Abstract
The measurement of gait characteristics during a self-administered 2-minute walk test (2MWT), in persons with multiple sclerosis (PwMS), using a single body-worn device, has the potential to provide high-density longitudinal information on disease progression, beyond what is currently measured in the clinician-administered 2MWT. The purpose of this study is to determine the test-retest reliability, standard error of measurement (SEM) and minimum detectable change (MDC) of features calculated on gait characteristics, harvested during a self-administered 2MWT in a home environment, in 51 PwMS and 11 healthy control (HC) subjects over 24 weeks, using a single waist-worn inertial sensor-based smartphone. Excellent, or good to excellent test-retest reliability were observed in 58 of the 92 temporal, spatial and spatiotemporal gait features in PwMS. However, these were less reliable for HCs. Low SEM% and MDC% values were observed for most of the distribution measures for all gait characteristics for PwMS and HCs. This study demonstrates the inter-session test-retest reliability and provides an indication of clinically important change estimates, for interpreting the outcomes of gait characteristics measured using a body-worn smartphone, during a self-administered 2MWT. This system thus provides a reliable measure of gait characteristics in PwMS, supporting its application for the longitudinal assessment of gait deficits in this population.
Highlights
Multiple sclerosis (MS) is a chronic autoimmune inflammatory disease of the central nervous system [1], which can gradually lead to gait deficits and the inability to fully activate the muscles of the lower limbs [2]
A total of 4854 tests were recorded from the waist from 101 participants
This study evaluated the between-session test-retest reliability, standard error of measurement (SEM) and minimum detectable change (MDC) of a comprehensive set of gait features harvested during a self-administered 2-minute walk test, using a single smartphone attached to the front of the waist in persons with MS (PwMS) and healthy control (HC)
Summary
Multiple sclerosis (MS) is a chronic autoimmune inflammatory disease of the central nervous system [1], which can gradually lead to gait deficits and the inability to fully activate the muscles of the lower limbs [2]. Plays a central role in the assessment of MS disease severity and progression. Sensors 2020, 20, 5906 tasks (e.g., timed-up-and-go (TUG), timed 25-foot walk (T25FW) and the 2- or 6-minute walk test (2MWT, 6MWT)) administered by trained clinical staff [7]. Central to these clinical assessments is the quantification of gait deficits and gait characteristics in PwMS. These assessments are administered infrequently, can be time- and resource-intensive and are prone to rater-dependent error
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