Gait disability in people with progressive multiple sclerosis (MS) is difficult to quantify using existing clinical tools. This study aims to identify reliable and objective gait-based biomarkers to monitor progressive multiple sclerosis (MS) in clinical settings. During routine clinical visits, 57 people with secondary progressive MS and 24 healthy controls walked for 6 minutes wearing three inertial motion sensors. Fifteen gait measures were computed from the sensor data and tested for between-session reliability, for differences between controls and people with moderate and severe MS disability, and for correlation with Expanded Disability Status Scale (EDSS) scores. The majority of gait measures showed good to excellent between-session reliability when assessed in a subgroup of 23 healthy controls and 25 people with MS. These measures showed that people with MS walked with significantly longer step and stride durations, reduced step and stride regularity, and experienced difficulties in controlling and maintaining a stable walk when compared to controls. These abnormalities significantly increased in people with a higher level of disability and correlated with their EDSS scores. Reliable and objective gait-based biomarkers using wearable sensors have been identified. These biomarkers may allow clinicians to quantify clinically relevant alterations in gait in people with progressive MS within the context of regular clinical visits.

Background The use of panic alarm systems for victims of domestic abuse is becoming increasingly popular. However, tests of these devices are rare. Consequently, it is presently unknown whether domestic abuse offenders are deterred by warning stickers informing them that a panic alarm system is installed on the premises, or whether alarm systems reduce domestic abuse recidivism. There is also a lack of data regarding whether adding an audio-recording feature to the panic alarm results in more prosecutions of domestic abuse offenders compared to standard panic alarm systems. Measuring the efficacy of warning stickers and audio recordings will enhance understanding of the overall effectiveness of panic alarm systems for domestic abuse. Methods This study used a pre-test-post-test, control group design, in which 300 eligible high-risk domestic abuse victims in London, UK, were randomly allocated to either a standard panic alarm system or a panic alarm system with audio-recording capabilities and a red warning sticker on a durable, A6-size sign displayed at eye level at the entrance to the premises. Each sticker was well lit to ensure maximum visibility. The gain scores of multiple measures at 6 months prior and 6 months post-randomisation were used to assess the treatment effects (including the number of calls for service, recorded crimes, and harm score), and a negative binomial generalised linear model was utilised to estimate the likelihood of criminal charges for domestic abuse offenders in the two systems. Outcomes Pre-post comparisons of recidivism suggested an overall reduction in both treatment arms, but there were no statistically significant differences between the two types of alarm systems across these crime measures. Nevertheless, the estimation model indicated a significant 57% increase in charges using the audio-recording alarm relative to the standard panic alarm system. Conclusions Using deterrent stickers to warn domestic abuse offenders of panic alarm systems does not lead to a reduction in subsequent harm to victims. Compared to ordinary panic alarms for high-risk domestic abuse victims, audio-recording systems provide valuable evidence that increases subsequent charges, and thus, these systems should be explored further.

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