Body-worn motion sensors detect balance and gait deficits in people with multiple sclerosis who have normal walking speed

Spain, R.I.; St. George, R.J.; Salarian, A.; Mancini, M.; Wagner, J.M.; Horak, F.B.; Bourdette, D.

doi:10.1016/j.gaitpost.2011.11.026

« Previous Next »Gait & Posture
Volume 35, Issue 4 , Pages 573-578, April 2012

Body-worn motion sensors detect balance and gait deficits in people with multiple sclerosis who have normal walking speed

R.I. Spain
- Neurology Service and MS Center of Excellence-West, Portland VA Medical Center and Department of Neurology, Oregon Health & Science University, Portland, OR, USA
- Corresponding author at: Portland VA Medical Center, Oregon Health & Science University, Mail Code: CR120 3181, S.W. Sam Jackson Park Road, Portland, Oregon 97239-3098, USA. Tel.: +1 503 346 0768; fax: +1 503 494 7289.
R.J. St. George
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
A. Salarian
- Balance Disorders Lab, Oregon Health & Science University, Beaverton, OR, USA
M. Mancini
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
J.M. Wagner
- Department of Physical Therapy and Athletic Training, Saint Louis University, St. Louis, MO, USA
F.B. Horak
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
D. Bourdette
- Neurology Service and MS Center of Excellence-West, Portland VA Medical Center and Department of Neurology, Oregon Health & Science University, Portland, OR, USA

Received 21 June 2011; received in revised form 10 November 2011; accepted 20 November 2011. published online 25 January 2012.

Highlights

► Stopwatch-timed mobility tests are insensitive to mild multiple sclerosis (MS). ► We compared timed mobility tests with instrumented body-worn sensors in the clinic. ► Stopwatch timed measures did not distinguish mild MS from control subjects. ► The sensors found significant differences in balance and gait parameters in MS. ► Body-worn sensors may prove a useful and practical MS mobility outcome measure.

Abstract

While balance and gait limitations are hallmarks of multiple sclerosis (MS), standard stopwatch-timed measures practical for use in the clinic are insensitive in minimally affected patients. This prevents early detection and intervention for mobility problems. The study sought to determine if body-worn sensors could detect differences in balance and gait between people with MS with normal walking speeds and healthy controls. Thirty-one MS and twenty-eight age- and sex-matched control subjects were tested using body-worn sensors both during quiet stance and gait (Timed Up and Go test, TUG). Results were compared to stopwatch-timed measures. Stopwatch durations of the TUG and Timed 25 Foot Walk tests were not significantly different between groups. However, during quiet stance with eyes closed, people with MS had significantly greater sway acceleration amplitude than controls (p=0.02). During gait, people with MS had greater trunk angular range of motion in roll (medio-lateral flexion, p=0.017) and yaw (axial rotation, p=0.026) planes. Turning duration through 180° was also longer in MS (p=0.031). Thus, body-worn motion sensors detected mobility differences between MS and healthy controls when traditional timed tests could not. This portable technology provides objective and quantitative mobility data previously not obtainable in the clinic, and may prove a useful outcome measure for early mobility changes in MS.