Background

Multiple sclerosis (MS) is a chronic autoimmune inflammatory disease of the central nervous system, affecting more than 2.3 million people worldwide. Fatigue is among the most common symptoms in MS, resulting in reduced mobility and quality of life. The six-minute walking test (6MWT) is commonly used as a measure of fatigability for the assessment of state fatigue throughout treatment or rehabilitation programs. This ‘gold standard’ test is time-consuming and can be difficult and exhausting for some patients with high levels of disability or high rates of fatigue.

Research question

Can short inertial sensor-based gait tests assess perceived state fatigue in MS patients?

Methods

Sixty-five MS patients equipped with one sensor on each foot performed the 6 min walk test (6MWT) and the 25-foot walk (25FW, at both preferred and fastest speed). Perceived state fatigue was measured after each minute of the 6MWT, using the Borg rating. The highest of these ratings served as a measure of overall perceived state fatigue. Stride-wise spatio-temporal gait parameters were extracted from the 25FW and from the first minute, first 2 min, and first 4 min of the 6MWT. Principal component analysis was performed. Perceived state fatigue was predicted in a regression analysis, using the principal components of gait parameters as predictors. Statistical tests evaluated differences in performance between the full 6MWT, the shortened 6MWT, and the 25FW.

Results

A mean absolute error of less than 2 points on the Borg rating was obtained using the shortened 6MWT and the 25FW. There were no significant differences between the prediction accuracy of the full 6MWT and that of the shortened gait tests.

Significance

It is possible to use shortened gait tests when evaluating perceived state fatigue in MS patients using inertial sensors. Substituting them for long gait tests may reduce the burden of the testing on both patients and clinicians. Further, the approach taken here may prompt future work to explore the use of short bouts of real-world walking with unobtrusive inertial sensors for state fatigue assessment.

中文翻译：

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基于惯性传感器的短步态测试反映多发性硬化症的感知状态疲劳

背景

多发性硬化症 (MS) 是一种中枢神经系统慢性自身免疫性炎症性疾病，影响全球超过 230 万人。疲劳是 MS 中最常见的症状之一，会导致行动不便和生活质量下降。六分钟步行测试 (6MWT) 通常用作疲劳性的衡量标准，用于评估整个治疗或康复计划中的状态疲劳。这种“黄金标准”测试非常耗时，对于一些残疾程度高或疲劳率高的患者来说可能是困难和疲惫的。

研究问题

基于惯性传感器的短步态测试能否评估 MS 患者的感知状态疲劳？

方法

65 名 MS 患者每只脚配备一个传感器，进行了 6 分钟步行测试 (6MWT) 和 25 英尺步行测试（25FW，以首选速度和最快速度）。在 6MWT 的每一分钟后，使用 Borg 等级测量感知状态疲劳。这些评级中最高的作为衡量整体感知状态疲劳的指标。从 25FW 和 6MWT 的第一分钟、前 2 分钟和前 4 分钟提取步态时空步态参数。进行了主成分分析。使用步态参数的主要成分作为预测因子，在回归分析中预测感知状态疲劳。统计测试评估了完整 6MWT、缩短的 6MWT 和 25FW 之间的性能差异。

结果

使用缩短的 6MWT 和 25FW 获得的 Borg 评级平均绝对误差小于 2 分。完整的 6MWT 和缩短的步态测试的预测准确性之间没有显着差异。

意义

在使用惯性传感器评估 MS 患者的感知状态疲劳时，可以使用缩短的步态测试。用它们代替长步态测试可以减轻患者和临床医生的测试负担。此外，这里采用的方法可能会促进未来的工作，以探索使用不显眼的惯性传感器在现实世界中进行短时间步行进行状态疲劳评估。