Continuous daily assessment of multiple sclerosis disability using remote step count monitoring

详细信息    查看全文

• 作者：V. J. Block ; A. Lizée ; E. Crabtree-Hartman ; C. J. Bevan…
• 关键词：Multiple sclerosis ; Outcome measurement ; Remote physical activity monitoring ; Accelerometer ; Progressive ; Relapsing
• 刊名：Journal of Neurology
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：264
• 期：2
• 页码：316-326
• 全文大小：
• 刊物类别：Medicine
• 刊物主题：Neurology; Neurosciences; Neuroradiology;
• 出版者：Springer Berlin Heidelberg
• ISSN：1432-1459
• 卷排序：264

文摘

Disability measures in multiple sclerosis (MS) rely heavily on ambulatory function, and current metrics fail to capture potentially important variability in walking behavior. We sought to determine whether remote step count monitoring using a consumer-friendly accelerometer (Fitbit Flex) can enhance MS disability assessment. 99 adults with relapsing or progressive MS able to walk ≥2-min were prospectively recruited. At 4 weeks, study retention was 97% and median Fitbit use was 97% of days. Substudy validation resulted in high interclass correlations between Fitbit, ActiGraph and manual step count tally during a 2-minute walk test, and between Fitbit and ActiGraph (ICC = 0.76) during 7-day home monitoring. Over 4 weeks of continuous monitoring, daily steps were lower in progressive versus relapsing MS (mean difference 2546 steps, p < 0.01). Lower average daily step count was associated with greater disability on the Expanded Disability Status Scale (EDSS) (p < 0.001). Within each EDSS category, substantial variability in step count was apparent (i.e., EDSS = 6.0 range 1097–7152). Step count demonstrated moderate-strong correlations with other walking measures. Lower average daily step count is associated with greater MS disability and captures important variability in real-world walking activity otherwise masked by standard disability scales, including the EDSS. These results support remote step count monitoring as an exploratory outcome in MS trials.