Abstract
Gait disorders are major causes of falls in patients with neurological diseases. Understanding these disorders allows prevention and better insights into underlying diseases. InertiaLocoGraphy (ILG) –the quantification of gait by using inertial measurement units (IMUs) –shows great potential to address this public health challenge, but protocols vary widely and normative values of gait parameters are still unavailable. This systematic review critically compares ILG protocols, questions features extracted from inertial signals and proposes a semeiological analysis of clinimetric characteristics for use in neurological clinical routine. For this systematic review, PubMed, Cochrane and EMBASE were searched for articles assessing gait quality by using IMUs that were published from January 1, 2014 to August 31, 2016. ILG was used to assess gait in a wide range of neurological disorders – including Parkinson disease, mild cognitive impairment, Alzheimer disease, cerebral palsy, and cerebellar atrophy – as well as in the faller or frail older population and in people presenting rheumatological pathologies. However, results have not yet been driving changes in clinical practice. One reason could be that studies mainly aimed at comparing pathological gait to healthy gait, but there is stronger need for semiological descriptions of gait perturbation, severity or prognostic assessment. Furthermore, protocols used to assess gait using IMUs are too many. Likely, outcomes are highly heterogeneous and difficult to compare across large panels of studies. Therefore, homogenization is needed to foster the use of ILG to assess gait quality in neurological routine practice. The pros and cons of each protocol are emphasized so that a compromise can be reached. As well, analysis of seven complementary clinical criteria (springiness, sturdiness, smoothness, steadiness, stability, symmetry, synchronization) is advocated.
Highlights
Walking is a complex activity and a permanent decisionmaking process that can be altered in a variety of neurological pathologies
Protocols designed to assess gait using inertial measurement units (IMUs) are many, and the plethora of quantified outcomes is an obstacle for a comprehensive overview of pathological gaits, which can be highly confusing for the clinician (Graham et al, 2008; Lord et al, 2013)
Detailed data as well as references to studies assessing gait in extraneurologic conditions can be found in Supplemental Material S3
Summary
Walking is a complex activity and a permanent decisionmaking process that can be altered in a variety of neurological pathologies. Gait disorders can lead to impaired mobility, disability, fear of falling or falls, which can result in reduced quality of life and increased risk of death (Wilson et al, 2002; Jørstad et al, 2005; Snijders et al, 2007). Assessment of walking impairments could help predict falls (Barrois et al, 2017) which could be an argument for prevention and correction measures. This review intends to provide a more thorough assessment of the features of IMUs and present a more complete assessment of the set-up to add to already published reviews of gait in Parkinson disease
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
