Janina R Behrens1, Sebastian Mertens2, Theresa Krüger2, Anuschka Grobelny2, Karen Otte3, Sebastian Mansow-Model3, Elona Gusho2, Friedemann Paul1, Alexander U Brandt4, Tanja Schmitz-Hübsch5. 1. NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany/Clinical and Experimental Multiple Sclerosis Research Center, Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany. 2. NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany. 3. Motognosis UG, Berlin, Germany. 4. NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany/Motognosis UG, Berlin, Germany/Clinical and Experimental Multiple Sclerosis Research Center, Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany alexander.brandt@charite.de. 5. NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany/Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Abstract
BACKGROUND: Multiple sclerosis (MS) patients frequently have postural control impairment but quantitative posturography is difficult to perform in clinical care. Recent technology facilitates new posturography approaches. OBJECTIVE: To evaluate construct validity of visual perceptive computing (VPC) for static posturography to study postural control in MS patients. METHODS: A total of 90 MS patients and 59 healthy controls (HCs) performed three stance tests: open, closed and tandem stance. Static posturography was performed using a VPC system with Microsoft Kinect. Clinical assessments included Expanded Disability Status Scale (EDSS), Timed-25-Foot-Walk, Short-Maximum-Speed-Walk and 12-item MS Walking Scale (MSWS-12) questionnaire. Reliability was assessed with intra-class correlation coefficients at retest. RESULTS: As a group, MS patients performed worse than HCs in all tests. The closed stance test showed best applicability and reliability. With closed eyes, in 36.7% of patients, the three-dimensional mean angular sway velocity (MSV-3D) was above HCs' 95th percentile. Higher MSV-3D was associated with decreased walking speed (p < 0.001); worse clinical scores, mainly attributable to the cerebellar functional system score (p < 0.001); and reflected in self-reported walking disability (MSWS-12, p < 0.001). CONCLUSION: Postural control can be reliably assessed by VPC-based static posturography in patients with MS. Abnormal postural control seems to predominantly reflect involvement of cerebellar circuits with impact on gait and walking disability.
BACKGROUND:Multiple sclerosis (MS) patients frequently have postural control impairment but quantitative posturography is difficult to perform in clinical care. Recent technology facilitates new posturography approaches. OBJECTIVE: To evaluate construct validity of visual perceptive computing (VPC) for static posturography to study postural control in MSpatients. METHODS: A total of 90 MSpatients and 59 healthy controls (HCs) performed three stance tests: open, closed and tandem stance. Static posturography was performed using a VPC system with Microsoft Kinect. Clinical assessments included Expanded Disability Status Scale (EDSS), Timed-25-Foot-Walk, Short-Maximum-Speed-Walk and 12-item MS Walking Scale (MSWS-12) questionnaire. Reliability was assessed with intra-class correlation coefficients at retest. RESULTS: As a group, MSpatients performed worse than HCs in all tests. The closed stance test showed best applicability and reliability. With closed eyes, in 36.7% of patients, the three-dimensional mean angular sway velocity (MSV-3D) was above HCs' 95th percentile. Higher MSV-3D was associated with decreased walking speed (p < 0.001); worse clinical scores, mainly attributable to the cerebellar functional system score (p < 0.001); and reflected in self-reported walking disability (MSWS-12, p < 0.001). CONCLUSION: Postural control can be reliably assessed by VPC-based static posturography in patients with MS. Abnormal postural control seems to predominantly reflect involvement of cerebellar circuits with impact on gait and walking disability.
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