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K. Inoue1, Y. Tsubouchi1, Y. Takeo1,2, T. Harada3, S. Ikeda1, M. Fujiki1
1Oita University Hospital, Department of Rehabilitation, Yufu, Japan, 2Oita University Graduate School of Welfare and Health Science, Department of Welfare and Health Science, Oita, Japan, 3Kagoshima University Hospital, Department of Rehabilitation, Kagoshima, Japan
Background: IInternational Cooperative Ataxia Rating Scale (ICARS) is a comprehensive assessment of motor coordination among spinocerebellar degeneration (SCD) patients. However, this is a semiquantitative assessment and is dependent on subjective assessment. Gait analysis is also often performed by visual examination, and differences in reliability and reproducibility due to differences in experience and the lack of objectivity exist.
Purpose: This study aimed to investigate the usefulness of triaxial accelerometer-based gait analysis in patients with SCD.
Methods: The subjects included 14 SCD patients admitted to the hospital between June 2017 and March 2020 (MSA-C:6, SCA3: 3, SCA6: 2, SCA31: 3), with a mean age of 63.7±14.4 years. Comfortable gait speed was measured using a triaxial accelerometer. Accelerometers were attached to the third lumbar process and the right calcaneal process with a sampling frequency of 200 Hz. Ten gait cycles were randomly selected from the acceleration data obtained. Root mean square (RMS) indicates gait stability, while stride-to-stride time variability (STV) indicates a variability in gait cycle time. Jerk indicates the smoothness of the lower limb sway. RMS was calculated as RMSx, RMSy, RMSz, and total RMS (RMSt). RMS was calculated by dividing the square of the walking speed because of the influence of the speed. Other assessments included the ICARS and Functional Balance Scale (FBS). Statistical analysis used Spearman's rank correlation coefficients to check the relevance of each variable, with a significance level of <5% (SPSS version 25.0).
Results: The mean of ICARS and FBS was 31.2±9.8 and 39.1±14.4 points, respectively. RMSt was positively correlated with ICARS (r = 0.79, p < 0.01) but was negatively correlated with FBS（r = −0.86, p < 0.01). Particularly, RMSx was positively correlated with ICARS (r = 0.77, p < 0.01) but was negatively correlated with FBS, while jerk was positively correlated with ICARS (r = 0.78, p< 0.01) and FBS (r = 0.74, p < 0.01). Jerk showed a positive correlation with ICARS (r = 0.78, p < 0.01) and a negative correlation with FBS (r = −0.67, p < 0.01). STV was not correlated with either ICARS or FBS.
Conclusion(s): In this study, an increase in RMS and jerk was found with the severity of ICARS, which was strongly correlated with the disease severity. RMSt and RMSx were negatively correlated with FBS, which was thought to reflect a balancing function. A particularly strong correlation in RMSx was found, which is valuable for future physical therapy programs. The data are expected to be useful.
Implications: Gait analysis using the triaxial accelerometer was less physically demanding and did not limit the location and time variation over long distances. Using triaxial accelerometers in patients with SCD is useful, which can be analyzed to determine disease severity and balance function.
Funding, acknowledgements: None
Keywords: Spinocerebellar degeneration, Gait analysis, Triaxial accelerometer
Topic: Neurology
Did this work require ethics approval? No
Institution: Oita University Medical Ethics Committee
Committee: Oita University Medical Ethics Committee
Reason: This is a retrospective study. Written informed consent was obtained from all patients enrolled in this study.
All authors, affiliations and abstracts have been published as submitted.
