Next Steps in Wearable Technology and Community Ambulation in Multiple Sclerosis

Frechette, Mikaela L; Meyer, Brett; Tulipani, Lindsey J.; Gurchiek, Reed D.; McGinnis, Ryan S.; Sosnoff, Jacob J.

doi:10.1007/s11910-019-0997-9

Cited by 48 publications

(40 citation statements)

References 97 publications

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“…In the present study we analysed the intra-session reliability of spatiotemporal gait parameters (means, variability and asymmetry) for assessing gait of participants with MS according to a pre-de ned number of gait cycles, representing short bouts of gait data extracted from the full walking trial. The main goal of this analysis is to evaluate a novel approach for gait analysis from data collected with wearable devices, supporting gait assessments in ambulatory care and less controlled settings, such as patients' homes or community ambulation, where gait data is often fragmented (Frechette et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

“…While stride time asymmetry and step time asymmetry have poor reliability, results show that gait asymmetry estimated from stance time, swing time, stride length and stride velocity should be further explored, since they provide reliable measures for short bouts of gait data and have a potential to diagnosis and monitoring symptoms of persons with MS (Frechette et al, 2019). This is a promising result that shows that measures describing gait variability and gait asymmetry, in particular of stride length and stride velocity, should be further investigated for their potential of completing neurological assessment of participants with MS and other neurological conditions.…”

Section: Objective Gait Assessment For Persons With Msmentioning

confidence: 99%

“…Gait impairment is highly prevalent in multiple sclerosis (MS), as the decline on neural control affects motor functions, and consequently gait, balance and mobility (Kamm, Uitdehaag, & Polman, 2014;Kurtzke, 1983). Objective gait measurements enable the assessment of the quality and performance of gait, including gait variability and asymmetry (Lord, Galna, & Rochester, 2013), providing important information to complete the neurological evaluation of persons with MS (Frechette et al, 2019;Vienne-Jumeau, Quijoux, Vidal, & Ricard, 2019). Objective gait assessments are high sensitive to changes in symptoms, supporting early diagnosis and the evaluation of therapeutic interventions (Hubble, Naughton, Silburn, & Cole, 2015;Spain et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

“…Data collected from wearable devices, equipped with inertial sensors, have been demonstrated to be effective in objective gait assessments, offering a portable and cost-effective solution compared to large or xed installations (Frechette et al, 2019;Simon, 2004;Vienne-Jumeau et al, 2019). However, if wearable devices are suitable for ambulatory care, home assessments and community ambulation, the variety of gait assessment protocols can be considered an obstacle for establishing reference values (Vienne-Jumeau et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

“…25ft walk, 6 minutes walking test, Timed-Upand-Go) (Engelhard, Dandu, Patek, Lach, & Goldman, 2016;Greene, Healy, Rutledge, Caul eld, & Tubridy, 2014;Kojima, Obuchi, Henmi, & Iketa, 2008). Moving for non-controlled environments, gait data may be fragmented and non-homogenous (Frechette et al, 2019). The variations and restrictions on gait assessment protocols (e.g.…”

Section: Introductionmentioning

confidence: 99%

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Short bouts of gait data and inertial sensors can provide reliable measures of spatiotemporal gait parameters from bilateral gait data of participants with multiple sclerosis

