Wednesday, 20 February 2013

Monitoring Movement. Moving out of the 20th centurary

Sosnoff JJ, Socie MJ, Boes MK, Sandroff BM, Motl RW. Does a waist-worn ActiGraph accelerometer quantify community ambulation in persons with multiple sclerosis? J Rehabil Res Dev. 2012;49:1405-10.

Accelerometry has been recognized as a method of objectively measuring community ambulation in persons with multiple sclerosis (MS). However, the assumption that walking itself serves as a major contributor to the accelerometer signal has yet to be tested. This study examined the assumption that community-based walking is a primary contributor to accelerometer output in MS. Ambulatory persons (5 males/17 females; 13 without aid/9 with aid) with MS wore a triaxial accelerometer (ActiGraph GT3X, Health One Technologies; Fort Walton Beach, Florida) as well as an IDEEA system (MiniSun, Inc; Fresno, Florida) over the course of a single day. Outcome measures for the accelerometer included movement counts/hour for the vertical, anterior-posterior, and mediolateral axes. Outcomes for the IDEEA system included percent time walking, sitting, and standing, as well as walking speed. Pearson product correlations (r) were used to examine the associations between outcomes from the accelerometer and IDEEA system. Significant correlations were observed between percent walking time and movement counts/hour along the vertical (r = 0.84) and anterior-posterior (r = 0.69) axes. Significant correlations were further noted between movement counts/hour along the vertical axis and walking speed (r = 0.45) and self-report walking impairment (r = -0.50) and disability (r = -0.46). Such observations further support accelerometry as an objective marker of community ambulation in persons with MS.

We have been saying for some time that we should be able to develop novel outcomes that could be used to monitor the effects of treatment. One approach is accelerometry, which provides a measure of movement. and can measure movement in different directions such as up-down, forward-backwards etc. and this study showed some correlation with walking (r=0.7-0.8. remember r=1 perfect correlation), At IPMSC last week there were talking about developing/incorporating new devices into studies involving progressive MS. Which ones actually will be adopted remains up for discussion

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