Quantity and quality of gait and turning in people with multiple sclerosis, Parkinson's disease and matched controls during daily living
Quantity and quality of gait and turning in people with multiple sclerosis, Parkinson's disease and matched controls during daily living
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DOI：
10.1007/s00415-020-09696-5
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发表时间：
2020-04-01
影响因子：
6
通讯作者：
Horak, Fay B.
中科院分区：
文献类型：
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作者：
Shah, Vrutangkumar V.;McNames, James;Horak, Fay B.
临床试验需要明确监测哪些特定的步态特征，作为每种神经疾病的行动能力衡量标准。作为第一步，本研究旨在从日常生活监测的角度探讨多发性硬化症患者(MS)和年龄匹配的健康对照组(MS-CTL)以及帕金森病患者(PD)和年龄匹配的健康对照组(PD-CTL)之间的最佳区分能力。此外，我们还调查了这些鉴别指标与多发性硬化症或帕金森病的疾病严重程度之间的关系。我们招募了13名MS患者，21名MS-CTL患者，29名特发性PD患者，20名PD-CTL患者。受试者在他们的脚和腰背部佩戴3个惯性传感器，为期一周。计算每个指标的受试者操作员特征(ROC)曲线下面积(AUC)，以确定最能将MS和PD组与其各自的对照队列分开的客观指标。在记录的58-66小时内，不同组之间佩戴传感器的粘附性相似(p=0.14)。活动量(活动测量，如每一步的平均步数，AUC=0.93)最能区分MS和MS-CTL的活动障碍。相反，活动质量(如转角，AUC=0.90)最能区分PD和PD-CTL的活动障碍。AUC>；0.80的活动度测量与疾病严重程度的MS和PD临床评分相关。因此，在日常生活中，MS和PD的活动障碍的特征指标有所不同，这表明临床试验和临床实践的活动障碍指标需要针对每一种神经疾病。
Clinical trials need to specify which specific gait characteristics to monitor as mobility measures for each neurological disorder. As a first step, this study aimed to investigate a set of measures from daily-life monitoring that best discriminate mobility between people with multiple sclerosis (MS) and age-matched healthy control subjects (MS-Ctl) and between people with Parkinson's disease (PD) and age-matched healthy control subjects (PD-Ctl). Further, we investigated how these discriminative measures relate to the disease severity of MS or PD. We recruited 13 people with MS, 21 MS-Ctl, 29 people with idiopathic PD, and 20 PD-Ctl. Subjects wore 3 inertial sensors on their feet and the lumbar back for a week. The Area Under Curves (AUC) from the receiver operator characteristic (ROC) plot was calculated for each measure to determine the objective measures that best separated the MS and PD groups from their respective control cohorts. Adherence wearing the sensors was similar among groups for 58-66 h of recording (p = 0.14). Quantity of mobility (activity measures, such as a median number of strides per gait bout, AUC = 0.93) best discriminated mobility impairments in MS from MS-Ctl. In contrast, quality of mobility (such as turn angle, AUC = 0.90) best discriminated mobility impairments in PD from PD-Ctl. Mobility measures with AUC > 0.80 were correlated with MS and PD clinical scores of disease severity. Thus, measures characterizing mobility impairments differ for MS versus PD during daily life suggesting that mobility measures for clinical trials and clinical practice need to be specific to each neurological disorder.