Insights into gait disorders: Walking variability using phase plot analysis,Huntington's disease |
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| Affiliation: | 1. Movement Science Group, Oxford Brookes University, Oxford, UK;2. Department of Rehabilitation Science, Jordan University of Science and Technology, Jordan;3. School of Healthcare Studies, Cardiff University, Cardiff, UK;4. Cardiff Schools of Biosciences and Medicine, Cardiff University, Cardiff, UK;5. Clinical Genetics, University of Oxford, Oxford, UK;6. Department of Clinical Neurology, University of Oxford,Oxford, UK;1. Department of Physical Therapy, Central Michigan University, Mt. Pleasant, MI, USA;2. Neuroscience Program, Central Michigan University, Mt. Pleasant, MI, USA;3. School of Engineering and Technology, Central Michigan University, Mt. Pleasant, MI, USA;1. Laboratory for Movement Analysis, University Children''s Hospital Basel (UKBB), Switzerland;2. Clinical Morphology and Biomedical Engineering, University of Basel, Switzerland;3. CTU Bern, Department of Clinical Research, and Institute of Social and Preventive Medicine (ISPM), University of Bern, Switzerland;4. Neuro-Orthopaedic Unit, University Children''s Hospital Basel (UKBB), Switzerland;1. Department of Neurological, and Movement Sciences, University of Verona, via Casorati, 43, Verona, Italy;2. Service de Médecine physique et Réadaptation, Cliniques universitaires Saint-Luc, Avenue Hippocrate, 10–1200 Brussels, Belgium;3. Service de Médecine physique et Réadaptation, Cliniques universitaires Saint-Luc, Avenue Hippocrate, 10–1200 Brussels, Belgium;4. Service de Chirurgie orthopédique, Cliniques universitaires Saint-Luc, Avenue Hippocrate, 10–1200 Brussels, Belgium;5. Institute of Neurosciences, université catholique de Louvain, Avenue Mounier 53 B1, 5304–1200 Brussels, Belgium;1. Biomechanics Research Building, University of Nebraska at Omaha, Omaha, NE 68182, USA;2. Department of Physical Therapy & Rehabilitation Science, University of Maryland, Baltimore, Baltimore, MD 21201, USA;1. Gait Laboratory, Central Remedial Clinic, Vernon Avenue, Clontarf, Dublin 3, Ireland;2. School of Physiotherapy, Royal College of Surgeons in Ireland, 123 St. Stephen''s Green, Dublin 2, Ireland;1. KU Leuven, Faculty of Kinesiology and Rehabilitation Sciences, Department of Rehabilitation Sciences, Tervuursevest 101, 3001 Heverlee, Belgium;2. University Hospital of Pellenberg, Clinical Motion Analysis Laboratory, Weligerveld 1, 3212 Pellenberg, Belgium;3. KU Leuven, Faculty of Medicine, Department of Development and Regeneration, Herestraat 49, 3000 Leuven, Belgium;4. ETH, Department of Health Sciences and Technology, Neural Control of Movement Lab, Rämistrasse 101, 8006 Zurich, Switzerland;5. KU Leuven, Science, Engineering and Technology Group, Department of Mechanical Engineering, Celestijnenlaan 300, 3001 Heverlee, Belgium |
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| Abstract: | Huntington's disease (HD) is a progressive inherited neurodegenerative disorder. Identifying sensitive methodologies to quantitatively measure early motor changes have been difficult to develop. This exploratory observational study investigated gait variability and symmetry in HD using phase plot analysis. We measured the walking of 22 controls and 35 HD gene carriers (7 premanifest (PreHD)), 16 early/mid (HD1) and 12 late stage (HD2) in Oxford and Cardiff, UK. The unified Huntington's disease rating scale-total motor scores (UHDRS-TMS) and disease burden scores (DBS) were used to quantify disease severity. Data was collected during a clinical walk test (8.8 or 10 m) using an inertial measurement unit attached to the trunk. The 6 middle strides were used to calculate gait variability determined by spatiotemporal parameters (co-efficient of variation (CoV)) and phase plot analysis. Phase plots considered the variability in consecutive wave forms from vertical movement and were quantified by SDA (spatiotemporal variability), SDB (temporal variability), ratio ∀ (ratio SDA:SDB) and Δangleβ (symmetry). Step time CoV was greater in manifest HD (p < 0.01, both manifest groups) than controls, as was stride length CoV for HD2 (p < 0.01). No differences were found in spatiotemporal variability between PreHD and controls (p > 0.05). Phase plot analysis identified differences between manifest HD and controls for SDB, Ratio ∀ and Δangle (all p < 0.01, both manifest groups). Furthermore Ratio ∀ was smaller in PreHD compared with controls (p < 0.01). Ratio ∀ also produced the strongest correlation with UHDRS-TMS (r = −0.61, p < 0.01) and was correlated with DBS (r = −0.42, p = 0.02). Phase plot analysis may be a sensitive method of detecting gait changes in HD and can be performed quickly during clinical walking tests. |
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| Keywords: | Huntington's disease Outcome measure Gait Motor control Variability |
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