Instrumented Version of the Modified Dynamic Gait Index in Patients With Neurologic Disorders

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Abstract

Background: Gait instability is common in adults with neurologic disorders and the modified Dynamic Gait Index (mDGI) was recently introduced to assess dynamic balance. However, instrumental assessment is needed to provide quantitative measures. Objective: To develop and validate an instrumented version of the mDGI. Design: Cross-sectional study. Setting: Clinical setting. Participants: Thirty adults with neurologic disorders (10 with multiple sclerosis, 10 with Parkinson disease, and 10 with stroke) and 20 healthy volunteers. Methods: Participants were assessed with the Timed Up and Go test (TUG) and with the mDGI. During the assessment of mDGI, data were collected by a single Inertial Measurement Unit (IMU) positioned on the sternum. Principal component analysis (PCA) was performed on the instrumented data extracting eight PC scores (ImPC) describing dynamic balance. The instrumented overall score (ImDGI) was then calculated as the sum of the mPCs. PCA revealed two components associated with stride features and regularity (ImDGI_Gait_Pattern) and trunk movements (ImDGI_Trunk_Sway). Spearman coefficients were calculated between mDGI and ImDGI, whereas Mann-Whitney (U) and Kruskal-Wallis (H) tests assessed differences between groups and neurologic conditions. Main Outcome Measurements: ImDGI. Results: ImDGI did not show ceiling effects, and good correlations were found between ImDGI and mDGI (r =.84), and TUG (r =.84) for people with neurologic disorders (P <.001). Significant differences among pathologies (H test(2)=12.5, P =.002) and between healthy participants and adults with neurologic disorders (U test = 47.0, P =.001) were found. ImDGI_Trunk_Sway discriminated between people using or not using walking aids and among the three pathologies (H(2) = 10.0, P =.007). Conclusions: The ImDGI test seems to provide valid measures to objectively assess dynamic balance in neurologic conditions and possibly quantify balance deficits also in adults with neurologic disorders.

Original languageEnglish
JournalPM and R
DOIs
Publication statusPublished - Jan 1 2019

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Nervous System Diseases
Gait
Principal Component Analysis
Nervous System
Healthy Volunteers
Pathology
Sternum
Multiple Sclerosis
Walking
Cross-Sectional Studies
Stroke

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Neurology
  • Clinical Neurology

Cite this

@article{7c5d21d16e494ce78c488ef836b3cb3e,
title = "Instrumented Version of the Modified Dynamic Gait Index in Patients With Neurologic Disorders",
abstract = "Background: Gait instability is common in adults with neurologic disorders and the modified Dynamic Gait Index (mDGI) was recently introduced to assess dynamic balance. However, instrumental assessment is needed to provide quantitative measures. Objective: To develop and validate an instrumented version of the mDGI. Design: Cross-sectional study. Setting: Clinical setting. Participants: Thirty adults with neurologic disorders (10 with multiple sclerosis, 10 with Parkinson disease, and 10 with stroke) and 20 healthy volunteers. Methods: Participants were assessed with the Timed Up and Go test (TUG) and with the mDGI. During the assessment of mDGI, data were collected by a single Inertial Measurement Unit (IMU) positioned on the sternum. Principal component analysis (PCA) was performed on the instrumented data extracting eight PC scores (ImPC) describing dynamic balance. The instrumented overall score (ImDGI) was then calculated as the sum of the mPCs. PCA revealed two components associated with stride features and regularity (ImDGI_Gait_Pattern) and trunk movements (ImDGI_Trunk_Sway). Spearman coefficients were calculated between mDGI and ImDGI, whereas Mann-Whitney (U) and Kruskal-Wallis (H) tests assessed differences between groups and neurologic conditions. Main Outcome Measurements: ImDGI. Results: ImDGI did not show ceiling effects, and good correlations were found between ImDGI and mDGI (r =.84), and TUG (r =.84) for people with neurologic disorders (P <.001). Significant differences among pathologies (H test(2)=12.5, P =.002) and between healthy participants and adults with neurologic disorders (U test = 47.0, P =.001) were found. ImDGI_Trunk_Sway discriminated between people using or not using walking aids and among the three pathologies (H(2) = 10.0, P =.007). Conclusions: The ImDGI test seems to provide valid measures to objectively assess dynamic balance in neurologic conditions and possibly quantify balance deficits also in adults with neurologic disorders.",
author = "Denise Anastasi and Ilaria Carpinella and Elisa Gervasoni and Matsuda, {Patricia N.} and Gabriele Bovi and Maurizio Ferrarin and Davide Cattaneo",
year = "2019",
month = "1",
day = "1",
doi = "10.1002/pmrj.12137",
language = "English",
journal = "PM and R",
issn = "1934-1482",
publisher = "Elsevier Inc.",

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T1 - Instrumented Version of the Modified Dynamic Gait Index in Patients With Neurologic Disorders

AU - Anastasi, Denise

AU - Carpinella, Ilaria

AU - Gervasoni, Elisa

AU - Matsuda, Patricia N.

