U-turn speed is a valid and reliable smartphone-based measure of multiple sclerosis-related gait and balance impairment
Cheng, Wei Yi (F. Hoffmann-La Roche Ltd)
Bourke, Alan K. (F. Hoffmann-La Roche Ltd)
Lipsmeier, Florian (F. Hoffmann-La Roche Ltd)
Bernasconi, Corrado (F. Hoffmann-La Roche Ltd)
Belachew, Shibeshih (F. Hoffmann-La Roche Ltd)
Gossens, Christian (F. Hoffmann-La Roche Ltd)
Graves, Jennifer S. (University of California)
Montalban, Xavier (Hospital Universitari Vall d'Hebron)
Lindemann, Michael (Baden-Wuerttemberg Cooperative State University)
Universitat Autònoma de Barcelona. Departament de Medicina

Date:	2021
Abstract:	Background: People living with multiple sclerosis (MS) experience impairments in gait and mobility, that are not fully captured with manually timed walking tests or rating scales administered during periodic clinical visits. We have developed a smartphone-based assessment of ambulation performance, the 5 U-Turn Test (5UTT), a quantitative self-administered test of U-turn ability while walking, for people with MS (PwMS). Research question: What is the test-retest reliability and concurrent validity of U-turn speed, an unsupervised self-assessment of gait and balance impairment, measured using a body-worn smartphone during the 5UTT? Methods: 76 PwMS and 25 healthy controls (HCs) participated in a cross-sectional non-randomised interventional feasibility study. The 5UTT was self-administered daily and the median U-turn speed, measured during a 14-day session, was compared against existing validated in-clinic measures of MS-related disability. Results: U-turn speed, measured during a 14-day session from the 5UTT, demonstrated good-to-excellent test-retest reliability in PwMS alone and combined with HCs (intraclass correlation coefficient [ICC] = 0. 87 [95 % CI: 0. 80-0. 92]) and moderate-to-excellent reliability in HCs alone (ICC = 0. 88 [95 % CI: 0. 69-0. 96]). U-turn speed was significantly correlated with in-clinic measures of walking speed, physical fatigue, ambulation impairment, overall MS-related disability and patients' self-perception of quality of life, at baseline, Week 12 and Week 24. The minimal detectable change of the U-turn speed from the 5UTT was low (19. 42 %) in PwMS and indicates a good precision of this measurement tool when compared with conventional in-clinic measures of walking performance. Significance: The frequent self-assessment of turn speed, as an outcome measure from a smartphone-based U-turn test, may represent an ecologically valid digital solution to remotely and reliably monitor gait and balance impairment in a home environment during MS clinical trials and practice.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Consumer wearable technology ; Digital health ; Gait and balance impairment ; Multiple sclerosis ; Turning while walking ; Turn speed ; Smartphone ; Accelerometer ; Gyroscope
Published in:	Gait and Posture, Vol. 84 (february 2021) , p. 120-126, ISSN 1879-2219

DOI: 10.1016/j.gaitpost.2020.11.025
PMID: 33310432

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