Search

Aims: To assess children's acceptance to wear a 3D-accelerometer which is attached to the waist under real-world conditions, and also to compare gait speed during supervised testing with the non-supervised gait speed in every-day life. Methods: In a controlled observational, cross sectional study thirty subjects with cerebral palsy (CP), with level I&II of the Gross Motor Function Classification System (GMFCS) and 30 healthy control children (Ctrl), aged 3–12 years, were asked to perform a 1-min-walking test (1 mwt) under laboratory conditions, and to wear an accelerometric device for a 1-week wearing home measurement (1 WHM). Acceptance was measured via wearing time, and by a questionnaire in which subjects rated restrictions in their daily living and wearing comfort. In addition, validity of 3D-accelerometric gait speed was checked through gold standard assessment of gait speed with a mobile perambulator. Results: Wearing time amounted to 10.3 (SD 3.4) hours per day, which was comparable between groups (T = 1.10, P = 0.3). Mode for wearing comfort [CP 1, Range (1,4), Ctrl 1, Range (1,6)] and restriction of daily living [CP 1, Range (1,3), Ctrl 1, Range (1,4)] was comparable between groups. Under laboratory conditions, Ctrl walked faster in the 1 mwt than CP (Ctrl 1.72 ± 0.29 m/s, CP 1.48 ± 0.41 m/s, P = 0.018). Similarly, a statistically significant difference was found when comparing real-world walking speed and laboratory walking speed (CP: 1 mwt 1.48 ± 0.41 m/s, 1 WHM 0.89 ± 0.09 m/s, P = 0.012; Ctrl: 1mwt 1.72 ± 0.29, 1 WHM 0.97 ± 0.06, P < 0.001). Conclusion: 3D-accelerometry is well-enough accepted in a pediatric population of patients with CP and a Ctrl group to allow valid assessments. Assessment outside the laboratory environment yields information about real world activity that was not captured by routine clinical tests. This suggests that assessment of habitual activities by wearable devices reflects the functioning of children in their home environment. This novel information constitutes an important goal for rehabilitation medicine. The study is registered at the German Register of Clinical Trials with the title “Acceptance and Validity of 3D Accelerometric Gait Analysis in Pediatric Patients” (AVAPed; DRKS00011919).

Hintergrund/Fragestellung: Prognostische Informationen sind unentbehrlich für alle Menschen mit chronischen Erkrankungen, die Entscheidungen über eine Dauertherapie treffen müssen. Zahlreiche Untersuchungen zeigen, dass sich Menschen mit Multipler Sklerose (MS) typischerweise nicht[zum vollständigen Text gelangen Sie über die oben angegebene URL], Nützliche patientenrelevante Forschung; 21. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin

Supplemental material, MSJ964774_supplemental_table_1 for Long-term prognostic counselling in people with multiple sclerosis using an online analytical processing tool by Ricardo Kosch, Insa Schiffmann, Martin Daumer, Christian Lederer, Antonio Scalfari, Ian Galea, Jutta Scheiderbauer, Anne Rahn and Christoph Heesen in Multiple Sclerosis Journal

Head stabilization is fundamental for balance during locomotion but can be impaired in elderly or diseased populations. Previous studies have identified several parameters of head stability with possible diagnostic value in a laboratory setting. Recently, the ecological validity of measures obtained in such controlled contexts has been called into question. The aim of this study was to investigate the ecological validity of previously described parameters of head stabilization in a real-world setting. Ten healthy subjects participated in the study. Head and trunk movements of each subject were recorded with inertial measurement units (IMUs) for a period of at least 10 h. Periods of locomotion were extracted from the measurements and predominant frequencies, root mean squares (RMSs) and bout lengths were estimated. As parameters of head stabilization, attenuation coefficients (ACs), harmonic ratios (HRs), coherences, and phase differences were computed. Predominant frequencies were distributed tightly around 2 Hz and ACs, HRs, and coherences exhibited the highest values in this frequency range. All head stability parameters exhibited characteristics consistent with previous reports, although higher variances were observed. These results suggest that head stabilization is tuned to the 2 Hz fundamental frequency of locomotion and that previously described measures of head stability could generalize to a real-world setting. This is the first study to address the ecological validity of these measures, highlighting the potential use of head stability parameters as diagnostic tools or outcome measures for clinical trials. The low cost and ease of use of the IMU technology used in this study could additionally be of benefit for a clinical application.