Development and validation of a composite digital balance score for spinocerebellar ataxia: a prospective study
Clinical trials in spinocerebellar ataxia are currently limited by the large sample sizes required by available clinical endpoints. We aimed to devise a digital composite measure of standing and walking balance using wearable inertial sensors that would require smaller sample sizes. The new score is...
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| Vydané v: | The Lancet. Digital health Ročník 7; číslo 9; s. 100905 |
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| Hlavní autori: | , , , , , , , , , , , , , |
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| Jazyk: | English |
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Elsevier Ltd
01.09.2025
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| ISSN: | 2589-7500, 2589-7500 |
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| Abstract | Clinical trials in spinocerebellar ataxia are currently limited by the large sample sizes required by available clinical endpoints. We aimed to devise a digital composite measure of standing and walking balance using wearable inertial sensors that would require smaller sample sizes. The new score is called the Score of Integrated Balance in Ataxia (SIBA).
In this study, we developed the SIBA based on a retrospective sample of adults (aged 18–75 years) with spinocerebellar ataxia types 1, 2, 3, or 6, recruited during clinical visits at five sites (four in the USA and one in Cuba) between June 23, 2017, and Aug 21, 2024. Participants were included if they had genetic confirmation of spinocerebellar ataxia, and were able to provide consent, walk 10 m independently without an assistive device, and stand unassisted for 30 s. A cohort of age-specific and sex-matched healthy controls were recruited from family members of the patients. To validate the SIBA, an independent sample of individuals with the same types of ataxias were recruited along with age-matched and sex-matched healthy controls from five centres in the USA (NCT04268147) between June 1, 2019, and April 30, 2024. We performed balance and gait assessments using six wearable sensors (Opal inertial measurement units, APDM Precision Motion, Clario, Portland, OR, USA) on the dorsum of each foot and hand, on the sternum, and on the lower lumbar (trunk) vertebral segments. We used the data from this assessment to develop a composite score from walking at a natural pace for 2 min and standing with feet together and apart for 30 s. We used a multiple criteria decision analysis to weight the relative importance of criteria to guide development of the score. The criteria represented the ability to distinguish groups with known differences, construct validity, reliability, progression, meaningfulness, and concurrent validity. The final composite score integrated two dynamic balance variables from gait (variability of toe-out and double-support time proportion of the gait cycle) and two static balance variables from stance (sway angle root mean square with normal stance width and sway acceleration root mean square with feet together). We compared the SIBA to the Scale for the Assessment and Rating of Ataxia (SARA) for reliability, the ability to distinguish between groups with known differences, construct validity, convergent validity, and the ability to track disease progression.
We included 258 individuals (131 females and 127 males) with spinocerebellar ataxia types 1, 2, 3, or 6 (40 premanifest and 218 ataxic) and 100 healthy controls (45 females and 55 males) in the development study; and 53 individuals (27 females and 26 males) with spinocerebellar ataxia types 1, 2, 3, or 6 and 24 healthy controls (14 females and 10 males) in the validation study. The SIBA showed concurrent validity with the SARA (r=0·736). The SIBA was also reliable (test–retest reliability; intraclass correlation coefficient=0·970), could distinguish between participants and healthy controls (area under the receiver operating characteristic curve [AUROC]=0·956), and related to fall risk (AUROC=0·760) in a validation cohort of ambulatory participants with spinocerebellar ataxia, independent from the larger, score-development cohort. Progression of ataxia over 1 year had an effect size five times larger than the SARA score (0·59 vs 0·11). Based on these estimates, clinical trials using the SIBA would require 88% fewer participants than SARA (171 vs 1491) to detect a 50% reduction in the rate of 1-year progression.
SIBA is a suitable digital measure of static and dynamic balance for the most common spinocerebellar ataxias in clinical trials. It may permit clinical trials to be completed more rapidly and with fewer participants. Future trials on responsiveness of the SIBA to interventions are needed in larger cohorts.
