title: Body-worn sensors capture variability, but not decline, of gait and balance measures in multiple sclerosis over 18 months.
abstract: Gait and balance deficits are a frequent complaint in MS but poorly captured by stopwatch-timed tests or rating scales. Body-worn accelerometers and gyroscopes are able to detect gait and balance abnormalities in people with MS who have normal walking speeds. Few longitudinal studies exist using this technology to study the evolution of mobility deficits. The purpose of this study was to determine if body-worn sensors detected any decline in gait and balance measures in people with MS over time. Twenty-seven people with MS (13 mildly disabled, self-rated expanded disability status scale 0-3.5; 14 moderately disabled, SR-EDSS 4.0-5.5) who had normal walking speeds and 18 matched control subjects underwent gait and balance testing using body-worn sensors every 6 months for 18 months. While no parameter worsened over time, the moderately disabled MS cohort performed more poorly than the mildly disabled MS cohort who, in turn, was worse than control subjects for both objective and subjective walking and balance measures. Furthermore, the moderately disabled MS cohort demonstrated greater variation in between-visit performance than did the less disabled MS cohort or controls (Bonferroni-corrected p<0.05). Variability may be a key indicator of worsening gait and balance disability in MS.
authors.affiliation: Neurology Service and MS Center of Excellence-West, Portland VA Medical Center, USA; Department of Neurology, Oregon Health & Science University, USA. Electronic address: spainr@ohsu.edu.
authors.forename: Rebecca I
authors.initials: RI
authors.lastname: Spain
authors.affiliation: Department of Neurology, Oregon Health & Science University, USA.
authors.forename: Martina
authors.initials: M
authors.lastname: Mancini
authors.affiliation: Department of Neurology, Oregon Health & Science University, USA.
authors.forename: Fay B
authors.initials: FB
authors.lastname: Horak
authors.affiliation: Neurology Service and MS Center of Excellence-West, Portland VA Medical Center, USA; Department of Neurology, Oregon Health & Science University, USA.
authors.forename: Dennis
authors.initials: D
authors.lastname: Bourdette
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D020233:Gait Disorders, Neurologic / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation*; D009103:Multiple Sclerosis / Q000503:physiopathology*; D004856:Postural Balance / Q000502:physiology*; D055815:Young Adult
keywords: Accelerometry; Gait; Multiple sclerosis; Outcome assessment; Postural balance