Clinical assessment of gait in individuals with multiple sclerosis using wearable inertial sensors: Comparison with patient-based measure

Background: This study aims to verify the feasibility of use of wearable accelerometers in an ambulatory environment to assess spatiotemporal parameters of gait in people with Multiple Sclerosis (pwMS), as well as the correlation of objective data with patient-reported outcomes. Methods: One hundred and five pwMS (Expanded Disability Status Scale, EDSS in the range 0-6.5) classified in three sub-groups (EDSS 0-1.5, EDSS 2-4, EDSS 4.5-6.5) and 47 healthy controls (HC) participated in the study. All the subjects were evaluated with the timed 25-foot walking test (T25FW) while wearing a commercially available accelerometer. PwMS also rated the impact of the disease on their walking abilities using the 12-item MS walking scale (MSWS-12). Results: All parameters objectively measured, except stride length, were significantly modified in pwMS with higher EDSS, with respect to HC and lower disability participants. Moderate to high correlations (r =0.57-0.79) were observed between gait parameters and MSWS-12 for pwMS of higher EDSS. The correlation was found moderate for the intermediate EDSS category (r =0.42-0.62). Conclusion: Wearable accelerometers are a useful tool for assessing gait performance for pwMS in a clinical setting, especially in cases of mild to moderate disability. Compared with other quantitative techniques, these devices allow patient testing under realistic conditions (i.e., fully dressed, with their usual shoes) using a simple procedure with immediate availability of data.