Biogen, Clario, Pfizer, and the Alexander von Humboldt Foundation. |
|---|---|
| AbstractList | Clinical trials in spinocerebellar ataxia are currently limited by the large sample sizes required by available clinical endpoints. We aimed to devise a digital composite measure of standing and walking balance using wearable inertial sensors that would require smaller sample sizes. The new score is called the Score of Integrated Balance in Ataxia (SIBA).BACKGROUNDClinical trials in spinocerebellar ataxia are currently limited by the large sample sizes required by available clinical endpoints. We aimed to devise a digital composite measure of standing and walking balance using wearable inertial sensors that would require smaller sample sizes. The new score is called the Score of Integrated Balance in Ataxia (SIBA).In this study, we developed the SIBA based on a retrospective sample of adults (aged 18-75 years) with spinocerebellar ataxia types 1, 2, 3, or 6, recruited during clinical visits at five sites (four in the USA and one in Cuba) between June 23, 2017, and Aug 21, 2024. Participants were included if they had genetic confirmation of spinocerebellar ataxia, and were able to provide consent, walk 10 m independently without an assistive device, and stand unassisted for 30 s. A cohort of age-specific and sex-matched healthy controls were recruited from family members of the patients. To validate the SIBA, an independent sample of individuals with the same types of ataxias were recruited along with age-matched and sex-matched healthy controls from five centres in the USA (NCT04268147) between June 1, 2019, and April 30, 2024. We performed balance and gait assessments using six wearable sensors (Opal inertial measurement units, APDM Precision Motion, Clario, Portland, OR, USA) on the dorsum of each foot and hand, on the sternum, and on the lower lumbar (trunk) vertebral segments. We used the data from this assessment to develop a composite score from walking at a natural pace for 2 min and standing with feet together and apart for 30 s. We used a multiple criteria decision analysis to weight the relative importance of criteria to guide development of the score. The criteria represented the ability to distinguish groups with known differences, construct validity, reliability, progression, meaningfulness, and concurrent validity. The final composite score integrated two dynamic balance variables from gait (variability of toe-out and double-support time proportion of the gait cycle) and two static balance variables from stance (sway angle root mean square with normal stance width and sway acceleration root mean square with feet together). We compared the SIBA to the Scale for the Assessment and Rating of Ataxia (SARA) for reliability, the ability to distinguish between groups with known differences, construct validity, convergent validity, and the ability to track disease progression.METHODSIn this study, we developed the SIBA based on a retrospective sample of adults (aged 18-75 years) with spinocerebellar ataxia types 1, 2, 3, or 6, recruited during clinical visits at five sites (four in the USA and one in Cuba) between June 23, 2017, and Aug 21, 2024. Participants were included if they had genetic confirmation of spinocerebellar ataxia, and were able to provide consent, walk 10 m independently without an assistive device, and stand unassisted for 30 s. A cohort of age-specific and sex-matched healthy controls were recruited from family members of the patients. To validate the SIBA, an independent sample of individuals with the same types of ataxias were recruited along with age-matched and sex-matched healthy controls from five centres in the USA (NCT04268147) between June 1, 2019, and April 30, 2024. We performed balance and gait assessments using six wearable sensors (Opal inertial measurement units, APDM Precision Motion, Clario, Portland, OR, USA) on the dorsum of each foot and hand, on the sternum, and on the lower lumbar (trunk) vertebral segments. We used the data from this assessment to develop a composite score from walking at a natural pace for 2 min and standing with feet together and apart for 30 s. We used a multiple criteria decision analysis to weight the relative importance of criteria to guide development of the score. The criteria represented the ability to distinguish groups with known differences, construct validity, reliability, progression, meaningfulness, and concurrent validity. The final composite score integrated two dynamic balance variables from gait (variability of toe-out and double-support time proportion of the gait cycle) and two static balance variables from stance (sway angle root mean square with normal stance width and sway acceleration root mean square with feet together). We compared the SIBA to the Scale for the Assessment and Rating of Ataxia (SARA) for reliability, the ability to distinguish between groups with known differences, construct validity, convergent validity, and the ability to track disease