As the potential for a treatment of Duchenne muscular dystrophy (DMD) grows, the need for methods for the early diagnosis of DMD becomes more and more important. Clinical experiences suggest that children with DMD will show some lack of motor ability in the early stage when compared with children at the same age, especially in balance and coordination abilities. Is it possible to quantify the coordination differences between DMD and typically developing (TD) children to achieve the goal of screening for DMD diseases? In this study, we introduced a Local Manifold Structure Mapping approach in phase space and extracted a novel index, relative coupling coefficient (RCC), from gait pattern signals, which were acquired by wearable accelerometers to evaluate the coordination of children with DMD during a walking task. Furthermore, we compared the RCC of 100 children with DMD and 100 TD children in four different age groups and verified the feasibility and reliability of the proposed indices to distinguish children with TD from DMD. T-test results show that, for all age groups, children of the same age with DMD and TD show significant differences in RCC (p < 0.001). Moreover, RCC comprehensively reflects that the coordination ability of DMD patients under walking tasks gradually decreases with age, which is consistent with clinical experience. As a functional biomarker extracted in the phase space of the gait data, the proposed coupling degree index RCC could sensitively distinguish between DMD and TD children at the same age and provide alternative insights and potentially valuable tools for the screening of DMD.

中文翻译：

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定量协调评估用于筛查患有Duchenne肌营养不良症的儿童。

随着治疗杜氏肌营养不良症（DMD）的潜力的增长，对DMD早期诊断方法的需求变得越来越重要。临床经验表明，与同龄儿童相比，DMD儿童在早期阶段会表现出一些运动能力不足，尤其是在平衡和协调能力方面。是否有可能量化DMD和通常发育（TD）儿童之间的协调差异，以实现筛查DMD疾病的目标？在这项研究中，我们介绍了一种在相空间中的局部流形结构映射方法，并从步态信号中提取了一个新的指标，相对耦合系数（RCC），该信号是可穿戴式加速度计获得的，用于评估步行中DMD儿童的协调性任务。此外，我们比较了四个不同年龄组的100名DMD儿童和100名TD儿童的RCC，并验证了所提出的指标区分TD儿童与DMD的可行性和可靠性。T检验结果表明，在所有年龄组中，患有DMD和TD的同龄儿童的RCC均存在显着差异（p <0.001）。此外，RCC全面反映了DMD患者在步行任务下的协调能力会随着年龄的增长而逐渐降低，这与临床经验是一致的。作为在步态数据的相空间中提取的功能性生物标志物，拟议的耦合程度指数RCC可以敏感地区分相同年龄的DMD和TD儿童，并为筛查DMD提供替代见解和潜在有价值的工具。