Discriminative ability, responsiveness, and interpretability of smoothness index of gait in people with multiple sclerosis.
Stefano Filippo Castiglia, Fulvio Dal Farra, Dante Trabassi and 6 others
PMID 39906096WHAT IT FOUND
A trunk sensor index (LDLJaML) detects gait smoothness problems in people with MS and tracks rehab progress.
A change greater than 4.02% in this index signals a clinically meaningful improvement in balance, giving therapists a specific, measurable target for treatment.
Key findings
01The LDLJaML index distinguishes people with MS from healthy controls, with values lower than -5.40 indicating impairment with 76% probability.
02LDLJaML improves significantly after rehabilitation, unlike the antero-posterior index which shows no change.
03An improvement greater than 4.02% in LDLJaML is the minimum clinically important difference, reflecting a meaningful gain in balance scores.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included only people with MS who could walk independently for at least 50 meters, so findings do not apply to those with severe mobility impairments. The sample size was small, and the validation sets were undersized, which may affect the generalizability of the specific cutoff values. The study did not differentiate between MS subtypes or specific levels of walking ability, potentially masking variations in how different patients respond to treatment.
Declared interests
The authors declared no conflicts of interest, and the research received no external funding.
The easy way to misread this
Do not assume the side-to-side smoothness index (LDLJaML) works for all gait directions or interventions. The forward-backward index did not change with rehabilitation, and the study only tested dynamic balance programs, so this metric may not track improvements in endurance or speed-focused training.