progression.We included 258 individuals (131 females and 127 males) with spinocerebellar ataxia types 1, 2, 3, or 6 (40 premanifest and 218 ataxic) and 100 healthy controls (45 females and 55 males) in the development study; and 53 individuals (27 females and 26 males) with spinocerebellar ataxia types 1, 2, 3, or 6 and 24 healthy controls (14 females and 10 males) in the validation study. The SIBA showed concurrent validity with the SARA (r=0·736). The SIBA was also reliable (test-retest reliability; intraclass correlation coefficient=0·970), could distinguish between participants and healthy controls (area under the receiver operating characteristic curve [AUROC]=0·956), and related to fall risk (AUROC=0·760) in a validation cohort of ambulatory participants with spinocerebellar ataxia, independent from the larger, score-development cohort. Progression of ataxia over 1 year had an effect size five times larger than the SARA score (0·59 vs 0·11). Based on these estimates, clinical trials using the SIBA would require 88% fewer participants than SARA (171 vs 1491) to detect a 50% reduction in the rate of 1-year progression.FINDINGSWe included 258 individuals (131 females and 127 males) with spinocerebellar ataxia types 1, 2, 3, or 6 (40 premanifest and 218 ataxic) and 100 healthy controls (45 females and 55 males) in the development study; and 53 individuals (27 females and 26 males) with spinocerebellar ataxia types 1, 2, 3, or 6 and 24 healthy controls (14 females and 10 males) in the validation study. The SIBA showed concurrent validity with the SARA (r=0·736). The SIBA was also reliable (test-retest reliability; intraclass correlation coefficient=0·970), could distinguish between participants and healthy controls (area under the receiver operating characteristic curve [AUROC]=0·956), and related to fall risk (AUROC=0·760) in a validation cohort of ambulatory participants with spinocerebellar ataxia, independent from the larger, score-development cohort. Progression of ataxia over 1 year had an effect size five times larger than the SARA score (0·59 vs 0·11). Based on these estimates, clinical trials using the SIBA would require 88% fewer participants than SARA (171 vs 1491) to detect a 50% reduction in the rate of 1-year progression.SIBA is a suitable digital measure of static and dynamic balance for the most common spinocerebellar ataxias in clinical trials. It may permit clinical trials to be completed more rapidly and with fewer participants. Future trials on responsiveness of the SIBA to interventions are needed in larger cohorts.INTERPRETATIONSIBA is a suitable digital measure of static and dynamic balance for the most common spinocerebellar ataxias in clinical trials. It may permit clinical trials to be completed more rapidly and with fewer participants. Future trials on responsiveness of the SIBA to interventions are needed in larger cohorts.Biogen, Clario, Pfizer, and the Alexander von Humboldt Foundation.FUNDINGBiogen, Clario, Pfizer, and the Alexander von Humboldt Foundation. SummaryBackgroundClinical trials in spinocerebellar ataxia are currently limited by the large sample sizes required by available clinical endpoints. We aimed to devise a digital composite measure of standing and walking balance using wearable inertial sensors that would require smaller sample sizes. The new score is called the Score of Integrated Balance in Ataxia (SIBA). MethodsIn this study, we developed the SIBA based on a retrospective sample of adults (aged 18–75 years) with spinocerebellar ataxia types 1, 2, 3, or 6, recruited during clinical visits at five sites (four in the USA and one in Cuba) between June 23, 2017, and Aug 21, 2024. Participants were included if they had genetic confirmation of spinocerebellar ataxia, and were able to provide consent, walk 10 m independently without an assistive device, and stand unassisted for 30 s. A cohort of age-specific and sex-matched healthy controls were recruited from family members of the patients. To validate the SIBA, an independent sample of individuals with the same types of ataxias were recruited along with age-matched and sex-matched healthy controls from five centres in the USA ( NCT04268147) between June 1, 2019, and April 30, 2024. We performed balance and gait assessments using six wearable sensors (Opal inertial measurement units, APDM Precision Motion, Clario, Portland, OR, USA) on the dorsum of each foot and hand, on the sternum, and on the lower lumbar (trunk) vertebral segments. We used the data from this assessment to develop a composite score from walking at a natural pace for 2 min and standing with feet together and apart for 30 s. We used a multiple criteria decision analysis to weight the relative importance of criteria to guide development of the score. The criteria represented the ability to distinguish groups with known differences, construct validity, reliability, progression, meaningfulness, and concurrent validity. The final composite score integrated two dynamic balance variables