Disability and Fatigue Can Be Objectively Measured in Multiple Sclerosis

PLoS One. 2016 Feb 10;11(2):e0148997. doi: 10.1371/journal.pone.0148997. eCollection 2016.

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.

MeSH terms

  • Accelerometry / instrumentation
  • Accelerometry / methods*
  • Adult
  • Ankle Joint / physiopathology
  • Biomechanical Phenomena
  • Cross-Sectional Studies
  • Disability Evaluation*
  • Female
  • Gait Disorders, Neurologic / diagnosis*
  • Gait Disorders, Neurologic / etiology
  • Gait Disorders, Neurologic / physiopathology
  • Hip Joint / physiopathology
  • Humans
  • Joints / physiology
  • Knee Joint / physiopathology
  • Magnetics / instrumentation
  • Male
  • Middle Aged
  • Multiple Sclerosis / complications*
  • Multiple Sclerosis / physiopathology
  • Multiple Sclerosis / psychology
  • Muscle Fatigue*
  • Muscle Weakness / etiology
  • Muscle Weakness / physiopathology
  • Observer Variation
  • Quality of Life
  • Range of Motion, Articular
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Symptom Assessment / methods
  • Walking
  • Young Adult

Grants and funding

Part of this work was supported by a grant from the Italian Institute of Technology (IIT) – Project Seed (“ITINERE—Interactive Technology: an Instrumented Novel Exoskeleton for Rehabilitation” 2009).