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

People with multiple sclerosis (pwMS) often suffer from gait impairments. These changes in gait have been well studied 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 pre...

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Veröffentlicht in:Journal of neurology Jg. 267; H. 7; S. 1912 - 1921
Hauptverfasser: Shema-Shiratzky, Shirley, Hillel, Inbar, Mirelman, Anat, Regev, Keren, Hsieh, Katherine L., Karni, Arnon, Devos, Hannes, Sosnoff, Jacob J., Hausdorff, Jeffrey M.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Berlin/Heidelberg Springer Berlin Heidelberg 01.07.2020
Springer Nature B.V
Schlagworte:
Accelerometry
Adult
Exercise
Exercise - physiology
Female
Gait
Gait Disorders, Neurologic - diagnosis
Gait Disorders, Neurologic - etiology
Gait Disorders, Neurologic - physiopathology
Humans
Laboratories
Male
Medicine
Medicine & Public Health
Middle Aged
Multiple sclerosis
Multiple Sclerosis - complications
Multiple Sclerosis - physiopathology
Neurology
Neuroradiology
Neurosciences
Original Communication
Physical activity
Rehabilitation
Severity of Illness Index
Walking
Walking - physiology
Wearable Electronic Devices
Multiple sclerosis
Gait
Daily living
Wearables
Accelerometer
Activity
Inertial measurement units
ISSN:0340-5354, 1432-1459, 1432-1459
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Zusammenfassung:People with multiple sclerosis (pwMS) often suffer from gait impairments. These changes in gait have been well studied 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.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:0340-5354
1432-1459
1432-1459
DOI:10.1007/s00415-020-09759-7