from gait (variability of toe-out and double-support time proportion of the gait cycle) and two static balance variables from stance (sway angle root mean square with normal stance width and sway acceleration root mean square with feet together). We compared the SIBA to the Scale for the Assessment and Rating of Ataxia (SARA) for reliability, the ability to distinguish between groups with known differences, construct validity, convergent validity, and the ability to track disease progression. FindingsWe included 258 individuals (131 females and 127 males) with spinocerebellar ataxia types 1, 2, 3, or 6 (40 premanifest and 218 ataxic) and 100 healthy controls (45 females and 55 males) in the development study; and 53 individuals (27 females and 26 males) with spinocerebellar ataxia types 1, 2, 3, or 6 and 24 healthy controls (14 females and 10 males) in the validation study. The SIBA showed concurrent validity with the SARA (r=0·736). The SIBA was also reliable (test–retest reliability; intraclass correlation coefficient=0·970), could distinguish between participants and healthy controls (area under the receiver operating characteristic curve [AUROC]=0·956), and related to fall risk (AUROC=0·760) in a validation cohort of ambulatory participants with spinocerebellar ataxia, independent from the larger, score-development cohort. Progression of ataxia over 1 year had an effect size five times larger than the SARA score (0·59 vs 0·11). Based on these estimates, clinical trials using the SIBA would require 88% fewer participants than SARA (171 vs 1491) to detect a 50% reduction in the rate of 1-year progression. InterpretationSIBA is a suitable digital measure of static and dynamic balance for the most common spinocerebellar ataxias in clinical trials. It may permit clinical trials to be completed more rapidly and with fewer participants. Future trials on responsiveness of the SIBA to interventions are needed in larger cohorts. FundingBiogen, Clario, Pfizer, and the Alexander von Humboldt Foundation. Clinical trials in spinocerebellar ataxia are currently limited by the large sample sizes required by available clinical endpoints. We aimed to devise a digital composite measure of standing and walking balance using wearable inertial sensors that would require smaller sample sizes. The new score is called the Score of Integrated Balance in Ataxia (SIBA). In this study, we developed the SIBA based on a retrospective sample of adults (aged 18–75 years) with spinocerebellar ataxia types 1, 2, 3, or 6, recruited during clinical visits at five sites (four in the USA and one in Cuba) between June 23, 2017, and Aug 21, 2024. Participants were included if they had genetic confirmation of spinocerebellar ataxia, and were able to provide consent, walk 10 m independently without an assistive device, and stand unassisted for 30 s. A cohort of age-specific and sex-matched healthy controls were recruited from family members of the patients. To validate the SIBA, an independent sample of individuals with the same types of ataxias were recruited along with age-matched and sex-matched healthy controls from five centres in the USA (NCT04268147) between June 1, 2019, and April 30, 2024. We performed balance and gait assessments using six wearable sensors (Opal inertial measurement units, APDM Precision Motion, Clario, Portland, OR, USA) on the dorsum of each foot and hand, on the sternum, and on the lower lumbar (trunk) vertebral segments. We used the data from this assessment to develop a composite score from walking at a natural pace for 2 min and standing with feet together and apart for 30 s. We used a multiple criteria decision analysis to weight the relative importance of criteria to guide development of the score. The criteria represented the ability to distinguish groups with known differences, construct validity, reliability, progression, meaningfulness, and concurrent validity. The final composite score integrated two dynamic balance variables from gait (variability of toe-out and double-support time proportion of the gait cycle) and two static balance variables from stance (sway angle root mean square with normal stance width and sway acceleration root mean square with feet together). We compared the SIBA to the Scale for the Assessment and Rating of Ataxia (SARA) for reliability, the ability to distinguish between groups with known differences, construct validity, convergent validity, and the ability to track disease progression. We included 258 individuals (131 females and 127 males) with spinocerebellar ataxia types 1, 2, 3, or 6 (40 premanifest and 218 ataxic) and 100 healthy controls (45 females and 55 males) in the development study; and 53 individuals (27 females and 26 males) with spinocerebellar ataxia types 1, 2, 3, or 6 and 24 healthy controls (14 females and 10 males) in the validation study. The SIBA showed concurrent validity with the SARA (r=0·736). The SIBA was also reliable (test–retest reliability; intraclass correlation coefficient=0·970), could