Identification of Gait Unbalance and Fallers Among Subjects with Cerebellar Ataxia by a Set of Trunk Acceleration-Derived Indices of Gait

doi:10.1007/s12311-021-01361-5

. 2023 Feb;22(1):46-58.

doi: 10.1007/s12311-021-01361-5. Epub 2022 Jan 26.

Identification of Gait Unbalance and Fallers Among Subjects with Cerebellar Ataxia by a Set of Trunk Acceleration-Derived Indices of Gait

Stefano Filippo Castiglia¹, Dante Trabassi², Antonella Tatarelli^{3

4}, Alberto Ranavolo³, Tiwana Varrecchia³, Lorenzo Fiori^{3

5}, Davide Di Lenola², Ettore Cioffi^{2

4}, Manikandan Raju⁴, Gianluca Coppola², Pietro Caliandro⁶, Carlo Casali², Mariano Serrao^{2

7}

Affiliations

¹ Department of Medical and Surgical Sciences and Biotechnologies, "Sapienza" University of Rome-Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy. stefanofilippo.castiglia@uniroma1.it.
² Department of Medical and Surgical Sciences and Biotechnologies, "Sapienza" University of Rome-Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy.
³ Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, via Fontana Candida, 1, Monte Porzio Catone, 00078, Rome, Italy.
⁴ Department of Human Neurosciences, Sapienza University of Rome, viale dell'Università 30, 00185, Rome, Italy.
⁵ Department of Physiology and Pharmacology, Sapienza University of Rome, piazzale Aldo Moro, 5, 00185, Rome, Italy.
⁶ Unità Operativa Complessa Neurologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy.
⁷ Movement Analysis Laboratory, Policlinico Italia, Piazza del Campidano, 6, 00162, Rome, Italy.

PMID: 35079958
DOI: 10.1007/s12311-021-01361-5

Identification of Gait Unbalance and Fallers Among Subjects with Cerebellar Ataxia by a Set of Trunk Acceleration-Derived Indices of Gait

Stefano Filippo Castiglia et al. Cerebellum. 2023 Feb.

. 2023 Feb;22(1):46-58.

doi: 10.1007/s12311-021-01361-5. Epub 2022 Jan 26.

Authors

Affiliations

¹ Department of Medical and Surgical Sciences and Biotechnologies, "Sapienza" University of Rome-Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy. stefanofilippo.castiglia@uniroma1.it.
² Department of Medical and Surgical Sciences and Biotechnologies, "Sapienza" University of Rome-Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy.
³ Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, via Fontana Candida, 1, Monte Porzio Catone, 00078, Rome, Italy.
⁴ Department of Human Neurosciences, Sapienza University of Rome, viale dell'Università 30, 00185, Rome, Italy.
⁵ Department of Physiology and Pharmacology, Sapienza University of Rome, piazzale Aldo Moro, 5, 00185, Rome, Italy.
⁶ Unità Operativa Complessa Neurologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy.
⁷ Movement Analysis Laboratory, Policlinico Italia, Piazza del Campidano, 6, 00162, Rome, Italy.

PMID: 35079958
DOI: 10.1007/s12311-021-01361-5

Abstract

This study aimed to assess the ability of 25 gait indices to characterize gait instability and recurrent fallers among persons with primary degenerative cerebellar ataxia (pwCA), regardless of gait speed, and investigate their correlation with clinical and kinematic variables. Trunk acceleration patterns were acquired during the gait of 34 pwCA, and 34 age- and speed-matched healthy subjects (HS_matched) using an inertial measurement unit. We calculated harmonic ratios (HR), percent recurrence, percent determinism, step length coefficient of variation, short-time largest Lyapunov exponent (sLLE), normalized jerk score, log-dimensionless jerk (LDLJ-A), root mean square (RMS), and root mean square ratio of accelerations (RMSR) in each spatial direction for each participant. Unpaired t-tests or Mann-Whitney tests were performed to identify significant differences between the pwCA and HS_matched groups. Receiver operating characteristics were plotted to assess the ability to characterize gait alterations in pwCA and fallers. Optimal cutoff points were identified, and post-test probabilities were calculated. The HRs showed to characterize gait instability and pwCA fallers with high probabilities. They were correlated with disease severity and stance, swing, and double support duration, regardless of gait speed. sLLEs, RMSs, RMSRs, and LDLJ-A were slightly able to characterize the gait of pwCA but failed to characterize fallers.

Keywords: Accelerometry; Cerebellar ataxia; Falls; Gait disorders; Harmonic ratio; Inertial measurement units; Neurologic.

