ↗
38. Wearable sensor-based quantitative gait analysis in Parkinson’s disease patients with different motor subtypes10.1038/s41746-024-01163-z ↗
39. IMU-Based Classification of Parkinson’s Disease From Gait: A Sensitivity Analysis on Sensor Location and Feature Selection10.1109/JBHI.2018.2865218 ↗
40. Jolliffe, I.T. (2002). Principal Component Analysis, Springer. [2nd ed.].
41. Free-living monitoring of Parkinson’s disease: Lessons from the field10.1002/mds.26718 ↗
42. Sway frequencies may predict postural instability in Parkinson’s disease: A novel convolutional neural network approach10.1186/s12984-025-01570-7 ↗
43. Amprimo, G., Masi, G., Priano, L., Azzaro, C., Galli, F., Pettiti, G., Mauro, A., and Ferraris, C. (2022). Assessment Tasks and Virtual Exergames for Remote Monitoring of Parkinson’s Disease: An Integrated Approach Based on Azure Kinect. Sensors, 22.10.20944/preprints202209.0422.v1 ↗
44. Dopaminergic medication does not improve stepping responses following backward and forward balance perturbations in patients with Parkinson’s disease10.1007/s00415-014-7496-3 ↗
45. Digital biomarkers for non-motor symptoms in Parkinson’s disease: The state of the art10.1038/s41746-024-01144-2 ↗
46. Stereolabs (2026, March 15). ZED 2 Stereo Camera. Available online: https://www.stereolabs.com/en-it/products/zed-2.
47. Duffy, J.R. (2013). Motor Speech Disorders: Substrates, Differential Diagnosis, and Management, Elsevier. [3rd ed.].
48. Vowel articulation in Parkinson’s disease10.1016/j.jvoice.2010.01.009 ↗
49. Life with communication changes in Parkinson’s disease10.1093/ageing/afj053 ↗
50. Aspects of speech rate and regularity in Parkinson’s disease10.1016/j.jns.2011.07.020 ↗
51. Robust Speech Recognition via Large-Scale Weak Supervision
52. Evaluating OpenAI’s Whisper ASR: Performance analysis across diverse accents and speaker traits10.1121/10.0024876 ↗
53. Automatic Assessment of Intelligibility in Noise in Parkinson Disease: Validation Study10.2196/40567 ↗
54. Parkinson’s disease: Clinical features and diagnosis10.1136/jnnp.2007.131045 ↗
55. Facial bradykinesia10.1136/jnnp-2012-303993 ↗
56. Bianchini, E., Rinaldi, D., Alborghetti, M., Simonelli, M., D’Audino, F., Onelli, C., Pegolo, E., and Pontieri, F.E. (2024). The Story behind the Mask: A Narrative Review on Hypomimia in Parkinson’s Disease. Brain Sci., 14.10.3390/brainsci14010109 ↗
57. Emotional and nonemotional facial expressions in people with Parkinson’s disease10.1017/S135561770410413X ↗
58. Facial emotion recognition in Parkinson’s disease: A review and new hypotheses10.1002/mds.27305 ↗
59. Analysis of blink rate patterns in normal subjects10.1002/mds.870120629 ↗
60. Spontaneous eye blink-based machine learning for tracking clinical fluctuations in Parkinson’s disease10.1038/s41531-025-01094-w ↗
61. Analysis of facial expressions in Parkinson’s disease through video-based automatic methods10.1016/j.jneumeth.2017.02.006 ↗
62. Ekman, P., and Friesen, W.V. (1978). Facial Action Coding System: A Technique for the Measurement of Facial Movement, Consulting Psychologists Press.10.1037/t27734-000 ↗