distinguish between participants and healthy controls (area under the receiver operating characteristic curve [AUROC]=0·956), and related to fall risk (AUROC=0·760) in a validation cohort of ambulatory participants with spinocerebellar ataxia, independent from the larger, score-development cohort. Progression of ataxia over 1 year had an effect size five times larger than the SARA score (0·59 vs 0·11). Based on these estimates, clinical trials using the SIBA would require 88% fewer participants than SARA (171 vs 1491) to detect a 50% reduction in the rate of 1-year progression. SIBA is a suitable digital measure of static and dynamic balance for the most common spinocerebellar ataxias in clinical trials. It may permit clinical trials to be completed more rapidly and with fewer participants. Future trials on responsiveness of the SIBA to interventions are needed in larger cohorts. Biogen, Clario, Pfizer, and the Alexander von Humboldt Foundation. |
| ArticleNumber | 100905 |
| Author | Carlson-Kuhta, Patricia Horak, Fay B Safarpour, Delaram Velázquez-Pérez, Luis Schmahmann, Jeremy D Gomez, Christopher M Rodríguez-Labrada, Roberto Shah, Vrutangkumar V Rosenthal, Liana S Casey, Hannah L El-Gohary, Mahmoud McNames, James Sowalsky, Kristen L Perlman, Susan |
| Author_xml | – sequence: 1 givenname: James orcidid: 0000-0001-8091-3560 surname: McNames fullname: McNames, James email: mcnames@pdx.edu organization: Department of Electrical and Computer Engineering, Portland State University, Portland, OR, USA – sequence: 2 givenname: Vrutangkumar V orcidid: 0000-0002-8626-1089 surname: Shah fullname: Shah, Vrutangkumar V organization: Precision Motion, APDM Wearable Technologies of Clario, Portland, OR, USA – sequence: 3 givenname: Hannah L orcidid: 0000-0002-6562-4020 surname: Casey fullname: Casey, Hannah L organization: Department of Neurology, University of Chicago, Chicago, IL, USA – sequence: 4 givenname: Kristen L surname: Sowalsky fullname: Sowalsky, Kristen L organization: Precision Motion, APDM Wearable Technologies of Clario, Portland, OR, USA – sequence: 5 givenname: Mahmoud surname: El-Gohary fullname: El-Gohary, Mahmoud organization: Precision Motion, APDM Wearable Technologies of Clario, Portland, OR, USA – sequence: 6 givenname: Delaram surname: Safarpour fullname: Safarpour, Delaram organization: Department of Neurology, Oregon Health & Science University, Portland, OR, USA – sequence: 7 givenname: Patricia orcidid: 0000-0002-5794-4155 surname: Carlson-Kuhta fullname: Carlson-Kuhta, Patricia organization: Department of Neurology, Oregon Health & Science University, Portland, OR, USA – sequence: 8 givenname: Jeremy D surname: Schmahmann fullname: Schmahmann, Jeremy D organization: Ataxia Center, Laboratory for Neuroanatomy and Cerebellar Neurobiology, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA – sequence: 9 givenname: Liana S surname: Rosenthal fullname: Rosenthal, Liana S organization: Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA – sequence: 10 givenname: Susan surname: Perlman fullname: Perlman, Susan organization: Department of Neurology, University of California, Los Angeles, CA, USA – sequence: 11 givenname: Roberto orcidid: 0000-0003-3193-7683 surname: Rodríguez-Labrada fullname: Rodríguez-Labrada, Roberto organization: Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba – sequence: 12 givenname: Luis surname: Velázquez-Pérez fullname: Velázquez-Pérez, Luis organization: Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba – sequence: 13 givenname: Fay B surname: Horak fullname: Horak, Fay B organization: Precision Motion, APDM Wearable Technologies of Clario, Portland, OR, USA – sequence: 14 givenname: Christopher M surname: Gomez fullname: Gomez, Christopher M organization: Department of Neurology, University of Chicago, Chicago, IL, USA |
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| Cites_doi | 10.1002/mds.29742 10.1016/S0022-510X(96)00231-6 10.1007/s12311-023-01625-2 10.1159/000342907 10.1212/01.wnl.0000219042.60538.92 10.1016/j.parkreldis.2025.107278 10.1016/S1474-4422(15)00202-1 10.1093/gerona/50A.1.M28 10.1007/s12311-010-0155-z 10.1212/01.WNL.0000156802.15466.79 10.1038/s41572-019-0074-3 10.1016/B978-0-323-98818-6.00021-2 10.1002/mds.29757 10.5334/ijic.65 10.1007/s00415-024-12475-1 10.1002/mds.29206 10.1002/mds.25684 10.2522/ptj.20150580 10.1016/j.gaitpost.2017.11.024 10.1037/1082-989X.1.1.30 10.1002/mds.28740 10.1002/mds.28670 10.1016/j.jval.2015.12.003 10.1186/s40673-015-0028-9 10.1002/mds.28343 10.1016/S0268-0033(96)00040-X |
