ECTRIMS eLearning

Ambulatory motor dysfunction in MS assessed by wearable inertial sensor metrics during the timed-up-and-go task (TUG)
Author(s): ,
C Oberndorfer
Affiliations:
Universität Erlangen-Nürnberg
,
J Barth
Affiliations:
Universität Erlangen-Nürnberg;ASTRUM IT, GmbH, Erlangen, Germany
,
J.H Guppy
Affiliations:
Brighton and Sussex Medical School, Brighton
,
J Bush
Affiliations:
Brighton and Sussex Medical School, Brighton
,
R Needham
Affiliations:
CSHER, Staffordshire University, Stoke-on-Trent
,
A Healy
Affiliations:
CSHER, Staffordshire University, Stoke-on-Trent
,
N Chockalingam
Affiliations:
CSHER, Staffordshire University, Stoke-on-Trent
,
C Herberz
Affiliations:
ASTRUM IT, GmbH, Erlangen, Germany
,
C.E.I Westling
Affiliations:
University of Sussex, Brighton, United Kingdom
,
B.M Eskofier
Affiliations:
Universität Erlangen-Nürnberg
,
D Roggen
Affiliations:
University of Sussex, Brighton, United Kingdom
,
J Klucken
Affiliations:
Universitätsklinikum Erlangen, Erlangen, Germany
,
W Rashid
Affiliations:
Hurstwood Park Neurosciences Centre, Haywards Heath, United Kingdom
H.J Witchel
Affiliations:
Brighton and Sussex Medical School, Brighton
ECTRIMS Learn. Witchel H. 09/16/16; 145945; P1262
Harry Witchel
Harry Witchel
Contributions
Abstract

Abstract: P1262

Type: Poster

Abstract Category: Therapy - disease modifying - Tools for detecting therapeutic response

Background: Individuals with MS suffer from ambulatory motor dysfunction; recently the timed-up-and-go (TUG) test has been shown to relate to ambulatory dysfunction (as judged by EDSS). To complement patient reports in the elderly, a range of objective performance metrics based on ambulation have been demonstrated as feasible, including the sit-to-stand transition time. These TUG metrics have not yet been applied to multiple sclerosis patients.

Methods: Fully-ambulatory persons with multiple sclerosis whose Hauser Ambulatory Index (HAI) was 2 or less (PwMS, N=17) and age-matched healthy volunteers (N=24) were instrumented with 7 inertial sensors with 3 axes of gyroscopy and accelerometry recording at 128 Hz. Participants performed the timed-up-and-go twice, and transition times between sitting and standing were calculated as described previously; in this study we focused only on the data from the sensor placed on the lumbar spine.

Results: PwMS reported their walking to be significantly more affected (according to the MSWS-12) than age-matched healthy controls (50.99±4.69 vs. 0, P< 0.001, unpaired t test), and their walking time in the timed 25 foot walk (T25FW) reflected this (6.09±0.27 seconds vs. 4.45±0.15, P< 0.001, unpaired t test). In the stopwatch measured TUG, significant differences were detected between PwMS and age-matched, healthy volunteers, (12.33±0.59 seconds vs. 10.04±0.33, P< 0.01). Similarly, the duration of the TUG as measured by the sensors was longer for PwMS than for the healthy volunteers (13.86±1.09 seconds vs. 10.19 ± 0.36, P< 0.01), and the transition times for sit-to-stand (PwMS 0.81±0.09 seconds vs. healthy 0.67±0.03) and stand-to-sit (PwMS 1.03±0.11 seconds vs. healthy 0.92±0.05) were longer for PwMS, but not significantly (P>0.1 for both). The range of the raw angular acceleration (in the pitch orientation) of the lumbar segment was significantly lower in PwMS (153.4±8.9 deg/second vs. 204.7±6.5, P< 0.001).

Conclusions: In this group (HAI< 2), traditional measures of ambulatory dysfunction (e.g. T25FW) are quite sensitive to multiple sclerosis. Wearable inertial sensors have the potential to provide specific metrics of ambulatory dysfunction (e.g. weakness) in MS with good face value. Future studies using these sensors have the potential to realise additional information on movement dysfunction, including specific deficits such as difficulties executing sitting and standing associated with disease progression.

