Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239-3098, USA.
Department of Electrical and Computer Engineering, Portland State University, Portland, OR, USA.
J Neuroeng Rehabil. 2020 Dec 1;17(1):159. doi: 10.1186/s12984-020-00781-4.
Recent findings suggest that a gait assessment at a discrete moment in a clinic or laboratory setting may not reflect functional, everyday mobility. As a step towards better understanding gait during daily life in neurological populations, we compared gait measures that best discriminated people with multiple sclerosis (MS) and people with Parkinson's Disease (PD) from their respective, age-matched, healthy control subjects (MS-Ctl, PD-Ctl) in laboratory tests versus a week of daily life monitoring.
We recruited 15 people with MS (age mean ± SD: 49 ± 10 years), 16 MS-Ctl (45 ± 11 years), 16 people with idiopathic PD (71 ± 5 years), and 15 PD-Ctl (69 ± 7 years). Subjects wore 3 inertial sensors (one each foot and lower back) in the laboratory followed by 7 days during daily life. Mann-Whitney U test and area under the curve (AUC) compared differences between PD and PD-Ctl, and between MS and MS-Ctl in the laboratory and in daily life.
Participants wore sensors for 60-68 h in daily life. Measures that best discriminated gait characteristics in people with MS and PD from their respective control groups were different between the laboratory gait test and a week of daily life. Specifically, the toe-off angle best discriminated MS versus MS-Ctl in the laboratory (AUC [95% CI] = 0.80 [0.63-0.96]) whereas gait speed in daily life (AUC = 0.84 [0.69-1.00]). In contrast, the lumbar coronal range of motion best discriminated PD versus PD-Ctl in the laboratory (AUC = 0.78 [0.59-0.96]) whereas foot-strike angle in daily life (AUC = 0.84 [0.70-0.98]). AUCs were larger in daily life compared to the laboratory.
Larger AUC for daily life gait measures compared to the laboratory gait measures suggest that daily life monitoring may be more sensitive to impairments from neurological disease, but each neurological disease may require different gait outcome measures.
最近的研究结果表明，在诊所或实验室环境中对特定时刻的步态进行评估可能无法反映日常的功能性移动能力。为了更好地了解神经疾病患者在日常生活中的步态，我们将比较在实验室测试中能够最好地区分多发性硬化症（MS）患者和帕金森病（PD）患者与各自年龄匹配的健康对照组（MS-Ctl、PD-Ctl）的步态测量值与一周的日常生活监测。
我们招募了 15 名 MS 患者（年龄均值±标准差：49±10 岁）、16 名 MS-Ctl（45±11 岁）、16 名特发性 PD 患者（71±5 岁）和 15 名 PD-Ctl（69±7 岁）。受试者在实验室中佩戴 3 个惯性传感器（每个脚和下背部各一个），然后在日常生活中佩戴 7 天。曼-惠特尼 U 检验和曲线下面积（AUC）比较了 PD 和 PD-Ctl 以及 MS 和 MS-Ctl 在实验室和日常生活中的差异。
参与者在日常生活中佩戴传感器的时间为 60-68 小时。在实验室步态测试和一周日常生活中，能够最好地区分 MS 和 PD 患者与各自对照组步态特征的测量值不同。具体来说，足趾离地角度在实验室中最好地区分 MS 与 MS-Ctl（AUC [95%CI] = 0.80 [0.63-0.96]），而日常生活中的步行速度（AUC = 0.84 [0.69-1.00]）。相比之下，腰椎冠状面运动范围在实验室中最好地区分 PD 与 PD-Ctl（AUC = 0.78 [0.59-0.96]），而日常生活中的足触地角度（AUC = 0.84 [0.70-0.98]）。日常生活中的 AUC 大于实验室中的 AUC。
日常生活步态测量的 AUC 大于实验室步态测量的 AUC，表明日常生活监测可能对神经疾病的损伤更敏感，但每种神经疾病可能需要不同的步态结果测量。
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