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| References | Schmahmann, Pierce, MacMore, L’Italien (bib16) 2021; 36 Schmitz-Hübsch, du Montcel, Baliko (bib2) 2006; 66 Ilg, Müller, Faber (bib7) 2022; 37 Middel, van Sonderen (bib20) 2002; 2 Fonteyn, Schmitz-Hübsch, Verstappen (bib27) 2013; 69 Velázquez-Pérez, Rodriguez-Labrada, González-Garcés (bib12) 2021; 36 Powell, Myers (bib15) 1995; 50A Seemann, Daghsen, Cazier (bib10) 2024; 39 McIlroy, Maki (bib14) 1997; 12 Takakusaki (bib23) 2023; 195 Fonteyn, Schmitz-Hübsch, Verstappen (bib28) 2010; 9 Gurfinkel, Cacciatore, Cordo, Horak (bib22) 2011; 58 Subramony, May, Lynch (bib5) 2005; 64 McGraw, Wong (bib17) 1996; 1 Levy (bib18) 2008 Efron, Tibshirani (bib19) 1994 Buckley, Mazzà, McNeill (bib1) 2018; 60 Trouillas, Takayanagi, Hallett (bib4) 1997; 145 Thokala, Devlin, Marsh (bib26) 2016; 19 Shah, Rodriguez-Labrada, Horak (bib9) 2021; 36 Horak, Mancini, Carlson-Kuhta, Nutt, Salarian (bib21) 2016; 96 Jacobi, du Montcel, Bauer (bib3) 2015; 14 Ilg, Milne, Schmitz-Hübsch (bib25) 2024; 23 Horak, Mancini (bib8) 2013; 28 Klockgether, Mariotti, Paulson (bib6) 2019; 5 Vizcarra, Casey, Hamedani, Gomez (bib30) 2025; 132 Shah, Muzyka, Jagodinsky (bib11) 2024; 39 Petit, Schmitz-Hübsch, Coarelli (bib29) 2024; 271 Kandel, Koester, Mack, Siegelbaum (bib24) 2021 Matsushima, Yoshida, Genno (bib13) 2015; 2 Horak (10.1016/j.landig.2025.100905_bib21) 2016; 96 Shah (10.1016/j.landig.2025.100905_bib9) 2021; 36 Seemann (10.1016/j.landig.2025.100905_bib10) 2024; 39 Efron (10.1016/j.landig.2025.100905_bib19) 1994 Buckley (10.1016/j.landig.2025.100905_bib1) 2018; 60 Trouillas (10.1016/j.landig.2025.100905_bib4) 1997; 145 Levy (10.1016/j.landig.2025.100905_bib18) 2008 Fonteyn (10.1016/j.landig.2025.100905_bib27) 2013; 69 Kandel (10.1016/j.landig.2025.100905_bib24) 2021 Velázquez-Pérez (10.1016/j.landig.2025.100905_bib12) 2021; 36 Powell (10.1016/j.landig.2025.100905_bib15) 1995; 50A Takakusaki (10.1016/j.landig.2025.100905_bib23) 2023; 195 Shah (10.1016/j.landig.2025.100905_bib11) 2024; 39 Fonteyn (10.1016/j.landig.2025.100905_bib28) 2010; 9 Middel (10.1016/j.landig.2025.100905_bib20) 2002; 2 Schmitz-Hübsch (10.1016/j.landig.2025.100905_bib2) 2006; 66 Matsushima (10.1016/j.landig.2025.100905_bib13) 2015; 2 Klockgether (10.1016/j.landig.2025.100905_bib6) 2019; 5 Schmahmann (10.1016/j.landig.2025.100905_bib16) 2021; 36 McGraw (10.1016/j.landig.2025.100905_bib17) 1996; 1 Thokala (10.1016/j.landig.2025.100905_bib26) 2016; 19 Subramony (10.1016/j.landig.2025.100905_bib5) 2005; 64 Horak (10.1016/j.landig.2025.100905_bib8) 2013; 28 McIlroy (10.1016/j.landig.2025.100905_bib14) 1997; 12 Jacobi (10.1016/j.landig.2025.100905_bib3) 2015; 14 Gurfinkel (10.1016/j.landig.2025.100905_bib22) 2011; 58 Ilg (10.1016/j.landig.2025.100905_bib7) 2022; 37 Ilg (10.1016/j.landig.2025.100905_bib25) 2024; 23 Petit (10.1016/j.landig.2025.100905_bib29) 2024; 271 Vizcarra (10.1016/j.landig.2025.100905_bib30) 2025; 132 |
| References_xml | – volume: 64 start-page: 1261 year: 2005 end-page: 1262 ident: bib5 article-title: Measuring Friedreich ataxia: interrater reliability of a neurologic rating scale publication-title: Neurology – volume: 96 start-page: 1364 year: 2016 end-page: 1371 ident: bib21 article-title: Balance and gait represent independent domains of mobility in Parkinson disease publication-title: Phys Ther – volume: 36 start-page: 471 year: 2021 end-page: 480 ident: bib12 article-title: Prodromal spinocerebellar ataxia type 2 subjects have quantifiable gait and postural sway deficits publication-title: Mov Disord – year: 2008 ident: bib18 article-title: Principles of signal detection and parameter estimation – volume: 50A start-page: M28 year: 1995 end-page: M34 ident: bib15 article-title: The Activities-specific Balance Confidence (ABC) Scale publication-title: J Gerontol A Biol Sci Med Sci – volume: 58 start-page: 3677 year: 2011 ident: bib22 article-title: Method to measure tone of axial and proximal muscle publication-title: J Vis Exp – volume: 23 start-page: 1566 year: 2024 end-page: 1592 ident: bib25 article-title: Quantitative gait and balance outcomes for ataxia trials: consensus recommendations by the Ataxia Global Initiative Working Group on Digital-Motor Biomarkers publication-title: Cerebellum – volume: 39 start-page: 663 year: 2024 end-page: 673 ident: bib11 article-title: Digital measures of postural sway quantify balance deficits in spinocerebellar ataxia publication-title: Mov Disord – volume: 36 start-page: 2367 year: 2021 end-page: 2377 ident: bib16 article-title: Development and validation of a patient-reported outcome measure of ataxia publication-title: Mov Disord – volume: 145 start-page: 205 year: 1997 end-page: 211 ident: bib4 article-title: International Cooperative Ataxia Rating Scale for pharmacological assessment of the cerebellar syndrome publication-title: J Neurol Sci – volume: 9 start-page: 232 year: 2010 end-page: 239 ident: bib28 article-title: Falls in spinocerebellar ataxias: results of the EuroSCA Fall Study publication-title: Cerebellum – volume: 69 start-page: 53 year: 2013 end-page: 57 ident: bib27 article-title: Prospective analysis of falls in dominant ataxias publication-title: Eur Neurol – volume: 2 start-page: 9 year: 2015 ident: bib13 article-title: Clinical assessment of standing and gait in ataxic patients using a triaxial accelerometer publication-title: Cerebellum Ataxias – volume: 19 start-page: 1 year: 2016 end-page: 13 ident: bib26 article-title: