Clinical assessment of standing and gait in ataxic patients using a triaxial accelerometer

Abstract

BackgroundThe aim of this study was to investigate the usefulness of a triaxial accelerometer for the clinical assessment of standing and gait impairment in ataxic patients quantitatively. Fifty-one patients with spinocerebellar ataxia (SCA) or multiple system atrophy with predominant cerebellar ataxia (MSA-C) and 56 healthy control subjects were enrolled. The subjects, with a triaxial accelerometer on their back, were indicated to stand for 30 s in four different conditions (eyes opened or closed, and feet apart or together) and then to walk 10 m for a total of 12 times on a flat floor at their usual walking speed. In standing analysis, the degree of body sway was assessed. In gait analysis, gait velocity, cadence, step length, step regularity (auto-correlation coefficient: AC), step repeatability (cross-correlation coefficient) and the degree of body sway (The ratio of root mean square in each direction to the root mean square vector magnitude: RMSR) were evaluated.ResultsThe degree of body sway in each standing condition and all parameters in gait showed a significant difference between the patients and control subjects. The AC and RMSR values, as well as the Scale for the Assessment and Rating of Ataxia score, showed a strong correlation with disease duration.ConclusionsVarious parameters obtained by a triaxial accelerometer can be sensitive and objective markers for the assessment and follow-up of standing and gait impairment in ataxic patients.

Test-Retest Reliability of an Automated Infrared-Assisted Trunk Accelerometer-Based Gait Analysis System

“…The excellent results of our studies were in accordance with previous AGA reliability studies regarding spatiotemporal gait parameters (velocity, cadence, step length) and trunk control (acceleration RMS). To our best knowledge, no accelerometric studies reported the reliability of gait symmetry and regularity with autocorrelation methods [ 13 ], the acceleration RMSR, and the degree of body sway [ 11 ] in clinical settings. Our study for the first time demonstrated that the IR-assist AGA system had excellent reliability of trunk control (step and stride regularity in AP direction; acceleration RMS and acceleration RMSR in ML direction; acceleration RMS and stride regularity in V direction).…”

“…Acceleration Root mean square ratio (RMSR) in the ML direction was calculated by dividing the RMS of the acceleration vector in the ML direction by the corresponding RMS acceleration vector magnitude [ 18 ]. The acceleration RMSR in the ML direction is associated with walking balance and has a common value at the preferred walking speed of healthy participants that can be used as a threshold for detecting gait abnormalities [ 11 , 18 ].…”

“…Furthermore, conventional lab-based equipment techniques, such as 3-dimensional motion capturing systems or force plates, though considered the gold standard for gait analysis, were restricted in their clinical application due to tedious data acquisition, costly lab equipment, and the need for specially trained personnel [ 9 , 10 ]. In contrast, accelerometers have a potential role in clinical gait analysis because they are wearable, wireless, and non-obtrusive [ 11 ]. It takes only 10 min to perform an accelerometer-based gait analysis (AGA) in a normal corridor or walkway [ 12 ].…”

“…Maffiuletti et al found excellent test-retest reliability for walking speed, cadence, step length, and stride length (ICC = 0.988–0.994) in a laboratory [ 17 ]. Although these studies had demonstrated excellent reliability of the accelerometer-based system for basic spatiotemporal gait parameters and acceleration RMS, no studies reported the reliability of gait symmetry, gait regularity with autocorrelation methods [ 13 ], and acceleration root mean square ratio (RMSR), or the degree of body sway [ 11 ]. Moreover, the limited and crowded space in a hospital environment may disturb clinical gait analysis.…”

Children with Heavy Prenatal Alcohol Exposure Exhibit Atypical Gait Characteristics

“…Additionally, there are neural correlates for some of the gait markers. The supplementary motor area (de Laat et al., ), cerebellum (Rao and Louis, ), and prefrontal cortex (Burhan et al., ) are implicated in gait cadence, whereas gait velocity is related to altered activity in the cerebellum (Matsushima et al., ), basal ganglia (Chastan et al., ), corpus callosum (Ryberg et al., ), prefrontal cortex (Burhan et al., ), and motor cortex (Annweiler et al., ). Step length involves basal ganglia structures (Chastan et al., ), and step length variability is related to hippocampal involvement (Shimada et al., ).…”