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References

1. Serrao M, Pierelli F, Ranavolo A, Draicchio F, Conte C, Don R, et al. Gait pattern in inherited cerebellar ataxias. Cerebellum [Internet]. Cerebellum; 2012 [cited 2021 Mar 23];11:194–211. Available from: https://pubmed.ncbi.nlm.nih.gov/21717229/
1. Serrao M, Ranavolo A, Casali C. Neurophysiology of gait. Handb Clin Neurol [Internet]. Elsevier B.V.; 2018 [cited 2021 Jun 23]. p. 299–303. Available from: https://pubmed.ncbi.nlm.nih.gov/29903447/
1. Chini G, Ranavolo A, Draicchio F, Casali C, Conte C, Martino G, et al. Local stability of the trunk in patients with degenerative cerebellar ataxia during walking. Cerebellum 2016 161 [Internet]. Springer; 2016 [cited 2021 Jul 21];16:26–33. Available from: https://link.springer.com/article/10.1007/s12311-016-0760-6
1. Conte C, Pierelli F, Casali C, Ranavolo A, Draicchio F, Martino G, et al. Upper body kinematics in patients with cerebellar ataxia. Cerebellum. 2014;13:689–97. - DOI
1. Serrao M, Chini G, Casali C, Conte C, Rinaldi M, Ranavolo A, et al. Progression of gait ataxia in patients with degenerative cerebellar disorders: a 4-year follow-up study. Cerebellum [Internet]. Springer New York LLC; 2017 [cited 2021 Jun 23];16:629–37. Available from: https://pubmed.ncbi.nlm.nih.gov/27924492/

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[1] Serrao M, Pierelli F, Ranavolo A, Draicchio F, Conte C, Don R, et al. Gait pattern in inherited cerebellar ataxias. Cerebellum [Internet]. Cerebellum; 2012 [cited 2021 Mar 23];11:194–211. Available from: https://pubmed.ncbi.nlm.nih.gov/21717229/

[2] Serrao M, Pierelli F, Ranavolo A, Draicchio F, Conte C, Don R, et al. Gait pattern in inherited cerebellar ataxias. Cerebellum [Internet]. Cerebellum; 2012 [cited 2021 Mar 23];11:194–211. Available from: https://pubmed.ncbi.nlm.nih.gov/21717229/

[3] Serrao M, Ranavolo A, Casali C. Neurophysiology of gait. Handb Clin Neurol [Internet]. Elsevier B.V.; 2018 [cited 2021 Jun 23]. p. 299–303. Available from: https://pubmed.ncbi.nlm.nih.gov/29903447/

[4] Serrao M, Ranavolo A, Casali C. Neurophysiology of gait. Handb Clin Neurol [Internet]. Elsevier B.V.; 2018 [cited 2021 Jun 23]. p. 299–303. Available from: https://pubmed.ncbi.nlm.nih.gov/29903447/

[5] Chini G, Ranavolo A, Draicchio F, Casali C, Conte C, Martino G, et al. Local stability of the trunk in patients with degenerative cerebellar ataxia during walking. Cerebellum 2016 161 [Internet]. Springer; 2016 [cited 2021 Jul 21];16:26–33. Available from: https://link.springer.com/article/10.1007/s12311-016-0760-6

[6] Chini G, Ranavolo A, Draicchio F, Casali C, Conte C, Martino G, et al. Local stability of the trunk in patients with degenerative cerebellar ataxia during walking. Cerebellum 2016 161 [Internet]. Springer; 2016 [cited 2021 Jul 21];16:26–33. Available from: https://link.springer.com/article/10.1007/s12311-016-0760-6

[7] Conte C, Pierelli F, Casali C, Ranavolo A, Draicchio F, Martino G, et al. Upper body kinematics in patients with cerebellar ataxia. Cerebellum. 2014;13:689–97. - DOI

[8] Conte C, Pierelli F, Casali C, Ranavolo A, Draicchio F, Martino G, et al. Upper body kinematics in patients with cerebellar ataxia. Cerebellum. 2014;13:689–97. - DOI

[9] Serrao M, Chini G, Casali C, Conte C, Rinaldi M, Ranavolo A, et al. Progression of gait ataxia in patients with degenerative cerebellar disorders: a 4-year follow-up study. Cerebellum [Internet]. Springer New York LLC; 2017 [cited 2021 Jun 23];16:629–37. Available from: https://pubmed.ncbi.nlm.nih.gov/27924492/

[10] Serrao M, Chini G, Casali C, Conte C, Rinaldi M, Ranavolo A, et al. Progression of gait ataxia in patients with degenerative cerebellar disorders: a 4-year follow-up study. Cerebellum [Internet]. Springer New York LLC; 2017 [cited 2021 Jun 23];16:629–37. Available from: https://pubmed.ncbi.nlm.nih.gov/27924492/

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Identification of Gait Unbalance and Fallers Among Subjects with Cerebellar Ataxia by a Set of Trunk Acceleration-Derived Indices of Gait

Affiliations

Identification of Gait Unbalance and Fallers Among Subjects with Cerebellar Ataxia by a Set of Trunk Acceleration-Derived Indices of Gait

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