Multiple criteria decision analysis for health care decision making—an introduction: report 1 of the ISPOR MCDA Emerging Good Practices Task Force publication-title: Value Health – volume: 14 start-page: 1101 year: 2015 end-page: 1108 ident: bib3 article-title: Long-term disease progression in spinocerebellar ataxia types 1, 2, 3, and 6: a longitudinal cohort study publication-title: Lancet Neurol – volume: 12 start-page: 66 year: 1997 end-page: 70 ident: bib14 article-title: Preferred placement of the feet during quiet stance: development of a standardized foot placement for balance testing publication-title: Clin Biomech (Bristol) – volume: 28 start-page: 1544 year: 2013 end-page: 1551 ident: bib8 article-title: Objective biomarkers of balance and gait for Parkinson’s disease using body-worn sensors publication-title: Mov Disord – volume: 1 start-page: 30 year: 1996 end-page: 46 ident: bib17 article-title: Forming inferences about some intraclass correlation coefficients publication-title: Psychol Methods – volume: 5 start-page: 24 year: 2019 ident: bib6 article-title: Spinocerebellar ataxia publication-title: Nat Rev Dis Primers – volume: 36 start-page: 2922 year: 2021 end-page: 2931 ident: bib9 article-title: Gait variability in spinocerebellar ataxia assessed using wearable inertial sensors publication-title: Mov Disord – volume: 195 start-page: 103 year: 2023 end-page: 126 ident: bib23 article-title: Gait control by the frontal lobe publication-title: Handb Clin Neurol – volume: 132 year: 2025 ident: bib30 article-title: Reliability of remote video ratings of the scale for assessment and rating of ataxia publication-title: Parkinsonism Relat Disord – volume: 66 start-page: 1717 year: 2006 end-page: 1720 ident: bib2 article-title: Scale for the assessment and rating of ataxia: development of a new clinical scale publication-title: Neurology – year: 2021 ident: bib24 article-title: Principles of neural science – volume: 60 start-page: 154 year: 2018 end-page: 163 ident: bib1 article-title: A systematic review of the gait characteristics associated with cerebellar ataxia publication-title: Gait Posture – volume: 39 start-page: 788 year: 2024 end-page: 797 ident: bib10 article-title: Digital gait measures capture 1-year progression in early-stage spinocerebellar ataxia type 2 publication-title: Mov Disord – volume: 37 start-page: 2295 year: 2022 end-page: 2301 ident: bib7 article-title: Digital gait biomarkers allow to capture 1-year longitudinal change in spinocerebellar ataxia type 3 publication-title: Mov Disord – volume: 2 start-page: e15 year: 2002 ident: bib20 article-title: Statistical significant change versus relevant or important change in (quasi) experimental design: some conceptual and methodological problems in estimating magnitude of intervention-related change in health services research publication-title: Int J Integr Care – year: 1994 ident: bib19 publication-title: An introduction to the bootstrap – volume: 271 start-page: 3743 year: 2024 end-page: 3753 ident: bib29 article-title: SARA captures disparate progression and responsiveness in spinocerebellar ataxias publication-title: J Neurol – volume: 39 start-page: 663 year: 2024 ident: 10.1016/j.landig.2025.100905_bib11 article-title: Digital measures of postural sway quantify balance deficits in spinocerebellar ataxia publication-title: Mov Disord doi: 10.1002/mds.29742 – volume: 145 start-page: 205 year: 1997 ident: 10.1016/j.landig.2025.100905_bib4 article-title: International Cooperative Ataxia Rating Scale for pharmacological assessment of the cerebellar syndrome publication-title: J Neurol Sci doi: 10.1016/S0022-510X(96)00231-6 – volume: 23 start-page: 1566 year: 2024 ident: 10.1016/j.landig.2025.100905_bib25 article-title: Quantitative gait and balance outcomes for ataxia trials: consensus recommendations by the Ataxia Global Initiative Working Group on Digital-Motor Biomarkers publication-title: Cerebellum doi: 10.1007/s12311-023-01625-2 – volume: 69 start-page: 53 year: 2013 ident: 10.1016/j.landig.2025.100905_bib27 article-title: Prospective analysis of falls in dominant ataxias publication-title: Eur Neurol doi: 10.1159/000342907 – volume: 66 start-page: 1717 year: 2006 ident: 10.1016/j.landig.2025.100905_bib2 article-title: Scale for the assessment and rating of ataxia: development of a new clinical scale publication-title: Neurology doi: 10.1212/01.wnl.0000219042.60538.92 – volume: 132 year: 2025 ident: 10.1016/j.landig.2025.100905_bib30 article-title: Reliability of remote video ratings of the scale for assessment and rating of ataxia publication-title: Parkinsonism Relat Disord doi: 10.1016/j.parkreldis.2025.107278 – year: 2008 ident: 10.1016/j.landig.2025.100905_bib18 – volume: 58 start-page: 3677 year: 2011 ident: 10.1016/j.landig.2025.100905_bib22 article-title: Method to measure tone of axial and proximal muscle publication-title: J Vis Exp – volume: 14 start-page: 1101 year: 2015 ident: 10.1016/j.landig.2025.100905_bib3 article-title: Long-term disease