TY - JOUR
T1 - Inertial Gait Sensors to Measure Mobility and Functioning in Hereditary Spastic Paraplegia
T2 - A Cross-sectional Multicenter Clinical Study
AU - Regensburger, Martin
AU - Spatz, Imke Tabea
AU - Ollenschläger, Malte
AU - Martindale, Christine F.
AU - Lindeburg, Philipp
AU - Kohl, Zacharias
AU - Eskofier, Björn
AU - Klucken, Jochen
AU - Schüle, Rebecca
AU - Klebe, Stephan
AU - Winkler, Jürgen
AU - Gaßner, Heiko
N1 - Funding Information:
This work was supported by the German Bundesministerium für Bildung und Forschung (BMBF) through the TreatHSP consortium (01GM1905B to M.R., J.W., and H.G., 01GM1905A to R.S., 01GM1905C to S.K.), by the Deutsche Forschungsgemeinschaft (German Research Foundation; 270949263/GRK2162 to M.R. and J.W.; Heisenberg professorship program grant 526 number ES 434/8-1 to B.E.), by the European Union's Horizon 2020 research and innovation program under the frame of the EJP-RD network PROSPAX (No 441409627 to R.S.), by the German Network of Neurodegenerative Disorders (DZNE), by the “Förderverein für HSP-Forschung,” and by the “Forschungsstiftung Medizin” at the University Hospital Erlangen. M.R. is a fellow of the Clinician Scientist Programme (IZKF, University Hospital Erlangen). R.S. is a member of the European Reference Network for Rare Neurological Diseases (ERN-RND). H.G. was supported by the Fraunhofer Internal Programs under Grant Nos. Attract 044-602140 and 044-602150.
Publisher Copyright:
© American Academy of Neurology.
PY - 2022/9/6
Y1 - 2022/9/6
N2 - Background and ObjectivesHereditary spastic paraplegia (HSP) causes progressive spasticity and weakness of the lower limbs. As neurologic examination and the clinical Spastic Paraplegia Rating Scale (SPRS) are subject to potential patient-dependent and clinician-dependent bias, instrumented gait analysis bears the potential to objectively quantify impaired gait. The aim of this study was to investigate gait cyclicity parameters by application of a mobile gait analysis system in a cross-sectional cohort of patients with HSP and a longitudinal fast progressing subcohort.MethodsUsing wearable sensors attached to the shoes, patients with HSP and controls performed a 4 × 10 m walking test during regular visits in 3 outpatient centers. Patients were also rated according to the SPRS, and in a subset, questionnaires on quality of life and fear of falling were obtained. An unsupervised segmentation algorithm was used to extract stride parameters and respective coefficients of variation.ResultsMobile gait analysis was performed in a total of 112 ambulatory patients with HSP and 112 age-matched and sex-matched controls. Although swing time was unchanged compared with controls, there were significant increases in the duration of the total stride phase and the duration of the stance phase, both regarding absolute values and coefficients of variation values. Although stride parameters did not correlate with age, weight, or height of the patients, there were significant associations of absolute stride parameters with single SPRS items reflecting impaired mobility (|r| > 0.50), with patients' quality of life (|r| > 0.44), and notably with disease duration (|r| > 0.27). Sensor-derived coefficients of variation, on the other hand, were associated with patient-reported fear of falling (|r| > 0.41) and cognitive impairment (|r| > 0.40). In a small 1-year follow-up analysis of patients with complicated HSP and fast progression, the absolute values of mobile gait parameters had significantly worsened compared with baseline.DiscussionThe presented wearable sensor system provides parameters of stride characteristics which seem clinically valid to reflect gait impairment in HSP. Owing to the feasibility regarding time, space, and costs, this study forms the basis for larger scale longitudinal and interventional studies in HSP.
AB - Background and ObjectivesHereditary spastic paraplegia (HSP) causes progressive spasticity and weakness of the lower limbs. As neurologic examination and the clinical Spastic Paraplegia Rating Scale (SPRS) are subject to potential patient-dependent and clinician-dependent bias, instrumented gait analysis bears the potential to objectively quantify impaired gait. The aim of this study was to investigate gait cyclicity parameters by application of a mobile gait analysis system in a cross-sectional cohort of patients with HSP and a longitudinal fast progressing subcohort.MethodsUsing wearable sensors attached to the shoes, patients with HSP and controls performed a 4 × 10 m walking test during regular visits in 3 outpatient centers. Patients were also rated according to the SPRS, and in a subset, questionnaires on quality of life and fear of falling were obtained. An unsupervised segmentation algorithm was used to extract stride parameters and respective coefficients of variation.ResultsMobile gait analysis was performed in a total of 112 ambulatory patients with HSP and 112 age-matched and sex-matched controls. Although swing time was unchanged compared with controls, there were significant increases in the duration of the total stride phase and the duration of the stance phase, both regarding absolute values and coefficients of variation values. Although stride parameters did not correlate with age, weight, or height of the patients, there were significant associations of absolute stride parameters with single SPRS items reflecting impaired mobility (|r| > 0.50), with patients' quality of life (|r| > 0.44), and notably with disease duration (|r| > 0.27). Sensor-derived coefficients of variation, on the other hand, were associated with patient-reported fear of falling (|r| > 0.41) and cognitive impairment (|r| > 0.40). In a small 1-year follow-up analysis of patients with complicated HSP and fast progression, the absolute values of mobile gait parameters had significantly worsened compared with baseline.DiscussionThe presented wearable sensor system provides parameters of stride characteristics which seem clinically valid to reflect gait impairment in HSP. Owing to the feasibility regarding time, space, and costs, this study forms the basis for larger scale longitudinal and interventional studies in HSP.
UR - http://www.scopus.com/inward/record.url?scp=85138586194&partnerID=8YFLogxK
UR - https://pubmed.ncbi.nlm.nih.gov/35667840
U2 - 10.1212/WNL.0000000000200819
DO - 10.1212/WNL.0000000000200819
M3 - Article
C2 - 35667840
AN - SCOPUS:85138586194
SN - 0028-3878
VL - 99
SP - e1079-89
JO - Neurology
JF - Neurology
IS - 10
ER -