title: Disability and Fatigue Can Be Objectively Measured in Multiple Sclerosis.
abstract: BACKGROUND
  The available clinical outcome measures of disability in multiple sclerosis are not adequately responsive or sensitive.
  
  
  OBJECTIVE
  To investigate the feasibility of inertial sensor-based gait analysis in multiple sclerosis.
  
  
  METHODS
  A cross-sectional study of 80 multiple sclerosis patients and 50 healthy controls was performed. Lower-limb kinematics was evaluated by using a commercially available magnetic inertial measurement unit system. Mean and standard deviation of range of motion (mROM, sROM) for each joint of lower limbs were calculated in one minute walking test. A motor performance index (E) defined as the sum of sROMs was proposed.
  
  
  RESULTS
  We established two novel observer-independent measures of disability. Hip mROM was extremely sensitive in measuring lower limb motor impairment, being correlated with muscle strength and also altered in patients without clinically detectable disability. On the other hand, E index discriminated patients according to disability, being altered only in patients with moderate and severe disability, regardless of walking speed. It was strongly correlated with fatigue and patient-perceived health status.
  
  
  CONCLUSIONS
  Inertial sensor-based gait analysis is feasible and can detect clinical and subclinical disability in multiple sclerosis.
authors: Dipartimento di Medicina dei Sistemi, Tor Vergata University, Rome, Italy.|IRCCS Istituto Neurologico Mediterraneo (INM) Neuromed, Pozzilli, Italy.
authors: Caterina
authors: C
authors: Motta
authors: Department of Mechanical and Aerospace Engineering, "Sapienza" University of Rome, Italy.
authors: Eduardo
authors: E
authors: Palermo
authors: Dipartimento di Medicina dei Sistemi, Tor Vergata University, Rome, Italy.|Fondazione Santa Lucia/Centro Europeo per la Ricerca sul Cervello (CERC), Rome, Italy.
authors: Valeria
authors: V
authors: Studer
authors: Don Carlo Gnocchi Onlus Foundation, Milan, Italy.
authors: Marco
authors: M
authors: Germanotta
authors: Dipartimento di Medicina dei Sistemi, Tor Vergata University, Rome, Italy.|Fondazione Santa Lucia/Centro Europeo per la Ricerca sul Cervello (CERC), Rome, Italy.
authors: Giorgio
authors: G
authors: Germani
authors: Dipartimento di Medicina dei Sistemi, Tor Vergata University, Rome, Italy.|IRCCS Istituto Neurologico Mediterraneo (INM) Neuromed, Pozzilli, Italy.
authors: Diego
authors: D
authors: Centonze
authors: Department of Mechanical and Aerospace Engineering, "Sapienza" University of Rome, Italy.
authors: Paolo
authors: P
authors: Cappa
authors: Dipartimento di Medicina dei Sistemi, Tor Vergata University, Rome, Italy.|IRCCS Istituto Neurologico Mediterraneo (INM) Neuromed, Pozzilli, Italy.|Neuroimmunology and Neuromuscolar Diseases Unit, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy.
authors: Silvia
authors: S
authors: Rossi
authors: Department of Economics and Management-Industrial Engineering, University of Tuscia, Viterbo, Italy.
authors: Stefano
authors: S
authors: Rossi
mesh_terms: D061725:Accelerometry / Q000295:instrumentation / Q000379:methods*; D000328:Adult; D000843:Ankle Joint / Q000503:physiopathology; D001696:Biomechanical Phenomena; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D020233:Gait Disorders, Neurologic / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D007596:Joints / Q000502:physiology; D007719:Knee Joint / Q000503:physiopathology; D008280:Magnetics / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D018763:Muscle Fatigue; D018908:Muscle Weakness / Q000209:etiology / Q000503:physiopathology; D015588:Observer Variation; D011788:Quality of Life; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D063189:Symptom Assessment / Q000379:methods; D016138:Walking; D055815:Young Adult