Body-worn sensors capture variability, but not decline, of gait and balance measures in multiple sclerosis over 18 months

Abstract

Gait and balance deficits are a frequent complaint in MS but poorly captured by stopwatch-timed tests or rating scales. Body-worn accelerometers and gyroscopes are able to detect gait and balance abnormalities in people with MS who have normal walking speeds. Few longitudinal studies exist using this technology to study the evolution of mobility deficits. The purpose of this study was to determine if body-worn sensors detected any decline in gait and balance measures in people with MS over time. Twenty-seven people with MS (13 mildly disabled, Self-Rated Expanded Disability Status Scale 0 -3.5; 14 moderately disabled, SR-EDSS 4.0 -5.5) who had normal walking speeds and 18 matched control subjects underwent gait and balance testing using body-worn sensors every 6 months for 18 months. While no parameter worsened over time, the moderately disabled MS cohort performed more poorly than the mildly disabled MS cohort who, in turn, were worse than control subjects for both objective and subjective walking and balance measures. Furthermore, the moderately disabled MS cohort demonstrated greater variation in between-visit performance than did the less disabled MS cohort or controls (Bonferroni-corrected p < 0.05). Variability may be a key indicator of worsening gait and balance disability in MS.

Concurrent validity and minimum detectable change of Senior Fitness Test components: instrumented vs. manual assessment

“…The MDC for the same test has been shown to vary substantially between populations, with clinical populations demonstrating greater MDCs, compared with healthy controls [11,12,[17][18][19]. Given that much of what we know regarding the MDC for the tests utilized in the present study were reported for populations with diagnosed pathologies, it makes direct comparisons between studies difficult.…”

Estimation of temporal gait parameters of multiple sclerosis patients in clinical setting using inertial sensors

“…People with MS frequently have neuromuscular deficits such as ataxia, early muscle fatigue, spasticity and sensory disturbances, which limit gait and considerably affect their everyday living activities [1]. Subtle walking difficulties, such as reduced walking speed, step length, cadence and increased step width can be detected at an early stage of the disease [2,3,4,5]. Walking limitations have negative consequences in activities of daily living, quality of life, as well as employment etc.…”

“…Like in many neurological disorders, such evaluations are typically approached by direct observation of the clinician supported by a timed analysis, functional scales and questionnaires. Information derived from neurological assessment is included in the expanded disability status scale (EDSS) and it is most widely used to evaluate disability in MS, in both daily clinical practice and trials [2,3,5]. However, it is essential to find new tools, complementary to the clinical scales, able to supply objective and quantitative data useful in supporting clinical assessment of the disability as well as its variations across time.…”

Posturografia dinâmica e tempo de marcha: marcadores de declínio funcional em pacientes com esclerose múltipla e leve incapacidade

“…Em um estudo recente Spain et al 70 , pacientes com EM também foram avaliados longitudinalmente ao longo de 18 meses (avaliações a cada 6 meses), sendo analisadas as mudanças no escore da EDSS, no tempo do T25FW, assim como nos testes de equilíbrio estático com olhos abertos e fechados, avaliados por sensores de movimento. Os Além disso, o desempenho nesses testes piora, à medida que a EDSS aumenta.…”