Disclosure:

CO: Supported by German Academic Exchange Service (DAAD). No relevant commercial support.

WR: supported by Brighton and Sussex University Hospital Trust. No relevant commercial support.

JHG, Jake Bush: undergraduate project students. No relevant support

RN: supported by Staffordshire Univ. No relevant commercial support.

JK: supported by FAU Erlangen. Additional funding from ASTRUM IT

NC: supported by Staffordshire Univ. No relevant commercial support.

CH: employed by ASTRUM IT, GmbH. Commercially supported.

CEIW: PhD student. No relevant support.

BME: supported by FAU Erlangen. Additional funding from ASTRUM IT

DR: supported by University of Sussex. No relevant commercial support

Jens Barth: Employed by ASTRUM IT, GmbH. Additional funding from Bavarian Research Foundation

HJW: supported by Brighton and Sussex Medical School. No relevant commercial support.

Abstract: P1262

Type: Poster

Abstract Category: Therapy - disease modifying - Tools for detecting therapeutic response

Background: Individuals with MS suffer from ambulatory motor dysfunction; recently the timed-up-and-go (TUG) test has been shown to relate to ambulatory dysfunction (as judged by EDSS). To complement patient reports in the elderly, a range of objective performance metrics based on ambulation have been demonstrated as feasible, including the sit-to-stand transition time. These TUG metrics have not yet been applied to multiple sclerosis patients.

Methods: Fully-ambulatory persons with multiple sclerosis whose Hauser Ambulatory Index (HAI) was 2 or less (PwMS, N=17) and age-matched healthy volunteers (N=24) were instrumented with 7 inertial sensors with 3 axes of gyroscopy and accelerometry recording at 128 Hz. Participants performed the timed-up-and-go twice, and transition times between sitting and standing were calculated as described previously; in this study we focused only on the data from the sensor placed on the lumbar spine.

Results: PwMS reported their walking to be significantly more affected (according to the MSWS-12) than age-matched healthy controls (50.99±4.69 vs. 0, P< 0.001, unpaired t test), and their walking time in the timed 25 foot walk (T25FW) reflected this (6.09±0.27 seconds vs. 4.45±0.15, P< 0.001, unpaired t test). In the stopwatch measured TUG, significant differences were detected between PwMS and age-matched, healthy volunteers, (12.33±0.59 seconds vs. 10.04±0.33, P< 0.01). Similarly, the duration of the TUG as measured by the sensors was longer for PwMS than for the healthy volunteers (13.86±1.09 seconds vs. 10.19 ± 0.36, P< 0.01), and the transition times for sit-to-stand (PwMS 0.81±0.09 seconds vs. healthy 0.67±0.03) and stand-to-sit (PwMS 1.03±0.11 seconds vs. healthy 0.92±0.05) were longer for PwMS, but not significantly (P>0.1 for both). The range of the raw angular acceleration (in the pitch orientation) of the lumbar segment was significantly lower in PwMS (153.4±8.9 deg/second vs. 204.7±6.5, P< 0.001).

Conclusions: In this group (HAI< 2), traditional measures of ambulatory dysfunction (e.g. T25FW) are quite sensitive to multiple sclerosis. Wearable inertial sensors have the potential to provide specific metrics of ambulatory dysfunction (e.g. weakness) in MS with good face value. Future studies using these sensors have the potential to realise additional information on movement dysfunction, including specific deficits such as difficulties executing sitting and standing associated with disease progression.

Disclosure:

CO: Supported by German Academic Exchange Service (DAAD). No relevant commercial support.

WR: supported by Brighton and Sussex University Hospital Trust. No relevant commercial support.

JHG, Jake Bush: undergraduate project students. No relevant support

RN: supported by Staffordshire Univ. No relevant commercial support.

JK: supported by FAU Erlangen. Additional funding from ASTRUM IT

NC: supported by Staffordshire Univ. No relevant commercial support.

CH: employed by ASTRUM IT, GmbH. Commercially supported.

CEIW: PhD student. No relevant support.

BME: supported by FAU Erlangen. Additional funding from ASTRUM IT

DR: supported by University of Sussex. No relevant commercial support

Jens Barth: Employed by ASTRUM IT, GmbH. Additional funding from Bavarian Research Foundation

HJW: supported by Brighton and Sussex Medical School. No relevant commercial support.

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