Gait Features and their Relationships to Physiological Attributes of Multiple Sclerosis

Abstract

To Riaz and Saira AcknowledgementsI would like to sincerely thank my advisor, Dr. Maite Brandt-Pearce, for her relentless support, understanding, and patience. It was her persistent encouragement which pushed me to be my best and guided me to the right direction whenever I was directionless. She inspired me not only as a role model but also as a friend. Her camaraderie, exemplary work ethic, determination, and emphasis on participating in group meetings, seminars, and social activities fostered my multi-dimensional technical skills and shaped me as an independent researcher. At the same time, it instilled team spirit, mutual respect, empathy, flexibility, and numerous other personal and interpersonal skills in me, which I will cherish for the rest of my life. Assessments of MS-associated cognitive and motor disability, the disease course and its progression, and decision-making regarding disease-modifying treatments and symptoms management, are based on clinical observations, comprised of outcomes of physical examinations and medical imaging, and patient-rated questionnaires. Being reliant on physicians' judgment in interpreting imaging and clinical outcomes, affected by the differences among individuals regarding the notion of disability or improvements, time-consuming, imprecise, having limited sensitivity to subtle changes in gait, and low variance in ratings are some of the drawbacks of current subjective evaluations. Moreover, patient-reported outcomes (PROs) are subject to response shifts due to changes within individuals over time regarding health standards, and could lead to confusing findings and discrepancies between expected and observed indicators, negatively impacting disease prognosis. We intend to augment existing information, on-going research, and currently-used speed and distance-based clinical assessments, for a neurologic condition, with new, objective, and clinically meaningful anchors. Although our goals are motivated for a target application (finding physiologically meaningful gait features for assessing functional quality in MS using inertial gait data), our test measures could be adopted for gait assessments and monitoring in other neurological disorders, balance, stability, and fall risk prediction, and general health and wellness applications.We derive inertial features using angular rate gait data collected using a body sensor node for improved gait assessment with three goals -(i) using variations in gait features over time, i.e., gait dynamics, to remove the inter-subject variability and guide personalized assessments in neurology-affected locomotion, aging, or chronic diseases, (ii) finding computationally efficient and robust gait features that neither require identification of exact gait cycles nor need a large dataset to capture gait deterioration and make physical sense, (iii) translating pathology-induced fluctuations into frequency-domain features to identify the impact of MS on important gait phases.We include gait variables for comparable controls in the study to determine ...

Impact of Multiple Sclerosis on Foot Health and Quality of Life: A Prospective Case-Control Investigation

“…Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS), which causes large focal lesions in the white matter of the brain and spinal cord ( 1 ). Gait dysfunction is an almost ubiquitous symptom even in the early stages of the disease, several factors, such as ataxia, hypertonic muscles and deformities of the musculoskeletal system, will affect the normal contact of the plantigrade foot ( 2 ), causing a significant reduction in functional independence and wellness of patients suffering from this neurological disease ( 3 ).…”