Gait characteristics in people with Friedreich ataxia: daily life versus clinic measures
IntroductionGait assessments in a clinical setting may not accurately reflect mobility in everyday life. To better understand gait during daily life, we compared measures that discriminated Friedreich ataxia (FRDA) from healthy control (HC) subjects in prescribed clinic tests and free, daily-life mo...
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Frontiers Media S.A.
2025-03-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1544453/full |
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| author | Hannah L. Casey Vrutangkumar V. Shah Vrutangkumar V. Shah Daniel Muzyka James McNames James McNames Mahmoud El-Gohary Kristen Sowalsky Delaram Safarpour Patricia Carlson-Kuhta Christian Rummey Fay B. Horak Fay B. Horak Christopher M. Gomez |
| author_facet | Hannah L. Casey Vrutangkumar V. Shah Vrutangkumar V. Shah Daniel Muzyka James McNames James McNames Mahmoud El-Gohary Kristen Sowalsky Delaram Safarpour Patricia Carlson-Kuhta Christian Rummey Fay B. Horak Fay B. Horak Christopher M. Gomez |
| author_sort | Hannah L. Casey |
| collection | DOAJ |
| description | IntroductionGait assessments in a clinical setting may not accurately reflect mobility in everyday life. To better understand gait during daily life, we compared measures that discriminated Friedreich ataxia (FRDA) from healthy control (HC) subjects in prescribed clinic tests and free, daily-life monitoring.MethodsWe recruited 9 people with FRDA (median age: 20, IQR [12, 48] years). A comparative healthy control (HC) subject cohort of 9 was sampled using propensity matching on age (median age: 18 [13, 22] years). Subjects wore 3 inertial sensors (one each foot and lower back) in the laboratory during a 2-min walk at a natural pace, followed by 7 days of daily life. For daily life analysis, a total of 99,216 strides across 1,008 h of recording were included. Mann–Whitney U test and area under the curve (AUC) compared gait differences between FRDA and HC when assessed in the laboratory and daily life. Pairwise Wilcoxon tests also compared if participants exhibited different metric values between the two environments.ResultsThe FRDA group exhibited lower levels of daily activity. Measures that best discriminated gait characteristics of FRDA from HC differed between environments. Variation in elevation of the feet at midswing best discriminated in-clinic (Clinic AUC = 1, Home AUC = 0.69), whereas slow gait speed performed best in daily life (Home AUC = 1, Clinic AUC = 0.64). Of the 17 measures tested, 11 had an AUC > 0.8 in-clinic and 8 had an AUC >0.8 at home. Variability of swing time (Clinic AUC = 0.97, Home AUC = 0.94) and double-support time (Clinic AUC = 0.94, Home AUC = 0.94) were the most sensitive and specific for FRDA in both environments.ConclusionDigital gait characteristics from inertial sensors are sensitive and specific for FRDA in both environments. However, different gait measures were more sensitive and specific during free-living versus prescribed gait, suggesting that in-clinic gait does not reflect daily life gait. |
| format | Article |
| id | doaj-art-0e1189ed8e1a48fcae0ac96150635caa |
| institution | DOAJ |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj-art-0e1189ed8e1a48fcae0ac96150635caa2025-08-20T02:56:03ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-03-011610.3389/fneur.2025.15444531544453Gait characteristics in people with Friedreich ataxia: daily life versus clinic measuresHannah L. Casey0Vrutangkumar V. Shah1Vrutangkumar V. Shah2Daniel Muzyka3James McNames4James McNames5Mahmoud El-Gohary6Kristen Sowalsky7Delaram Safarpour8Patricia Carlson-Kuhta9Christian Rummey10Fay B. Horak11Fay B. Horak12Christopher M. Gomez13Department of Neurology, The University of Chicago, Chicago, IL, United StatesAPDM Wearable Technologies - A Clario Company, Portland, OR, United StatesDepartment of Neurology, Oregon Health & Science University, Portland, OR, United StatesAPDM Wearable Technologies - A Clario Company, Portland, OR, United StatesAPDM Wearable Technologies - A Clario Company, Portland, OR, United StatesDepartment