AU - Bovi, Gabriele

AU - Ferrarin, Maurizio

AU - Cattaneo, Davide

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Gait instability is common in adults with neurologic disorders and the modified Dynamic Gait Index (mDGI) was recently introduced to assess dynamic balance. However, instrumental assessment is needed to provide quantitative measures. Objective: To develop and validate an instrumented version of the mDGI. Design: Cross-sectional study. Setting: Clinical setting. Participants: Thirty adults with neurologic disorders (10 with multiple sclerosis, 10 with Parkinson disease, and 10 with stroke) and 20 healthy volunteers. Methods: Participants were assessed with the Timed Up and Go test (TUG) and with the mDGI. During the assessment of mDGI, data were collected by a single Inertial Measurement Unit (IMU) positioned on the sternum. Principal component analysis (PCA) was performed on the instrumented data extracting eight PC scores (ImPC) describing dynamic balance. The instrumented overall score (ImDGI) was then calculated as the sum of the mPCs. PCA revealed two components associated with stride features and regularity (ImDGI_Gait_Pattern) and trunk movements (ImDGI_Trunk_Sway). Spearman coefficients were calculated between mDGI and ImDGI, whereas Mann-Whitney (U) and Kruskal-Wallis (H) tests assessed differences between groups and neurologic conditions. Main Outcome Measurements: ImDGI. Results: ImDGI did not show ceiling effects, and good correlations were found between ImDGI and mDGI (r =.84), and TUG (r =.84) for people with neurologic disorders (P <.001). Significant differences among pathologies (H test(2)=12.5, P =.002) and between healthy participants and adults with neurologic disorders (U test = 47.0, P =.001) were found. ImDGI_Trunk_Sway discriminated between people using or not using walking aids and among the three pathologies (H(2) = 10.0, P =.007). Conclusions: The ImDGI test seems to provide valid measures to objectively assess dynamic balance in neurologic conditions and possibly quantify balance deficits also in adults with neurologic disorders.

AB - Background: Gait instability is common in adults with neurologic disorders and the modified Dynamic Gait Index (mDGI) was recently introduced to assess dynamic balance. However, instrumental assessment is needed to provide quantitative measures. Objective: To develop and validate an instrumented version of the mDGI. Design: Cross-sectional study. Setting: Clinical setting. Participants: Thirty adults with neurologic disorders (10 with multiple sclerosis, 10 with Parkinson disease, and 10 with stroke) and 20 healthy volunteers. Methods: Participants were assessed with the Timed Up and Go test (TUG) and with the mDGI. During the assessment of mDGI, data were collected by a single Inertial Measurement Unit (IMU) positioned on the sternum. Principal component analysis (PCA) was performed on the instrumented data extracting eight PC scores (ImPC) describing dynamic balance. The instrumented overall score (ImDGI) was then calculated as the sum of the mPCs. PCA revealed two components associated with stride features and regularity (ImDGI_Gait_Pattern) and trunk movements (ImDGI_Trunk_Sway). Spearman coefficients were calculated between mDGI and ImDGI, whereas Mann-Whitney (U) and Kruskal-Wallis (H) tests assessed differences between groups and neurologic conditions. Main Outcome Measurements: ImDGI. Results: ImDGI did not show ceiling effects, and good correlations were found between ImDGI and mDGI (r =.84), and TUG (r =.84) for people with neurologic disorders (P <.001). Significant differences among pathologies (H test(2)=12.5, P =.002) and between healthy participants and adults with neurologic disorders (U test = 47.0, P =.001) were found. ImDGI_Trunk_Sway discriminated between people using or not using walking aids and among the three pathologies (H(2) = 10.0, P =.007). Conclusions: The ImDGI test seems to provide valid measures to objectively assess dynamic balance in neurologic conditions and possibly quantify balance deficits also in adults with neurologic disorders.

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