Lukac Meghan, Luben Hannah, Martin Anne E, Simmons Zachary, Geronimo Andrew
Department of Mechanical Engineering, Pennsylvania State University, University Park, PA, USA.
Department of Neurology, Penn State College of Medicine, Hershey, PA, USA.
Digit Biomark. 2023 May 30;8(1):22-29. doi: 10.1159/000530067. eCollection 2024 Jan-Dec.
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that alters gait and increases the risk of falls. The current model of care involves in-person multidisciplinary clinic visits to, in part, assess alterations in gait, evaluate safety, and make recommendations for management. Clinic visits, however, are relatively infrequent, and multidisciplinary evaluations can be physically demanding for patients. To better understand how gait changes over time in those with ALS and enable healthcare providers to properly respond to these changes, remote monitoring of functional mobility would be advantageous.
The objective of this study was to remotely track long-term changes in walking speed using wearable inertial measurement units (IMUs). Nine ALS patients and 6 healthy controls submitted twice-weekly home walking recordings for 24 and 4 weeks, respectively. An IMU data processing method was developed and validated against laboratory-measured walking speed.
For both ALS patients and healthy controls, home walking speed was less than clinic walking speed by an average of 0.19 m/s ( = 0.0024). Over 24 weeks, home walking speed significantly decreased for 5 of 9 ALS patients at an average of -0.021 m/s/months ( = 0.005). Those who eventually transitioned to using assistive device (AD) while on the study demonstrated a greater decrease in walking speed than those who did not.
Remote longitudinal gait monitoring of ALS patients is feasible with the use of an IMU. Decreases in walking speed were detected in the majority of patients, most strongly in those who eventually transitioned to an AD. Home walking speed may more accurately represent the walking abilities of ALS patients in their real-life environments, a finding which further supports the case for remote monitoring in ALS.
肌萎缩侧索硬化症（ALS）是一种进行性神经退行性疾病，会改变步态并增加跌倒风险。当前的护理模式包括亲自前往多学科诊所就诊，部分目的是评估步态变化、评估安全性并提出管理建议。然而，诊所就诊相对不频繁，多学科评估对患者来说体力消耗较大。为了更好地了解ALS患者的步态如何随时间变化，并使医疗保健提供者能够对这些变化做出适当反应，远程监测功能移动性将是有益的。
本研究的目的是使用可穿戴惯性测量单元（IMU）远程跟踪步行速度的长期变化。9名ALS患者和6名健康对照者分别在24周和4周内每周提交两次家庭步行记录。开发了一种IMU数据处理方法，并与实验室测量的步行速度进行了验证。
对于ALS患者和健康对照者，家庭步行速度平均比诊所步行速度慢0.19米/秒（P = 0.0024）。在24周内，9名ALS患者中有5名的家庭步行速度显著下降，平均为-0.021米/秒/月（P = 0.005）。在研究期间最终转而使用辅助设备（AD）的患者，其步行速度下降幅度大于未使用辅助设备的患者。
使用IMU对ALS患者进行远程纵向步态监测是可行的。大多数患者的步行速度下降，在最终转而使用AD的患者中最为明显。家庭步行速度可能更准确地反映ALS患者在现实生活环境中的步行能力，这一发现进一步支持了对ALS进行远程监测的理由。
