Thigh-Derived Inertial Sensor Metrics to Assess the Sit-to-Stand and Stand-to-Sit Transitions in the Timed Up and Go (TUG) Task for Quantifying Mobility Impairment in Multiple Sclerosis

Introduction: Inertial sensors generate objective and sensitive metrics of movement disability that may indicate fall risk in many clinical conditions including multiple sclerosis (MS). The Timed-Up-And-Go (TUG) task is used to assess patient mobility because it incorporates clinically-relevant subm...

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Main Authors: Harry J. Witchel, Cäcilia Oberndorfer, Robert Needham, Aoife Healy, Carina E. I. Westling, Joseph H. Guppy, Jake Bush, Jens Barth, Chantal Herberz, Daniel Roggen, Björn M. Eskofier, Waqar Rashid, Nachiappan Chockalingam, Jochen Klucken
Format: Article
Language:English
Published: Frontiers Media S.A. 2018-09-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/article/10.3389/fneur.2018.00684/full
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author Harry J. Witchel
Cäcilia Oberndorfer
Robert Needham
Aoife Healy
Carina E. I. Westling
Joseph H. Guppy
Jake Bush
Jens Barth
Chantal Herberz
Daniel Roggen
Björn M. Eskofier
Waqar Rashid
Nachiappan Chockalingam
Jochen Klucken
author_facet Harry J. Witchel
Cäcilia Oberndorfer
Robert Needham
Aoife Healy
Carina E. I. Westling
Joseph H. Guppy
Jake Bush
Jens Barth
Chantal Herberz
Daniel Roggen
Björn M. Eskofier
Waqar Rashid
Nachiappan Chockalingam
Jochen Klucken
author_sort Harry J. Witchel
collection DOAJ
description Introduction: Inertial sensors generate objective and sensitive metrics of movement disability that may indicate fall risk in many clinical conditions including multiple sclerosis (MS). The Timed-Up-And-Go (TUG) task is used to assess patient mobility because it incorporates clinically-relevant submovements during standing. Most sensor-based TUG research has focused on the placement of sensors at the spine, hip or ankles; an examination of thigh activity in TUG in multiple sclerosis is wanting.Methods: We used validated sensors (x-IMU by x-io) to derive transparent metrics for the sit-to-stand (SI-ST) transition and the stand-to-sit (ST-SI) transition of TUG, and compared effect sizes for metrics from inertial sensors on the thighs to effect sizes for metrics from a sensor placed at the L3 level of the lumbar spine. Twenty-three healthy volunteers were compared to 17 ambulatory persons with MS (PwMS, HAI ≤ 2).Results: During the SI-ST transition, the metric with the largest effect size comparing healthy volunteers to PwMS was the Area Under the Curve of the thigh angular velocity in the pitch direction–representing both thigh and knee extension; the peak of the spine pitch angular velocity during SI-ST also had a large effect size, as did some temporal measures of duration of SI-ST, although less so. During the ST-SI transition the metric with the largest effect size in PwMS was the peak of the spine angular velocity curve in the roll direction. A regression was performed.Discussion: We propose for PwMS that the diminished peak angular velocity during SI-ST directly represents extensor weakness, while the increased roll during ST-SI represents diminished postural control.Conclusions: During the SI-ST transition of TUG, angular velocities can discriminate between healthy volunteers and ambulatory PwMS better than temporal features. Sensor placement on the thighs provides additional discrimination compared to sensor placement at the lumbar spine.
