Wearable sensors can reliably quantify gait alterations associated with disability in people with progressive multiple s
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ORIGINAL COMMUNICATION
Wearable sensors can reliably quantify gait alterations associated with disability in people with progressive multiple sclerosis in a clinical setting Lorenza Angelini1 · William Hodgkinson2 · Craig Smith2 · Jessie Moorman Dodd2 · Basil Sharrack3 · Claudia Mazzà1 · David Paling4 Received: 14 January 2020 / Revised: 15 May 2020 / Accepted: 16 May 2020 © The Author(s) 2020
Abstract Gait disability in people with progressive multiple sclerosis (MS) is difficult to quantify using existing clinical tools. This study aims to identify reliable and objective gait-based biomarkers to monitor progressive multiple sclerosis (MS) in clinical settings. During routine clinical visits, 57 people with secondary progressive MS and 24 healthy controls walked for 6 minutes wearing three inertial motion sensors. Fifteen gait measures were computed from the sensor data and tested for between-session reliability, for differences between controls and people with moderate and severe MS disability, and for correlation with Expanded Disability Status Scale (EDSS) scores. The majority of gait measures showed good to excellent between-session reliability when assessed in a subgroup of 23 healthy controls and 25 people with MS. These measures showed that people with MS walked with significantly longer step and stride durations, reduced step and stride regularity, and experienced difficulties in controlling and maintaining a stable walk when compared to controls. These abnormalities significantly increased in people with a higher level of disability and correlated with their EDSS scores. Reliable and objective gait-based biomarkers using wearable sensors have been identified. These biomarkers may allow clinicians to quantify clinically relevant alterations in gait in people with progressive MS within the context of regular clinical visits. Keywords Test-retest reliability · Gait analysis · Balance · Temporal parameters · Regularity · Six-minute walk
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00415-020-09928-8) contains supplementary material, which is available to authorized users.
Multiple sclerosis (MS) is a common immune-mediated inflammatory and degenerative disease of the brain and spinal cord [1]. The initial clinical course is variable, but the majority of patients either present with or transition into a progressive course, characterised by the gradual
* Lorenza Angelini [email protected]
David Paling [email protected]
William Hodgkinson [email protected]
1
Department of Mechanical Engineering and Insigneo Institute for in silico Medicine, University of Sheffield, Pam Liversidge Building, Mappin Street, Sheffield S1 3JD, UK
2
Medical School, University of Sheffield, Sheffield, UK
3
Academic Department of Neuroscience, Sheffield NIHR Neuroscience BRC, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
4
Sheffield Institute of Translational Neuroscience, Sheffield Teaching Hospital NHS Fo
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