Local Dynamic Stability of Gait in People With Early Multiple Sclerosis and No-to-Mild Neurological Impairment

Caronni, Antonio; Gervasoni, Elisa; Ferrarin, Maurizio; Anastasi, Denise; Brichetto, Giampaolo; Giovanni, Rachele Di; Prosperini, Luca; Tacchino, Andrea; Solaro, Claudio; Rovaris, Marco; Cattaneo, Davide; Carpinella, Ilaria

doi:10.1109/tnsre.2020.2991636

Cited by 23 publications

(35 citation statements)

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“…Gait symmetry was computed separately on the three components of trunk acceleration, but only the medio‐lateral one was used in the subsequent multiple regression analysis (see Statistical Analysis), since it showed a higher bivariate correlation with the MSWS‐12 score (Pearson's r = −0.46, p < 0.001), compared to the antero‐posterior ( r = −0.26, p = 0.020) and vertical metrics ( r = −0.34, p = 0.002). gait instability (a.u. ), quantified through the short‐term Lyapunov exponent (sLyE) computed on trunk accelerations over the duration of one step, as fully detailed elsewhere [24]. As previously described [35], the sLyE reflects the capability of the locomotor system to cope with small perturbations naturally occurring during gait (e.g., external mechanical disturbances or internal motor control errors).…”

Section: Methodsmentioning

confidence: 99%

“…Each parameter was calculated on the middle 10 strides of each straight‐line walking bout and then averaged over the whole trial. All the above metrics have been previously proposed as reliable and valid biomarkers to objectively characterize walking anomalies in PwMS with different disability levels [24,36–39].…”

Section: Methodsmentioning

confidence: 99%

“…All the above metrics have been previously proposed as reliable and valid biomarkers to objectively characterize walking anomalies in PwMS with different disability levels [24,[36][37][38][39].…”

Section: Introductionmentioning

confidence: 99%

“…Several studies using instrumented assessments found that, compared to healthy subjects, PwMS with mean EDSS scores between 1 and 2.5 walked with altered gait rhythm (i.e., reduced velocity, cadence, stride length and prolonged double‐support time) [17–19], impaired lower limb kinematics, kinetics and muscular activity [17–19], and poorer gait quality in terms of increased gait variability and asymmetry [20,21] and reduced smoothness and stability [22–24]. Despite these results, to our knowledge there are still no studies that have shown which of the above locomotor anomalies have a real impact on perceived daily‐life walking ability in early‐stage PwMS.…”

Section: Introductionmentioning

confidence: 99%

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Instrumentally assessed gait quality is more relevant than gait endurance and velocity to explain patient‐reported walking ability in early‐stage multiple sclerosis

Carpinella

Gervasoni

Anastasi

et al. 2021

Euro J of Neurology

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Background and purpose People with multiple sclerosis (PwMS) often report walking limitations even when the gold standard Expanded Disability Status Scale (EDSS) indicates normal walking endurance/autonomy. The present multicenter study on early‐stage PwMS aims at analyzing which aspects are associated with patient‐reported walking limitations measured with the 12‐item Multiple Sclerosis Walking Scale (MSWS‐12). Methods Eighty‐two PwMS (EDSS ≤ 2.5) were assessed using the Fullerton Advanced Balance Scale—short (FAB‐s), the Fatigue Severity Scale (FSS) and the 6‐min Walk Test (6MWT), the latter administered also to 21 healthy subjects. Participants performed the 6MWT wearing three inertial sensors on ankles and trunk. Instrumented metrics describing gait velocity (stride length and frequency) and quality (regularity, symmetry, instability) were computed from sensor data. Fatigue (FSS), balance (FAB‐s), walking endurance (6MWT) and instrumented metrics were entered in a multiple regression model with MSWS‐12 as dependent variable. Results Gait symmetry, gait instability, fatigue and balance were significantly associated with self‐rated walking ability, whilst walking endurance and velocity were not. Fatigue, balance, gait symmetry and instability were more impaired in participants reporting mild‐to‐moderate (MSMM‐PWL, 25 ≤ MSWS‐12 < 75) compared to those reporting none‐to‐minimal (MSnm‐PWL, 0 ≤ MSWS‐12 ≤ 25) perceived walking limitations. Compared to healthy subjects, gait symmetry and stability were reduced in MSnm‐PWL and MSMM‐PWL, even in those participants with EDSS ≤ 1.5. Conclusion Instrumentally assessed gait quality aspects (symmetry and instability) are associated with patient‐reported walking ability in early‐stage PwMS and seem sensitive biomarkers to detect subtle impairments even in the earliest stages of the disease (EDSS ≤ 1.5). Future studies should assess their ability to follow walking change due to MS progression or pharmacological/rehabilitation interventions.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Instrumentally assessed gait quality is more relevant than gait endurance and velocity to explain patient‐reported walking ability in early‐stage multiple sclerosis

Carpinella

Gervasoni

Anastasi

et al. 2021

Euro J of Neurology

Self Cite

View full text Add to dashboard Cite

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“…Investigations of gait data based on nonlinear time series with or without a robotic walker enable the deduction of useful information regarding the intrinsic dynamical changes. Most of the nonlinear time series analysis-based studies on gait focused on the local dynamic stability using the maximum Lyapunov exponent [18][19][20][21]. However, studies on the sensitivity of the maximum Lyapunov exponent indicated that this measure is suitable for assessing the local dynamic stability at a group level [22], but cannot be used to detect small differences at an individual level [23].…”

Section: Introductionmentioning

confidence: 99%

Changes in the Determinism of the Gait Dynamics with the Intervention of a Robotic Walker

Wan

Yamada

2020

Applied Sciences

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(1) Robotic walkers have gradually been developed over the last decade, and their use has caused changes in gait. However, detailed gait analyses during robotic walker-assisted walking have not been performed. In this study, we aim to identify the changes in determinism of gait dynamics owing to the intervention of a robotic walker. (2) Eleven healthy subjects participated in walking experiments under normal walking, rollator-assisted walking, and robotic walker-assisted walking conditions. We analyzed the measured trunk acceleration to derive the gait parameters, local scaling exponent (LSE, from correlation sum), and percentage of determinism (%DET, from recurrence plot). (3) The walking speed during rollator-assisted walking was significantly lower than that during robotic walker-assisted walking. Changes in the shape of the LSE along the anterior–posterior direction revealed the influence of the robotic walker at an individual level. The changes in %DET along the anterior–posterior direction were also significantly different between normal walking and robotic walker-assisted walking. (4) The rollator decreased the walking speed in comparison to normal walking. The changed LSE and reduced %DET imply reduced deterministic patterns and disturbance to the gait dynamics. The robotic walker only affects the gait dynamics in the anterior–posterior direction. Furthermore, the burden on the subjects was reduced during robotic walker-assisted walking.

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Stability analysis of a novel mobile spray-painting robot for touch-up painting in vehicle repair plant

Zhang

Wang

2022

J Mech Sci Technol

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Local Dynamic Stability of Gait in People With Early Multiple Sclerosis and No-to-Mild Neurological Impairment

Cited by 23 publications

References 62 publications

Instrumentally assessed gait quality is more relevant than gait endurance and velocity to explain patient‐reported walking ability in early‐stage multiple sclerosis

Instrumentally assessed gait quality is more relevant than gait endurance and velocity to explain patient‐reported walking ability in early‐stage multiple sclerosis

Changes in the Determinism of the Gait Dynamics with the Intervention of a Robotic Walker

Stability analysis of a novel mobile spray-painting robot for touch-up painting in vehicle repair plant

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