Gait abnormalities in minimally disabled people with Multiple Sclerosis: A 3D-motion analysis study

Liparoti, Marianna; Corte, Marida Della; Rucco, Rosaria; Sorrentino, Pierpaolo; Sparaco, Maddalena; Capuano, Rocco; Minino, Roberta; Lavorgna, Luigi; Agosti, Valeria; Sorrentino, Giuseppe

doi:10.1016/j.msard.2019.01.028

Cited by 42 publications

(42 citation statements)

References 68 publications

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“…Firstly, they assess only the time taken to execute the test (e.g., TUG and T25FW) or the distance travelled in a given time (6 min for the 6MWT), without providing objective measures of the different components and characteristics of the task that could be useful to describe how the performance is possibly impaired [11]. Secondly, these clinical tests have a relatively limited sensitivity to change [9,12,13] and a flooring effect [9,14] that makes it difficult to detect possible alterations in minimally impaired pwMS [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Is a Wearable Sensor-Based Characterisation of Gait Robust Enough to Overcome Differences Between Measurement Protocols? A Multi-Centric Pragmatic Study in Patients with Multiple Sclerosis

Angelini

Carpinella

Cattaneo

et al. 2019

Sensors

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Inertial measurement units (IMUs) allow accurate quantification of gait impairment of people with multiple sclerosis (pwMS). Nonetheless, it is not clear how IMU-based metrics might be influenced by pragmatic aspects associated with clinical translation of this approach, such as data collection settings and gait protocols. In this study, we hypothesised that these aspects do not significantly alter those characteristics of gait that are more related to quality and energetic efficiency and are quantifiable via acceleration related metrics, such as intensity, smoothness, stability, symmetry, and regularity. To test this hypothesis, we compared 33 IMU-based metrics extracted from data, retrospectively collected by two independent centres on two matched cohorts of pwMS. As a worst-case scenario, a walking test was performed in the two centres at a different speed along corridors of different lengths, using different IMU systems, which were also positioned differently. The results showed that the majority of the temporal metrics (9 out of 12) exhibited significant between-centre differences. Conversely, the between-centre differences in the gait quality metrics were small and comparable to those associated with a test-retest analysis under equivalent conditions. Therefore, the gait quality metrics are promising candidates for reliable multi-centric studies aiming at assessing rehabilitation interventions within a routine clinical context.

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Section: Introductionmentioning

confidence: 99%

Is a Wearable Sensor-Based Characterisation of Gait Robust Enough to Overcome Differences Between Measurement Protocols? A Multi-Centric Pragmatic Study in Patients with Multiple Sclerosis

Angelini

Carpinella

Cattaneo

et al. 2019

Sensors

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“…We found positive correlations between TDI and stability parameters such as stride width (r=0. 28 Finally, Figure 2c shows the positive correlation between TDI and clinical motor condition assessed trough the UPDRS-III score (r = 0.538, p < 0.001).…”

Section: Tdi Correlation Analysismentioning

confidence: 90%

“…The stability parameters consisted of stride width (meters), stance time (seconds), swing time (seconds), double limb support time (DLS) (seconds). For each spatio-temporal value (excluding speed) we computed the CV, a derived parameter expression of stability 28 , obtained by dividing the standard deviation by the mean value, then multiplying the result by one hundred.…”

Section: Spatiotemporal Parametersmentioning

confidence: 99%

A synthetic kinematic index of trunk displacement conveying the overall motor condition in Parkinson’s disease