progression in spinocerebellar ataxia types 1, 2, 3, and 6: a longitudinal cohort study publication-title: Lancet Neurol doi: 10.1016/S1474-4422(15)00202-1 – volume: 50A start-page: M28 year: 1995 ident: 10.1016/j.landig.2025.100905_bib15 article-title: The Activities-specific Balance Confidence (ABC) Scale publication-title: J Gerontol A Biol Sci Med Sci doi: 10.1093/gerona/50A.1.M28 – volume: 9 start-page: 232 year: 2010 ident: 10.1016/j.landig.2025.100905_bib28 article-title: Falls in spinocerebellar ataxias: results of the EuroSCA Fall Study publication-title: Cerebellum doi: 10.1007/s12311-010-0155-z – volume: 64 start-page: 1261 year: 2005 ident: 10.1016/j.landig.2025.100905_bib5 article-title: Measuring Friedreich ataxia: interrater reliability of a neurologic rating scale publication-title: Neurology doi: 10.1212/01.WNL.0000156802.15466.79 – volume: 5 start-page: 24 year: 2019 ident: 10.1016/j.landig.2025.100905_bib6 article-title: Spinocerebellar ataxia publication-title: Nat Rev Dis Primers doi: 10.1038/s41572-019-0074-3 – volume: 195 start-page: 103 year: 2023 ident: 10.1016/j.landig.2025.100905_bib23 article-title: Gait control by the frontal lobe publication-title: Handb Clin Neurol doi: 10.1016/B978-0-323-98818-6.00021-2 – volume: 39 start-page: 788 year: 2024 ident: 10.1016/j.landig.2025.100905_bib10 article-title: Digital gait measures capture 1-year progression in early-stage spinocerebellar ataxia type 2 publication-title: Mov Disord doi: 10.1002/mds.29757 – volume: 2 start-page: e15 year: 2002 ident: 10.1016/j.landig.2025.100905_bib20 article-title: Statistical significant change versus relevant or important change in (quasi) experimental design: some conceptual and methodological problems in estimating magnitude of intervention-related change in health services research publication-title: Int J Integr Care doi: 10.5334/ijic.65 – volume: 271 start-page: 3743 year: 2024 ident: 10.1016/j.landig.2025.100905_bib29 article-title: SARA captures disparate progression and responsiveness in spinocerebellar ataxias publication-title: J Neurol doi: 10.1007/s00415-024-12475-1 – year: 2021 ident: 10.1016/j.landig.2025.100905_bib24 – volume: 37 start-page: 2295 year: 2022 ident: 10.1016/j.landig.2025.100905_bib7 article-title: Digital gait biomarkers allow to capture 1-year longitudinal change in spinocerebellar ataxia type 3 publication-title: Mov Disord doi: 10.1002/mds.29206 – volume: 28 start-page: 1544 year: 2013 ident: 10.1016/j.landig.2025.100905_bib8 article-title: Objective biomarkers of balance and gait for Parkinson’s disease using body-worn sensors publication-title: Mov Disord doi: 10.1002/mds.25684 – volume: 96 start-page: 1364 year: 2016 ident: 10.1016/j.landig.2025.100905_bib21 article-title: Balance and gait represent independent domains of mobility in Parkinson disease publication-title: Phys Ther doi: 10.2522/ptj.20150580 – volume: 60 start-page: 154 year: 2018 ident: 10.1016/j.landig.2025.100905_bib1 article-title: A systematic review of the gait characteristics associated with cerebellar ataxia publication-title: Gait Posture doi: 10.1016/j.gaitpost.2017.11.024 – volume: 1 start-page: 30 year: 1996 ident: 10.1016/j.landig.2025.100905_bib17 article-title: Forming inferences about some intraclass correlation coefficients publication-title: Psychol Methods doi: 10.1037/1082-989X.1.1.30 – volume: 36 start-page: 2922 year: 2021 ident: 10.1016/j.landig.2025.100905_bib9 article-title: Gait variability in spinocerebellar ataxia assessed using wearable inertial sensors publication-title: Mov Disord doi: 10.1002/mds.28740 – volume: 36 start-page: 2367 year: 2021 ident: 10.1016/j.landig.2025.100905_bib16 article-title: Development and validation of a patient-reported outcome measure of ataxia publication-title: Mov Disord doi: 10.1002/mds.28670 – volume: 19 start-page: 1 year: 2016 ident: 10.1016/j.landig.2025.100905_bib26 article-title: Multiple criteria decision analysis for health care decision making—an introduction: report 1 of the ISPOR MCDA Emerging Good Practices Task Force publication-title: Value Health doi: 10.1016/j.jval.2015.12.003 – year: 1994 ident: 10.1016/j.landig.2025.100905_bib19 – volume: 2 start-page: 9 year: 2015 ident: 10.1016/j.landig.2025.100905_bib13 article-title: Clinical assessment of standing and gait in ataxic patients using a triaxial accelerometer publication-title: Cerebellum Ataxias doi: 10.1186/s40673-015-0028-9 – volume: 36 start-page: 471 year: 2021 ident: 10.1016/j.landig.2025.100905_bib12 article-title: Prodromal spinocerebellar ataxia type 2 subjects have quantifiable gait and postural sway deficits publication-title: Mov Disord doi: 10.1002/mds.28343 – volume: 12 start-page: 66 year: 1997 ident: 10.1016/j.landig.2025.100905_bib14 article-title: Preferred placement of the feet during quiet stance: development of a standardized foot placement for balance testing publication-title: Clin Biomech (Bristol) doi: 10.1016/S0268-0033(96)00040-X |
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