Vrutangkumar V Shah1, James McNames2, Graham Harker3, Carolin Curtze4, Patricia Carlson-Kuhta3, Rebecca I Spain5, Mahmoud El-Gohary6, Martina Mancini3, Fay B Horak7. 1. Department of Neurology, Oregon Health & Science University, Portland, OR, USA. Electronic address: shahvr@ohsu.edu. 2. Department of Electrical and Computer Engineering, Portland State University, Portland, OR, USA; APDM, Inc., Portland, OR, USA. 3. Department of Neurology, Oregon Health & Science University, Portland, OR, USA. 4. Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE, USA. 5. Department of Neurology, Oregon Health & Science University, Portland, OR, USA; Veterans Affairs Portland Health Care System, Portland, OR, USA. 6. APDM, Inc., Portland, OR, USA. 7. Department of Neurology, Oregon Health & Science University, Portland, OR, USA; APDM, Inc., Portland, OR, USA.
Abstract
BACKGROUND: There is currently no consensus about standardized gait bout definitions when passively monitoring walking during normal daily life activities. It is also not known how different definitions of a gait bout in daily life monitoring affects the ability to distinguish pathological gait quality. Specifically, how many seconds of a pause with no walking indicates an end to one gait bout and the start of another bout? In this study, we investigated the effect of 3 gait bout definitions on the discriminative ability to distinguish quality of walking in people with multiple sclerosis (MS) from healthy control subjects (HC) during a week of daily living. METHODS: 15 subjects with MS and 16 HC wore instrumented socks on each foot and one Opal sensor over the lower lumbar area for a week of daily activities for at least 8 h/day. Three gait bout definitions were based on the length of the pause between the end of one gait bout and start of another bout (1.25 s, 2.50 s, and 5.0 s pause). Area under the curve (AUC) was used to compare gait quality measures in MS versus HC. RESULTS: Total number of gait bouts over the week were statistically significantly different across bout definitions, as expected. However, AUCs of gait quality measures (such as gait speed, stride length, stride time) discriminating people with MS from HC were not different despite the 3 bout definitions. SIGNIFICANCE: Quality of gait measures that discriminate MS from HC during daily life are not influenced by the length of a gait bout, despite large differences in quantity of gait across bout definitions. Thus, gait quality measures in people with MS versus controls can be compared across studies using different gait bout definitions with pause lengths ≤5 s.
BACKGROUND: There is currently no consensus about standardized gait bout definitions when passively monitoring walking during normal daily life activities. It is also not known how different definitions of a gait bout in daily life monitoring affects the ability to distinguish pathological gait quality. Specifically, how many seconds of a pause with no walking indicates an end to one gait bout and the start of another bout? In this study, we investigated the effect of 3 gait bout definitions on the discriminative ability to distinguish quality of walking in people with multiple sclerosis (MS) from healthy control subjects (HC) during a week of daily living. METHODS: 15 subjects with MS and 16 HC wore instrumented socks on each foot and one Opal sensor over the lower lumbar area for a week of daily activities for at least 8 h/day. Three gait bout definitions were based on the length of the pause between the end of one gait bout and start of another bout (1.25 s, 2.50 s, and 5.0 s pause). Area under the curve (AUC) was used to compare gait quality measures in MS versus HC. RESULTS: Total number of gait bouts over the week were statistically significantly different across bout definitions, as expected. However, AUCs of gait quality measures (such as gait speed, stride length, stride time) discriminating people with MS from HC were not different despite the 3 bout definitions. SIGNIFICANCE: Quality of gait measures that discriminate MS from HC during daily life are not influenced by the length of a gait bout, despite large differences in quantity of gait across bout definitions. Thus, gait quality measures in people with MS versus controls can be compared across studies using different gait bout definitions with pause lengths ≤5 s.
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Authors: Vrutangkumar V Shah; James McNames; Martina Mancini; Patricia Carlson-Kuhta; Rebecca I Spain; John G Nutt; Mahmoud El-Gohary; Carolin Curtze; Fay B Horak Journal: J Neuroeng Rehabil Date: 2020-12-01 Impact factor: 4.262