Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15W7, Kita-ku, Sapporo, 060-8638, Japan.
Department of Biostatistics, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
Cerebellum. 2019 Aug;18(4):721-730. doi: 10.1007/s12311-019-01025-5.
We reported previously that the average medial-lateral gait amplitude while walking on a straight path determined using triaxial accelerometers fixed on the middle of the upper back may be a quantitative and concise indicator for the severity of cerebellar ataxia. Considering that gait ataxia is a typical initial symptom in a variety of spinocerebellar degeneration (SCD), we aimed to develop quantitative biomarkers for cerebellar ataxia as metric variables. We used triaxial accelerometers to analyze gait parameters in 14 patients with SCD at 3 points over 3 years (at baseline, 1.5 years and 3 years). Analysis of covariance (ANCOVA) models adjusted for the baseline scores were used to estimate sample sizes. The mean medial-lateral amplitude (ML) gained by a triaxial accelerometer fixed on upper back could detect the each 1.5-year change. In the 14 patients, the mean ML(m) was 0.032 ± 0.007(SD) at entry, 0.037 ± 0.008 after 1.5-year follow, and 0.042 ± 0.020 after 3-year follow. In contrast, SARA gait scores were 2.9, 2.9, and 3.0, respectively. The responsiveness of the quantitative evaluation of gait ataxia by triaxial accelerometers is higher than that of the SARA within a 1.5-year follow-up period. Gait analysis by triaxial accelerometers will be complementary to the evaluation of scales like SARA in the assessment of clinical severity of SCD patients in early stage.
我们之前报道过，使用固定在上背部中间的三轴加速度计在直线路径上行走时的平均横向步态幅度可能是小脑共济失调严重程度的定量和简洁指标。考虑到步态共济失调是多种脊髓小脑变性（SCD）的典型初始症状，我们旨在开发小脑共济失调的定量生物标志物作为度量变量。我们使用三轴加速度计在 3 年内的 3 个时间点分析了 14 例 SCD 患者的步态参数（基线、1.5 年和 3 年）。使用协方差分析（ANCOVA）模型对基线评分进行调整，以估计样本量。固定在上背部的三轴加速度计获得的平均横向幅度（ML）可以检测到每 1.5 年的变化。在 14 名患者中，平均 ML(m)在入组时为 0.032±0.007(SD)，1.5 年后随访时为 0.037±0.008，3 年后随访时为 0.042±0.020。相比之下，SARA 步态评分分别为 2.9、2.9 和 3.0。在 1.5 年随访期间，三轴加速度计对步态共济失调的定量评估的反应性高于 SARA。三轴加速度计的步态分析将与 SARA 等量表的评估互补，以评估早期 SCD 患者的临床严重程度。
