Contributions
Abstract: EP1406
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: Disease burden in people with Multiple Sclerosis (PwMS) is traditionally quantified by EDSS. A digital gait-mat (Gaitrite) quantifies multiple gait dimensions including: base of support (BoS), stride length (StrL), step length(StpL), double support(DS), single support(SS), and a global score (Functional Ambulation Profile-FAP). A 20% change in velocity is defined significant despite variability within EDSS groups. Use of comprehensive analytics could identify disability prior to critical progression thresholds being passed. Defining the window of opportunity to intervene prior to the appearance of disability might improve MS care.
Objective: Explore the relationship of objective gait domains for preferred waking speed (PWS) within homologous EDSS groups in PwMS.
Methods: Cross sectional retrospective analysis of PwMS who underwent computerized gait analysis in the course of routine care, EDSS < 6.5. EDSS scores were grouped: 0-2.5 (low). 3-4.5 (medium), and 5-6.5 (high). Mean (M), standard deviation (SD) and percent variability (coefficient of variation) were calculated for each EDSS group for FAP, BoS, StrL, StpL, DS, SS.
Results: 255 PwMS, 72% female, age range 46+/-10 years. Gait domain values and variability within the EDSS were identified: EDSS 0-2.5 FAP:94.38M, 8.23SD, 8.73%, EDSS 3-4.5: FAP:82.53M, 16.75SD, 20.30%, EDSS 5-6.5 FAP:58.03M, 16.24SD, 28.19%; EDSS 0-2.5 BoS:10.76M, 3.74SD, 34.81%, EDSS 3-4.5 BoS:13.66M, 4.56SD, 33.34%, EDSS 5-.6.5 BoS:11.93M, 4.67SD, 39.46%; EDSS 0-2.5 StrL:130.59M, 18.03SD, 13.81%, EDSS 3-4.5 StrL:107.98M, 23.41SD, 21.68%, EDSS5-6.5 StrL:81.21M, 23.61SD, 29.28%. EDSS 0-2.5 StpL: 64.88M, 9.02SD, 13.91%, EDSS 3-4.5 StpL:53.66M, 11.71SD, 21.82%, EDSS 5-6.5 StpL:39.90M, 10.89SD, 27.49%; EDSS 0-2.5 SS:36.80M, 2.85SD, 7.74%, EDSS 3-4.5 SS:34.13M, 2.76SD, 8.07%, EDSS 5-6.5 SS:28.69M, 9.79SD, 34.37%; EDSS 0-2.5 DS:26.76M, 5.06SD, 18.90%, EDSS 3-4.5 DS:31.85M, 5.45SD, 17.13%, and EDSS 5-6.5 DS:44.83M, 17.13SD, 25.57%.
Conclusion: Quantified gait abnormalities in PwMS demonstrate variability within EDSS groups; the degree of variability in some homologous groups were >20%. The degree of variability increased across EDSS groups, and with increasing disability suggests that groups of “homologous” physical disability within the EDSS are not homologous. Patient centric quantified analysis of disease impact/change might improve choice/timing of treatment interventions.
Disclosure: (This research was not supported by outside funding):
MG- Research support (Biogen, EMD Serono, Novartis, Sanofi, Teva); speaker fees/consultant (Acorda, Amgen, Biogen, EMD Serono, Medtronic, Novartis, Sanofi, Saol Therapeutics, Teva).
JS- Nothing to disclose
AG- Nothing to disclose
MZ- Speaker fees (Acorda, Biogen, Genzyme and Teva)
BB- Speaker fees (Biogen, Genotech, Genzyme and Teva).
LF- nothing to disclose
MB- Nothing to disclose
Abstract: EP1406
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: Disease burden in people with Multiple Sclerosis (PwMS) is traditionally quantified by EDSS. A digital gait-mat (Gaitrite) quantifies multiple gait dimensions including: base of support (BoS), stride length (StrL), step length(StpL), double support(DS), single support(SS), and a global score (Functional Ambulation Profile-FAP). A 20% change in velocity is defined significant despite variability within EDSS groups. Use of comprehensive analytics could identify disability prior to critical progression thresholds being passed. Defining the window of opportunity to intervene prior to the appearance of disability might improve MS care.
Objective: Explore the relationship of objective gait domains for preferred waking speed (PWS) within homologous EDSS groups in PwMS.
Methods: Cross sectional retrospective analysis of PwMS who underwent computerized gait analysis in the course of routine care, EDSS < 6.5. EDSS scores were grouped: 0-2.5 (low). 3-4.5 (medium), and 5-6.5 (high). Mean (M), standard deviation (SD) and percent variability (coefficient of variation) were calculated for each EDSS group for FAP, BoS, StrL, StpL, DS, SS.
Results: 255 PwMS, 72% female, age range 46+/-10 years. Gait domain values and variability within the EDSS were identified: EDSS 0-2.5 FAP:94.38M, 8.23SD, 8.73%, EDSS 3-4.5: FAP:82.53M, 16.75SD, 20.30%, EDSS 5-6.5 FAP:58.03M, 16.24SD, 28.19%; EDSS 0-2.5 BoS:10.76M, 3.74SD, 34.81%, EDSS 3-4.5 BoS:13.66M, 4.56SD, 33.34%, EDSS 5-.6.5 BoS:11.93M, 4.67SD, 39.46%; EDSS 0-2.5 StrL:130.59M, 18.03SD, 13.81%, EDSS 3-4.5 StrL:107.98M, 23.41SD, 21.68%, EDSS5-6.5 StrL:81.21M, 23.61SD, 29.28%. EDSS 0-2.5 StpL: 64.88M, 9.02SD, 13.91%, EDSS 3-4.5 StpL:53.66M, 11.71SD, 21.82%, EDSS 5-6.5 StpL:39.90M, 10.89SD, 27.49%; EDSS 0-2.5 SS:36.80M, 2.85SD, 7.74%, EDSS 3-4.5 SS:34.13M, 2.76SD, 8.07%, EDSS 5-6.5 SS:28.69M, 9.79SD, 34.37%; EDSS 0-2.5 DS:26.76M, 5.06SD, 18.90%, EDSS 3-4.5 DS:31.85M, 5.45SD, 17.13%, and EDSS 5-6.5 DS:44.83M, 17.13SD, 25.57%.
Conclusion: Quantified gait abnormalities in PwMS demonstrate variability within EDSS groups; the degree of variability in some homologous groups were >20%. The degree of variability increased across EDSS groups, and with increasing disability suggests that groups of “homologous” physical disability within the EDSS are not homologous. Patient centric quantified analysis of disease impact/change might improve choice/timing of treatment interventions.
Disclosure: (This research was not supported by outside funding):
MG- Research support (Biogen, EMD Serono, Novartis, Sanofi, Teva); speaker fees/consultant (Acorda, Amgen, Biogen, EMD Serono, Medtronic, Novartis, Sanofi, Saol Therapeutics, Teva).
JS- Nothing to disclose
AG- Nothing to disclose
MZ- Speaker fees (Acorda, Biogen, Genzyme and Teva)
BB- Speaker fees (Biogen, Genotech, Genzyme and Teva).
LF- nothing to disclose
MB- Nothing to disclose