Clinic vs. daily life gait characteristics in patients with spinocerebellar ataxia

Recent findings suggest that a single gait assessment in a clinic may not reflect everyday mobility. We compared gait measures that best differentiated individuals with spinocerebellar ataxia (SCA) from age-matched healthy controls (HC) during a supervised gait test in the clinic vs. a week of unsup...

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Published in:Frontiers in digital health Vol. 7; p. 1590150
Main Authors: Shah, Vrutangkumar V., Muzyka, Daniel, Jagodinsky, Adam, Casey, Hannah, McNames, James, El-Gohary, Mahmoud, Sowalsky, Kristen, Safarpour, Delaram, Carlson-Kuhta, Patricia, Horak, Fay B., Gomez, Christopher M.
Format: Journal Article
Language:English
Published: Switzerland Frontiers Media S.A 2025
Subjects:
daily life monitoring
gait
IMUs
spinocerebellar ataxia
wearable technology
IMUs
wearable technology
gait
spinocerebellar ataxia
daily life monitoring
ISSN:2673-253X, 2673-253X
Online Access:Get full text
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Summary:Recent findings suggest that a single gait assessment in a clinic may not reflect everyday mobility. We compared gait measures that best differentiated individuals with spinocerebellar ataxia (SCA) from age-matched healthy controls (HC) during a supervised gait test in the clinic vs. a week of unsupervised gait during daily life. Twenty-six individuals with SCA types 1, 2, 3, and 6, and 13 (HC) wore three Opal inertial sensors (on both feet and lower back) during a 2-minute walk in the clinic and for seven days in daily life. Seventeen gait measures were analyzed to investigate the group differences using Mann-Whitney -tests and area under the curve (AUC). Ten gait measures were significantly worse in SCA than HC for the clinic test (  < 0.003), but only 3 were worse in daily life (  < 0.003). Only a few gait measures consistently discriminated groups in both environments. Specifically, variability in Swing Time and Double Support Time had AUCs of 0.99 (  < 0.0001) and 0.96 (  < 0.0001) in the clinic, and 0.84 (  < 0.0003) and 0.80 (  < 0.002) in daily life, respectively. Clinical gait measures showed stronger correlations with clinical outcomes (ie, SARA and FARS-ADL; r = 0.50-0.77) than between daily life gait measures (r = 0.31-0.49). Gait activity in daily life was not statistically significant between the SCA and HC groups (  > 0.06). Digital gait measures discriminate SCA in both environments. In-clinic measures are more sensitive, while daily life measures provide ecological validity, highlighting a trade-off and offering complementary insights.
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ISSN:2673-253X
2673-253X
DOI:10.3389/fdgth.2025.1590150