Disability and Fatigue Can Be Objectively Measured in Multiple Sclerosis.

Caterina Motta,Stefano Rossi,Silvia Rossi,Paolo Cappa,Eduardo Palermo,Valeria Studer,Giorgio Germani,Diego Centonze,Marco Germanotta,Sreeram V Ramagopalan

doi:10.1371/journal.pone.0148997

Abstract

BackgroundThe available clinical outcome measures of disability in multiple sclerosis are not adequately responsive or sensitive.ObjectiveTo investigate the feasibility of inertial sensor-based gait analysis in multiple sclerosis.MethodsA 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.ResultsWe 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.ConclusionsInertial sensor-based gait analysis is feasible and can detect clinical and subclinical disability in multiple sclerosis.

Highlights

Disability assessment had become fundamental part of standard multiple sclerosis (MS) practice and clinical research
Hip mROM was extremely sensitive in measuring lower limb motor impairment, being correlated with muscle strength and altered in patients without clinically detectable disability
E index discriminated patients according to disability, being altered only in patients with moderate and severe disability, regardless of walking speed

Summary

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

Objective

Introduction

Discussion