of Electrical and Computer Engineering, Portland State University, Portland, OR, United StatesAPDM Wearable Technologies - A Clario Company, Portland, OR, United StatesAPDM Wearable Technologies - A Clario Company, Portland, OR, United StatesDepartment of Neurology, Oregon Health & Science University, Portland, OR, United StatesDepartment of Neurology, Oregon Health & Science University, Portland, OR, United StatesClinical Data Science GmbH, Basel, SwitzerlandAPDM Wearable Technologies - A Clario Company, Portland, OR, United StatesDepartment of Neurology, Oregon Health & Science University, Portland, OR, United StatesDepartment of Neurology, The University of Chicago, Chicago, IL, United StatesIntroductionGait assessments in a clinical setting may not accurately reflect mobility in everyday life. To better understand gait during daily life, we compared measures that discriminated Friedreich ataxia (FRDA) from healthy control (HC) subjects in prescribed clinic tests and free, daily-life monitoring.MethodsWe recruited 9 people with FRDA (median age: 20, IQR [12, 48] years). A comparative healthy control (HC) subject cohort of 9 was sampled using propensity matching on age (median age: 18 [13, 22] years). Subjects wore 3 inertial sensors (one each foot and lower back) in the laboratory during a 2-min walk at a natural pace, followed by 7 days of daily life. For daily life analysis, a total of 99,216 strides across 1,008 h of recording were included. Mann–Whitney U test and area under the curve (AUC) compared gait differences between FRDA and HC when assessed in the laboratory and daily life. Pairwise Wilcoxon tests also compared if participants exhibited different metric values between the two environments.ResultsThe FRDA group exhibited lower levels of daily activity. Measures that best discriminated gait characteristics of FRDA from HC differed between environments. Variation in elevation of the feet at midswing best discriminated in-clinic (Clinic AUC = 1, Home AUC = 0.69), whereas slow gait speed performed best in daily life (Home AUC = 1, Clinic AUC = 0.64). Of the 17 measures tested, 11 had an AUC > 0.8 in-clinic and 8 had an AUC >0.8 at home. Variability of swing time (Clinic AUC = 0.97, Home AUC = 0.94) and double-support time (Clinic AUC = 0.94, Home AUC = 0.94) were the most sensitive and specific for FRDA in both environments.ConclusionDigital gait characteristics from inertial sensors are sensitive and specific for FRDA in both environments. However, different gait measures were more sensitive and specific during free-living versus prescribed gait, suggesting that in-clinic gait does not reflect daily life gait.https://www.frontiersin.org/articles/10.3389/fneur.2025.1544453/fullgaitfree-livingFriedreich’s ataxiawearable inertial sensorsdigital biomarkerclinical trials |
| spellingShingle | Hannah L. Casey Vrutangkumar V. Shah Vrutangkumar V. Shah Daniel Muzyka James McNames James McNames Mahmoud El-Gohary Kristen Sowalsky Delaram Safarpour Patricia Carlson-Kuhta Christian Rummey Fay B. Horak Fay B. Horak Christopher M. Gomez Gait characteristics in people with Friedreich ataxia: daily life versus clinic measures Frontiers in Neurology gait free-living Friedreich’s ataxia wearable inertial sensors digital biomarker clinical trials |
| title | Gait characteristics in people with Friedreich ataxia: daily life versus clinic measures |
| title_full | Gait characteristics in people with Friedreich ataxia: daily life versus clinic measures |
| title_fullStr | Gait characteristics in people with Friedreich ataxia: daily life versus clinic measures |
| title_full_unstemmed | Gait characteristics in people with Friedreich ataxia: daily life versus clinic measures |
| title_short | Gait characteristics in people with Friedreich ataxia: daily life versus clinic measures |
| title_sort | gait characteristics in people with friedreich ataxia daily life versus clinic measures |
| topic | gait free-living Friedreich’s ataxia wearable inertial sensors digital biomarker clinical trials |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1544453/full |
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