Ader

Greene

McManus

et al. 2020

Preprint

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Background:Wearable devices equipped with inertial sensors enable objective gait assessment for persons with multiple sclerosis (MS), with potential use in ambulatory care or home and community-based assessments. However, gait data collected in non-controlled settings is often fragmented and may not provide enough information for reliable measures. We evaluate a novel approach, extracting pre-defined numbers of gait cycles from the full length of a walking task, and their effects on the reliability of spatiotemporal gait parameters.Methods:The present study evaluates intra-session reliability of spatiotemporal gait parameters for short bouts of gait data extracted from the full length of the walking tasks to 1) determine the effects of the length of the walking task on the reliability of calculated measures and 2) identify spatiotemporal gait parameters that can provide reliable measures for gait assessments and reference data in different settings.Thirty-seven participants (37) diagnosed with relapsing-remitting MS (EDSS rage 0 to 4.5) executed two trials, walking 20m each, with inertial sensors attached to their right and left shanks. Previously published algorithms were applied to identify gait events from the medio-lateral angular velocity. Short bouts of gait data were extracted from each trial, with lengths varying from 3 to 9 gait cycles. Twenty-one measures of spatiotemporal gait parameters were calculated. Intraclass correlation coefficients (ICCs) were calculated to evaluate how the degree of agreement between the two trials of each participant varied with the number of gait cycles included in the analysis.Results:Spatiotemporal gait parameters calculated as the mean across included gait cycles reach excellent reliability from three gait cycles. Stride time variability and asymmetry, as well as stride velocity variability and asymmetry, reach good reliability from six gait cycles and should be further explored for persons with MS, while stride time asymmetry and step time asymmetry do not seem to provide reliable measures and should be reported carefully.Conclusion:Short bouts of gait data, including at least six gait cycles of bilateral data, can provide reliable gait measurements for persons with MS, opening new perspectives for gait assessment using wearable devices in non-controlled environments, to support monitoring of symptoms of persons with neurological diseases.Trial registrationNot applicable.

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Section: Discussionmentioning

confidence: 99%

Section: Objective Gait Assessment For Persons With Msmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Short bouts of gait data and inertial sensors can provide reliable measures of spatiotemporal gait parameters from bilateral gait data of participants with multiple sclerosis

Ader

Greene

McManus

et al. 2020

Preprint

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What the Tech? The Management of Neurological Dysfunction Through the Use of Digital Technology

Carswell

Rea

2021

Advances in Experimental Medicine and Biology

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A wearable sensor identifies alterations in community ambulation in multiple sclerosis: contributors to real-world gait quality and physical activity

et al. 2020

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People with multiple sclerosis (pwMS) often suffer from gait impairments. These changes in gait have been wellstudied in laboratory and clinical settings. A thorough investigation of gait alterations during community ambulation and their contributing factors, however, is lacking. The aim of the present study was to evaluate community ambulation and physical activity in pwMS and healthy controls and to compare in-lab gait to community ambulation. To this end, 104 subjects were studied:44 pwMS and 60 healthy controls (whose age was similar to the controls). The subjects wore a tri-axial, lower-back accelerometer during usual-walking and dual-task walking in the lab and during community ambulation (1 week) to evaluate the amount, type, and quality of activity. The results showed that during community ambulation, pwMS took fewer steps and walked more slowly, with greater asymmetry, and larger stride-to-stride variability, compared to the healthy controls (p<0.001). Gait speed during most of community ambulation was significantly lower than the in-lab usual-walking value and similar to the in-lab dual-tasking value. Significant group (pwMS /controls) by walking condition (in-lab/community ambulation) interactions were observed (e.g., gait speed).Greater disability was associated with fewer steps and reduced gait speed during community ambulation. In contrast, physical fatigue was correlated with sedentary activity but was not related to any of the measures of community ambulation gait quality including gait speed. This disparity suggests that more than one mechanism contributes to community ambulation and physical activity in pwMS. Together, these findings demonstrate that during community ambulation, pwMS have marked gait alterations in multiple gait features, reminiscent of dual-task walking measured in the laboratory. Disease-related factors associated with these changes might be targets of rehabilitation.

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Next Steps in Wearable Technology and Community Ambulation in Multiple Sclerosis

Cited by 48 publications

References 97 publications

Short bouts of gait data and inertial sensors can provide reliable measures of spatiotemporal gait parameters from bilateral gait data of participants with multiple sclerosis

Short bouts of gait data and inertial sensors can provide reliable measures of spatiotemporal gait parameters from bilateral gait data of participants with multiple sclerosis

What the Tech? The Management of Neurological Dysfunction Through the Use of Digital Technology

A wearable sensor identifies alterations in community ambulation in multiple sclerosis: contributors to real-world gait quality and physical activity

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