TY - JOUR
T1 - Short inertial sensor-based gait tests reflect perceived state fatigue in multiple sclerosis
AU - Ibrahim, Alzhraa A.
AU - Flachenecker, Felix
AU - Gaßner, Heiko
AU - Rothammer, Veit
AU - Klucken, Jochen
AU - Eskofier, Bjoern M.
AU - Kluge, Felix
N1 - Funding Information:
This work was supported by the Medical Faculty, Friedrich-Alexander-Universität (FAU) Erlangen- Nürnberg. Alzhraa A. Ibrahim is funded by a full scholarship from the Ministry of Higher Education of the Arab Republic of Egypt. H.G. and F.K. received funding from the IMI Mobilise-D project (Grant agreement 820820). B. E. was supported by the DFG within the framework of the Heisenberg Professorship Programme (Grant ES 434/8–1).
Publisher Copyright:
© 2022
PY - 2022/2
Y1 - 2022/2
N2 - Background: Multiple sclerosis (MS) is a chronic autoimmune inflammatory disease of the central nervous system, affecting more than 2.3 million people worldwide. Fatigue is among the most common symptoms in MS, resulting in reduced mobility and quality of life. The six-minute walking test (6MWT) is commonly used as a measure of fatigability for the assessment of state fatigue throughout treatment or rehabilitation programs. This ‘gold standard’ test is time-consuming and can be difficult and exhausting for some patients with high levels of disability or high rates of fatigue. Research question: Can short inertial sensor-based gait tests assess perceived state fatigue in MS patients? Methods: Sixty-five MS patients equipped with one sensor on each foot performed the 6 min walk test (6MWT) and the 25-foot walk (25FW, at both preferred and fastest speed). Perceived state fatigue was measured after each minute of the 6MWT, using the Borg rating. The highest of these ratings served as a measure of overall perceived state fatigue. Stride-wise spatio-temporal gait parameters were extracted from the 25FW and from the first minute, first 2 min, and first 4 min of the 6MWT. Principal component analysis was performed. Perceived state fatigue was predicted in a regression analysis, using the principal components of gait parameters as predictors. Statistical tests evaluated differences in performance between the full 6MWT, the shortened 6MWT, and the 25FW. Results: A mean absolute error of less than 2 points on the Borg rating was obtained using the shortened 6MWT and the 25FW. There were no significant differences between the prediction accuracy of the full 6MWT and that of the shortened gait tests. Significance: It is possible to use shortened gait tests when evaluating perceived state fatigue in MS patients using inertial sensors. Substituting them for long gait tests may reduce the burden of the testing on both patients and clinicians. Further, the approach taken here may prompt future work to explore the use of short bouts of real-world walking with unobtrusive inertial sensors for state fatigue assessment.
AB - Background: Multiple sclerosis (MS) is a chronic autoimmune inflammatory disease of the central nervous system, affecting more than 2.3 million people worldwide. Fatigue is among the most common symptoms in MS, resulting in reduced mobility and quality of life. The six-minute walking test (6MWT) is commonly used as a measure of fatigability for the assessment of state fatigue throughout treatment or rehabilitation programs. This ‘gold standard’ test is time-consuming and can be difficult and exhausting for some patients with high levels of disability or high rates of fatigue. Research question: Can short inertial sensor-based gait tests assess perceived state fatigue in MS patients? Methods: Sixty-five MS patients equipped with one sensor on each foot performed the 6 min walk test (6MWT) and the 25-foot walk (25FW, at both preferred and fastest speed). Perceived state fatigue was measured after each minute of the 6MWT, using the Borg rating. The highest of these ratings served as a measure of overall perceived state fatigue. Stride-wise spatio-temporal gait parameters were extracted from the 25FW and from the first minute, first 2 min, and first 4 min of the 6MWT. Principal component analysis was performed. Perceived state fatigue was predicted in a regression analysis, using the principal components of gait parameters as predictors. Statistical tests evaluated differences in performance between the full 6MWT, the shortened 6MWT, and the 25FW. Results: A mean absolute error of less than 2 points on the Borg rating was obtained using the shortened 6MWT and the 25FW. There were no significant differences between the prediction accuracy of the full 6MWT and that of the shortened gait tests. Significance: It is possible to use shortened gait tests when evaluating perceived state fatigue in MS patients using inertial sensors. Substituting them for long gait tests may reduce the burden of the testing on both patients and clinicians. Further, the approach taken here may prompt future work to explore the use of short bouts of real-world walking with unobtrusive inertial sensors for state fatigue assessment.
KW - Accelerometer
KW - Fatigue
KW - IMU
KW - MS
KW - Short gait test
UR - http://www.scopus.com/inward/record.url?scp=85122964012&partnerID=8YFLogxK
UR - https://pubmed.ncbi.nlm.nih.gov/35063910/
U2 - 10.1016/j.msard.2022.103519
DO - 10.1016/j.msard.2022.103519
M3 - Article
AN - SCOPUS:85122964012
SN - 2211-0348
VL - 58
JO - Multiple Sclerosis and Related Disorders
JF - Multiple Sclerosis and Related Disorders
M1 - 103519
ER -