Clinical assessment of standing and gait in ataxic patients using a triaxial accelerometer

Akira Matsushima, Kunihiro Yoshida, Hirokazu Genno, Asuka Murata, Setsuko Matsuzawa, Katsuya Nakamura, Akinori Nakamura, Shu-ichi Ikeda

The aim of this study was to investigate the usefulness of a triaxial accelerometer for the clinical assessment of standing and gait impairment in ataxic patients quantitatively. Fifty-one patients with spinocerebellar ataxia (SCA) or multiple system atrophy with predominant cerebellar ataxia (MSA-C) and 56 healthy control subjects were enrolled. The subjects, with a triaxial accelerometer on their back, were indicated to stand for 30 s in four different conditions (eyes opened or closed, and feet apart or together) and then to walk 10 m for a total of 12 times on a flat floor at their usual walking speed. In standing analysis, the degree of body sway was assessed. In gait analysis, gait velocity, cadence, step length, step regularity (auto-correlation coefficient: AC), step repeatability (cross-correlation coefficient) and the degree of body sway (The ratio of root mean square in each direction to the root mean square vector magnitude: RMSR) were evaluated. The degree of body sway in each standing condition and all parameters in gait showed a significant difference between the patients and control subjects. The AC and RMSR values, as well as the Scale for the Assessment and Rating of Ataxia score, showed a strong correlation with disease duration. Various parameters obtained by a triaxial accelerometer can be sensitive and objective markers for the assessment and follow-up of standing and gait impairment in ataxic patients.