Body-worn sensors capture variability, but not decline, of gait and balance measures in multiple sclerosis over 18 months

- We measured gait and balance using body-worn sensors in MS patients with normal walking speeds.
- Gait and balance did not worsen when tested every 6 months for total of 18 months.
- Performance on objective and subjective mobility measures segregated by global disability level.
- Between-visit variability was highest in the most disabled MS cohort.
- Variability may be an indicator of MS disability and functional decline.

Gait and balance deficits are a frequent complaint in MS but poorly captured by stopwatch-timed tests or rating scales. Body-worn accelerometers and gyroscopes are able to detect gait and balance abnormalities in people with MS who have normal walking speeds. Few longitudinal studies exist using this technology to study the evolution of mobility deficits. The purpose of this study was to determine if body-worn sensors detected any decline in gait and balance measures in people with MS over time. Twenty-seven people with MS (13 mildly disabled, self-rated expanded disability status scale 0-3.5; 14 moderately disabled, SR-EDSS 4.0-5.5) who had normal walking speeds and 18 matched control subjects underwent gait and balance testing using body-worn sensors every 6 months for 18 months. While no parameter worsened over time, the moderately disabled MS cohort performed more poorly than the mildly disabled MS cohort who, in turn, was worse than control subjects for both objective and subjective walking and balance measures. Furthermore, the moderately disabled MS cohort demonstrated greater variation in between-visit performance than did the less disabled MS cohort or controls (Bonferroni-corrected p < 0.05). Variability may be a key indicator of worsening gait and balance disability in MS.