Wearable sensors can reliably quantify gait alterations associated with disability in people with progressive multiple sclerosis in a clinical setting

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.

Evaluation of Prolonged Walking in Persons with Multiple Sclerosis: Reliability of the Spatio-Temporal Walking Variables during the 6-Minute Walk Test

“…Moreover, another study highlighted excellent reliability during a 6MWT (without the specific instruction to walk as long-distance as possible) with several walking parameter values acquired with small inertial sensors. In this study, the higher the EDSS score, the more the reliability was increased [27], which may explain the good to excellent reliability values in our study in persons with severe MS.…”

“…Although several studies have highlighted good reliability of the 6MWT score (i.e., the distance traveled in meters measured only one time at the end of the 6MWT) [16], little is known about the reliability of the ST variables across the 6MWT in PwMS with several measures during the 6MWT [27]. Moreover, to our knowledge, no study has analyzed the reliability of perceived exertion during the 6MWT (e.g., using the Borg scale).…”

Walking stability in patients with benign paroxysmal positional vertigo: an objective assessment using wearable accelerometers and machine learning

“…Walking stability during natural walking have been used to quantify the balance ability and disease severity, which can be accessed using wearable sensors without the limitations of a gait laboratory environment [11][12][13]. The sensor-based measurements of walking stability include acceleration root mean square (RMS) harmonic ratio (HR), gait variability, gait symmetry and gait regularity [14].…”

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

“…In a direct comparison of the Mobility Lab with the GAITRite system, Schmitz-Hübsch et al have demonstrated that the portable sensors meet the criteria for validity, reliability and objectivity (Schmitz-Hübsch et al, 2016). A recent work has confirmed that the opal sensors are reliable in test-retest analysis and suitable for clinical use (Angelini et al, 2020). We use six portable sensors for the analysis of balance carrying out the Romberg test and for the detailed analysis of different spatial and temporal gait parameters during the 2-MWT.…”