Lopez

Minino

Sorrentino

et al. 2020

Preprint

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BACKGROUND: Parkinson's disease (PD) is characterized by motor impairment, affecting quality of life and increasing fall risk, due to ineffective postural control. To this day, the diagnosis remains based on clinical approach. Similarly, motor evaluation is based on heterogeneous, operator-dependent observational criteria. A synthetic, replicable index to quantify motor impairment is still lacking. In this paper, we build upon the idea that the trunk is crucial in balance control. Hence, we have designed a new measure of postural stability which assess the trunk displacement in relation to the center of mass, that we named trunk displacement index (TDI). METHODS: Twenty-three PD patients and twenty-three healthy controls underwent clinical (UPDRS-III) and motor examination (3D gait analysis). The TDI was extracted from kinematic measurements using a stereophotogrammetric system. A correlation analysis was performed to assess the relationship of TDI with typical gait parameters, to verify its biomechanical value, and UPDRS-III, to observe its clinical relevance. Finally, its sensitivity was measured, comparing pre- and post- L-DOPA subclinical intake. RESULTS: The TDI showed significant correlations with many gait parameters, including both velocity and stability characteristics of gait, and with the UPDRS-III. Finally, the TDI resulted capable in discriminating between off and on state in PD, whereas typical gait parameters failed two show any difference between those two conditions. CONCLUSIONS: Our results suggest that the TDI may be considered a highly sensitive biomechanical index, reflecting the overall motor condition in PD, and provided of clinical relevance due to the correlation with the clinical evaluation.

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“…The study of Liparoti et al showed a decrease in velocity and stability parameters in pwMS with minimal impairment during single task as well as dual task condition confirming previous observations of those spatiotemporal measurements. In regard of kinematics, they found an increased ankle dorsiflexion in the phase of single support, which they considered to be the earliest change in kinematics associated with velocity and stability changes (Liparoti et al, 2019).…”

Section: Video-based Analysis Systemsmentioning

confidence: 98%

“…Especially marker-based systems involve extensive technological and human resources as well as a longer preparation time reducing their practicability in clinical use (Shanahan et al, 2018). Although most of the trials combined video analysis techniques with force plates or electromyography (EMG), which assess spatiotemporal measurements, and connect kinematics with ground reaction forces or EMG results (Benedetti et al, 1999;Martin et al, 2006;Galea et al, 2017), some of the camera systems can generate spatiotemporal parameters independently (Behrens et al, 2014;Liparoti et al, 2019). Benedetti et al found that pwMS with EDSS 0-2 had increased flexion in hip, knee and ankle plantarflexion during initial contact, and reduced extension of hip and knee at the toe off phase.…”

Section: Video-based Analysis Systemsmentioning

confidence: 99%

The Dresden Protocol for Multidimensional Walking Assessment (DMWA) in Clinical Practice

et al. 2020

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Walking impairments represent one of the most debilitating symptom areas for people with multiple sclerosis (MS). It is important to detect even slightest walking impairments in order to start and optimize necessary interventions in time to counteract further progression of the disability. For this reason, a regular monitoring through gait analysis is highly necessary. At advanced stages of MS with significant walking impairment, this assessment is also necessary to optimize symptomatic treatment, choose the most suitable walking aid and plan individualized rehabilitation. In clinical practice, walking impairment is only assessed at higher levels of the disease using e.g., the Expanded Disability Status Scale (EDSS). In contrast to the EDSS, standardized functional tests such as walking speed, walking endurance and balance as well as walking quality and gait-related patient-reported outcomes allow a more holistic and sensitive assessment of walking impairment. In recent years, the MS Center Dresden has established a standardized monitoring procedure for the routine multidimensional assessment of gait and balance disorders. In the following protocol, we present the techniques and procedures for the analysis of gait and balance of people with MS at the MS Center Dresden. Patients are assessed with a multidimensional gait analysis at least once a year. This enables long-term monitoring of walking impairment, which allows early active intervention regarding further progression of disease and improves the current standard clinical practice.

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Gait abnormalities in minimally disabled people with Multiple Sclerosis: A 3D-motion analysis study

Cited by 42 publications

References 68 publications

Is a Wearable Sensor-Based Characterisation of Gait Robust Enough to Overcome Differences Between Measurement Protocols? A Multi-Centric Pragmatic Study in Patients with Multiple Sclerosis

Is a Wearable Sensor-Based Characterisation of Gait Robust Enough to Overcome Differences Between Measurement Protocols? A Multi-Centric Pragmatic Study in Patients with Multiple Sclerosis

A synthetic kinematic index of trunk displacement conveying the overall motor condition in Parkinson’s disease

The Dresden Protocol for Multidimensional Walking Assessment (DMWA) in Clinical Practice

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