Polhemus Ashley, Delgado-Ortiz Laura, Brittain Gavin, Chynkiamis Nikolaos, Salis Francesca, Gaßner Heiko, Gross Michaela, Kirk Cameron, Rossanigo Rachele, Taraldsen Kristin, Balta Diletta, Breuls Sofie, Buttery Sara, Cardenas Gabriela, Endress Christoph, Gugenhan Julia, Keogh Alison, Kluge Felix, Koch Sarah, Micó-Amigo M Encarna, Nerz Corinna, Sieber Chloé, Williams Parris, Bergquist Ronny, Bosch de Basea Magda, Buckley Ellen, Hansen Clint, Mikolaizak A Stefanie, Schwickert Lars, Scott Kirsty, Stallforth Sabine, van Uem Janet, Vereijken Beatrix, Cereatti Andrea, Demeyer Heleen, Hopkinson Nicholas, Maetzler Walter, Troosters Thierry, Vogiatzis Ioannis, Yarnall Alison, Becker Clemens, Garcia-Aymerich Judith, Leocani Letizia, Mazzà Claudia, Rochester Lynn, Sharrack Basil, Frei Anja, Puhan Milo
Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
ISGlobal, Barcelona, Spain.
NPJ Digit Med. 2021 Oct 14;4(1):149. doi: 10.1038/s41746-021-00513-5.
Physical mobility is essential to health, and patients often rate it as a high-priority clinical outcome. Digital mobility outcomes (DMOs), such as real-world gait speed or step count, show promise as clinical measures in many medical conditions. However, current research is nascent and fragmented by discipline. This scoping review maps existing evidence on the clinical utility of DMOs, identifying commonalities across traditional disciplinary divides. In November 2019, 11 databases were searched for records investigating the validity and responsiveness of 34 DMOs in four diverse medical conditions (Parkinson's disease, multiple sclerosis, chronic obstructive pulmonary disease, hip fracture). Searches yielded 19,672 unique records. After screening, 855 records representing 775 studies were included and charted in systematic maps. Studies frequently investigated gait speed (70.4% of studies), step length (30.7%), cadence (21.4%), and daily step count (20.7%). They studied differences between healthy and pathological gait (36.4%), associations between DMOs and clinical measures (48.8%) or outcomes (4.3%), and responsiveness to interventions (26.8%). Gait speed, step length, cadence, step time and step count exhibited consistent evidence of validity and responsiveness in multiple conditions, although the evidence was inconsistent or lacking for other DMOs. If DMOs are to be adopted as mainstream tools, further work is needed to establish their predictive validity, responsiveness, and ecological validity. Cross-disciplinary efforts to align methodology and validate DMOs may facilitate their adoption into clinical practice.
身体活动能力对健康至关重要，患者通常将其列为高度优先的临床结果。数字活动结果（DMOs），如现实世界中的步态速度或步数，在许多医疗状况下有望作为临床指标。然而，目前的研究尚处于初期阶段，且按学科划分较为零散。本综述梳理了关于DMOs临床效用的现有证据，识别跨越传统学科界限的共性。2019年11月，检索了11个数据库，以查找调查34种DMOs在四种不同医疗状况（帕金森病、多发性硬化症、慢性阻塞性肺疾病、髋部骨折）中的有效性和反应性的记录。检索产生了19672条独特记录。筛选后，纳入了代表775项研究的855条记录，并绘制在系统地图中。研究经常调查步态速度（占研究的70.4%）、步长（30.7%）、步频（21.4%）和每日步数（20.7%）。他们研究了健康步态与病理步态之间的差异（36.4%）、DMOs与临床指标（48.8%）或结果（4.3%）之间的关联，以及对干预措施的反应性（26.8%）。步态速度、步长、步频、步时和步数在多种状况下均表现出一致的有效性和反应性证据，尽管其他DMOs的证据不一致或缺乏。如果要将DMOs作为主流工具采用，需要进一步开展工作以确立其预测效度、反应性和生态效度。跨学科努力以统一方法并验证DMOs可能有助于将其应用于临床实践。