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spelling doaj.art-9b97a4b88b464f919deeccdef64ba61a2022-12-21T21:03:20ZengFrontiers Media S.A.Frontiers in Neurology1664-22952018-09-01910.3389/fneur.2018.00684330208Thigh-Derived Inertial Sensor Metrics to Assess the Sit-to-Stand and Stand-to-Sit Transitions in the Timed Up and Go (TUG) Task for Quantifying Mobility Impairment in Multiple SclerosisHarry J. Witchel0Cäcilia Oberndorfer1Robert Needham2Aoife Healy3Carina E. I. Westling4Joseph H. Guppy5Jake Bush6Jens Barth7Chantal Herberz8Daniel Roggen9Björn M. Eskofier10Waqar Rashid11Nachiappan Chockalingam12Jochen Klucken13Brighton and Sussex Medical School, University of Sussex, Brighton, United KingdomFriedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, GermanyCentre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent, United KingdomCentre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent, United KingdomSchool of Media, Film and Music, University of Sussex, Brighton, United KingdomBrighton and Sussex Medical School, University of Sussex, Brighton, United KingdomBrighton and Sussex Medical School, University of Sussex, Brighton, United KingdomFriedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, GermanyASTRUM IT, GmbH, Erlangen, GermanyDepartment of Engineering and Design, University of Sussex, Brighton, United KingdomFriedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, GermanyHurstwood Park Neuroscience Centre, Haywards Heath, United KingdomCentre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent, United KingdomMolekulare Neurologie, Universitätsklinikum Erlangen, Erlangen, GermanyIntroduction: Inertial sensors generate objective and sensitive metrics of movement disability that may indicate fall risk in many clinical conditions including multiple sclerosis (MS). The Timed-Up-And-Go (TUG) task is used to assess patient mobility because it incorporates clinically-relevant submovements during standing. Most sensor-based TUG research has focused on the placement of sensors at the spine, hip or ankles; an examination of thigh activity in TUG in multiple sclerosis is wanting.Methods: We used validated sensors (x-IMU by x-io) to derive transparent metrics for the sit-to-stand (SI-ST) transition and the stand-to-sit (ST-SI) transition of TUG, and compared effect sizes for metrics from inertial sensors on the thighs to effect sizes for metrics from a sensor placed at the L3 level of the lumbar spine. Twenty-three healthy volunteers were compared to 17 ambulatory persons with MS (PwMS, HAI ≤ 2).Results: During the SI-ST transition, the metric with the largest effect size comparing healthy volunteers to PwMS was the Area Under the Curve of the thigh angular velocity in the pitch direction–representing both thigh and knee extension; the peak of the spine pitch angular velocity during SI-ST also had a large effect size, as did some temporal measures of duration of SI-ST, although less so. During the ST-SI transition the metric with the largest effect size in PwMS was the peak of the spine angular velocity curve in the roll direction. A regression was performed.Discussion: We propose for PwMS that the diminished peak angular velocity during SI-ST directly represents extensor weakness, while the increased roll during ST-SI represents diminished postural control.Conclusions: During the SI-ST transition of TUG, angular velocities can discriminate between healthy volunteers and ambulatory PwMS better than temporal features. Sensor placement on the thighs provides additional discrimination compared to sensor placement at the lumbar spine.https://www.frontiersin.org/article/10.3389/fneur.2018.00684/fullwearablegyroscopegaitmobilitywalkingstanding
spellingShingle Harry J. Witchel
Cäcilia Oberndorfer
Robert Needham
Aoife Healy
Carina E. I. Westling
Joseph H. Guppy
Jake Bush
Jens Barth
Chantal Herberz
Daniel Roggen
Björn M. Eskofier
Waqar Rashid
Nachiappan Chockalingam
Jochen Klucken
Thigh-Derived Inertial Sensor Metrics to Assess the Sit-to-Stand and Stand-to-Sit Transitions in the Timed Up and Go (TUG) Task for Quantifying Mobility Impairment in Multiple Sclerosis
Frontiers in Neurology
wearable
gyroscope
gait
mobility
walking
standing
title Thigh-Derived Inertial Sensor Metrics to Assess the Sit-to-Stand and Stand-to-Sit Transitions in the Timed Up and Go (TUG) Task for Quantifying Mobility Impairment in Multiple Sclerosis
title_full Thigh-Derived Inertial Sensor Metrics to Assess the Sit-to-Stand and Stand-to-Sit Transitions in the Timed Up and Go (TUG) Task for Quantifying Mobility Impairment in Multiple Sclerosis
title_fullStr Thigh-Derived Inertial Sensor Metrics to Assess the Sit-to-Stand and Stand-to-Sit Transitions in the Timed Up and Go (TUG) Task for Quantifying Mobility Impairment in Multiple Sclerosis
title_full_unstemmed Thigh-Derived Inertial Sensor Metrics to Assess the Sit-to-Stand and Stand-to-Sit Transitions in the Timed Up and Go (TUG) Task for Quantifying Mobility Impairment in Multiple Sclerosis
title_short Thigh-Derived Inertial Sensor Metrics to Assess the Sit-to-Stand and Stand-to-Sit Transitions in the Timed Up and Go (TUG) Task for Quantifying Mobility Impairment in Multiple Sclerosis
title_sort thigh derived inertial sensor metrics to assess the sit to stand and stand to sit transitions in the timed up and go tug task for quantifying mobility impairment in multiple sclerosis
topic wearable
gyroscope
gait
mobility
walking
standing
url https://www.frontiersin.org/article/10.3389/fneur.2018.00684/full
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